Infection Control for CNAs
Master the essential principles of infection control that every Certified Nursing Assistant must know to protect patients, themselves, and coworkers from infectious diseases.
Infection control is one of the most critical responsibilities of a Certified Nursing Assistant. Healthcare-associated infections (HAIs) affect millions of patients each year and can lead to serious complications, extended hospital stays, and even death. By understanding and consistently applying infection prevention strategies, you can break the chain of infection and create a safer environment for everyone in your care.
What You'll Learn
The Chain of Infection
Understanding the chain of infection is fundamental to preventing disease transmission. Think of it as a chain with six links—if you break any one link, you stop the infection from spreading.
The pathogen (bacteria, virus, fungus, or parasite) that causes the infection.
Where the pathogen lives and multiplies (humans, animals, environment, equipment).
How the pathogen leaves the reservoir (respiratory tract, blood, skin, GI tract).
How the pathogen spreads (direct contact, droplets, airborne, vehicle, vector).
How the pathogen enters a new host (mucous membranes, broken skin, respiratory tract).
A person whose immune system cannot fight off the infection effectively.
Your Role as a CNA
As a CNA, you can break this chain at multiple points through proper hand hygiene, correct use of PPE, environmental cleaning, and following isolation protocols. Healthcare-associated infections cost billions of dollars annually and cause thousands of preventable deaths—making infection control one of your most important responsibilities.
Standard Precautions & PPE
Standard precautions are infection control practices used with ALL patients regardless of their diagnosis or presumed infection status. They are based on the principle that all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents.
Key Components of Standard Precautions
Hand Hygiene
Before and after every patient contact, before clean/aseptic procedures, after body fluid exposure, after touching patient surroundings.
Personal Protective Equipment (PPE)
Wear appropriate PPE when exposure to blood or body fluids is anticipated.
Respiratory Hygiene
Cover coughs and sneezes, use tissues, perform hand hygiene after contact with respiratory secretions.
Safe Handling of Equipment
Properly clean and disinfect contaminated equipment and surfaces between patients.
Types of PPE
🧤 Gloves
Use when touching blood, body fluids, mucous membranes, non-intact skin, or contaminated items.
- • Change between patients
- • Change between dirty and clean tasks on same patient
- • Never wash or reuse disposable gloves
🥼 Gowns
Protect skin and clothing when splashes or sprays of blood or body fluids are anticipated.
- • Wear during procedures that may generate splashes
- • Remove before leaving patient room
- • Do not re-enter room wearing same gown
😷 Masks
Protect mucous membranes of nose and mouth from splashes and sprays.
- • Surgical masks for droplet protection
- • N95 respirators for airborne precautions
- • Must cover nose AND mouth
🥽 Eye Protection
Goggles or face shields protect eyes from splashes and sprays.
- • Use during procedures that may generate splashes
- • Personal eyeglasses are NOT adequate protection
- • Face shields protect entire face
Correct Order for Removing PPE
Always remove PPE in the correct order to avoid self-contamination:
- 1. Gloves — Most contaminated, remove first
- 2. Gown — Unfasten and roll away from body
- 3. Eye protection — Remove by headband or earpieces
- 4. Mask — Remove by ties or ear loops (don't touch front)
- 5. Hand hygiene — Always wash hands after removing PPE
Hand Hygiene Techniques
Hand hygiene is the single most effective way to prevent the spread of infection in healthcare settings. The CDC estimates that proper hand hygiene could prevent nearly half of all healthcare-associated infections.
Handwashing with Soap & Water
Use when hands are visibly soiled, after using restroom, before eating, or after caring for patients with C. diff or norovirus.
- 1. Wet hands with clean running water
- 2. Apply soap and lather well
- 3. Scrub all surfaces for at least 20 seconds
- 4. Include between fingers, under nails, and wrists
- 5. Rinse thoroughly under running water
- 6. Dry with clean paper towel
- 7. Use towel to turn off faucet
Alcohol-Based Hand Sanitizer
Use when hands are NOT visibly dirty. Actually more effective than soap at killing most pathogens. Must contain 60-95% alcohol.
- 1. Apply product to palm of one hand
- 2. Use enough to cover all hand surfaces
- 3. Rub hands together vigorously
- 4. Cover all surfaces including between fingers
- 5. Continue rubbing until hands are dry
- 6. Should take about 20 seconds
- 7. Do not wipe or rinse off
The 5 Moments for Hand Hygiene (WHO)
Before Patient Contact
Before Clean/Aseptic Procedure
After Body Fluid Exposure
After Patient Contact
After Touching Patient Surroundings
Important Exception
Always use soap and water (not alcohol-based sanitizer) when caring for patients with Clostridioides difficile (C. diff) or norovirus. These pathogens form spores that alcohol cannot kill effectively. Scrubbing with soap and water physically removes the spores from your hands.
Transmission-Based Precautions
Transmission-based precautions are used in addition to standard precautions for patients with known or suspected infections that require additional measures to prevent transmission. There are three categories based on how the infection spreads.
For infections spread by direct or indirect contact with the patient or contaminated surfaces.
Examples:
- • MRSA (Methicillin-resistant Staph aureus)
- • VRE (Vancomycin-resistant Enterococcus)
- • C. difficile (C. diff)
- • Scabies, lice
- • Wound infections with heavy drainage
Requirements:
- • Gown and gloves for all patient contact
- • Private room (or cohort with same infection)
- • Dedicated equipment (stethoscope, BP cuff)
- • Remove PPE before leaving room
For infections spread through respiratory droplets (larger particles that travel up to 6 feet and fall quickly).
Examples:
- • Influenza (flu)
- • Pertussis (whooping cough)
- • Bacterial meningitis
- • Mumps, rubella
- • Strep throat, strep pneumonia
Requirements:
- • Surgical mask within 6 feet of patient
- • Private room (or cohort)
- • Patient wears mask during transport
- • Door may remain open
For infections spread through tiny airborne particles (droplet nuclei) that remain suspended in air and can travel long distances.
Examples:
- • Tuberculosis (TB)
- • Measles (rubeola)
- • Chickenpox (varicella)
- • Disseminated herpes zoster (shingles)
Requirements:
- • N95 respirator (must be fit-tested)
- • Airborne infection isolation room (AIIR)
- • Negative pressure room
- • Door must remain CLOSED
- • Patient wears surgical mask during transport
Look for Isolation Signs
Always check for isolation signage on patient doors before entering. The sign will indicate which type of precautions are required. If you're unsure which precautions apply, always ask your nurse before entering the room.
Handling Biohazardous Waste
Proper disposal of biohazardous materials protects healthcare workers, patients, visitors, and the environment. Understanding what goes where is essential for workplace safety.
Sharps Containers
Puncture-resistant containers for sharp objects:
- • Needles (never recap!)
- • Scalpels and razor blades
- • Broken glass
- • Any item that could puncture skin
Never overfill past the fill line!
Red Biohazard Bags
For items contaminated with blood or body fluids:
- • Blood-soaked bandages and dressings
- • Used PPE (gloves, gowns)
- • Wound care supplies
- • Items saturated with body fluids
Look for the biohazard symbol
Contaminated Linens
Handle soiled linens carefully:
- • Place in designated laundry bags
- • Do not sort or rinse
- • Handle with gloves
- • Do not hold against your body
- • Roll contaminated side inward
Regular Trash
Non-contaminated items go in regular waste:
- • Paper, packaging materials
- • Food waste
- • Items not soiled with blood/body fluids
- • Clean disposable supplies
Spill Cleanup
If you encounter a spill of blood or body fluids:
- 1 Put on appropriate PPE (gloves at minimum, gown if large spill)
- 2 Contain the spill with absorbent material
- 3 Clean area with appropriate disinfectant (follow facility protocol)
- 4 Dispose of cleaning materials in biohazard container
- 5 Remove PPE and perform hand hygiene
Needlestick or Exposure?
If you experience a needlestick injury or exposure to blood/body fluids, report it to your supervisor immediately. Wash the affected area with soap and water (flush eyes with water if eye exposure). Timely reporting is critical for proper follow-up care and may be required for workers' compensation.
Key Takeaways
- The chain of infection has 6 links — breaking any one stops transmission
- Standard precautions apply to ALL patients regardless of diagnosis
- Hand hygiene is #1 — the single most effective way to prevent infection spread
- Remove PPE in the correct order: gloves, gown, eye protection, mask, then hand hygiene
- Three types of transmission-based precautions: Contact, Droplet, and Airborne
- Report exposures immediately — needlesticks and body fluid exposures require prompt attention
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