Standard Precautions and Hand Hygiene

Standard precautions are the foundation of infection prevention in healthcare. The 2026 NCLEX-RN Test Plan emphasizes a proactive approach to safety and infection control, making this content essential for exam success.

What Are Standard Precautions?

Standard precautions are infection control practices applied to ALL patients in ALL healthcare settings, regardless of suspected or confirmed infection status. They assume that all blood, body fluids (except sweat), non-intact skin, and mucous membranes may contain transmissible infectious agents.

Components of Standard Precautions

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Hand Hygiene: The Golden Rule

Hand hygiene is the single most effective method for preventing healthcare-associated infections (HAIs). The CDC and WHO emphasize that proper hand hygiene can prevent up to 50% of HAIs.

Two Methods of Hand Hygiene

Critical Concept: C. difficile and Spore-Forming Organisms

Alcohol-based hand rubs do NOT kill spore-forming organisms like Clostridioides difficile (C. diff). When caring for patients with C. diff or other spore-forming pathogens, soap and water is mandatory.

Exam Tip: If the question mentions C. diff, diarrhea, or spore-forming organisms, the answer is always soap and water, never alcohol-based hand rub.

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The WHO 5 Moments for Hand Hygiene

The World Health Organization identifies 5 critical moments when hand hygiene must occur:

The Patient Zone Concept

The patient zone includes the patient and all surfaces immediately surrounding them (bed, bedside table, IV pole, monitors). Everything in this zone is considered potentially contaminated with the patient's flora.

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Hand Hygiene Technique

Alcohol-Based Hand Rub (ABHR)

1. Apply product to palm of one hand
2. Rub hands together covering all surfaces
3. Rub until hands feel dry (minimum 20 seconds)
4. Do not rinse or wipe

Soap and Water Technique

1. Wet hands with water
2. Apply soap
3. Lather and rub for at least 20 seconds
4. Clean under fingernails
5. Rinse thoroughly
6. Dry with disposable towel
7. Use towel to turn off faucet

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Respiratory Hygiene and Cough Etiquette

Respiratory hygiene applies to anyone entering a healthcare facility with signs of respiratory infection:

• Cover mouth and nose when coughing or sneezing
• Use tissues and dispose immediately
• Perform hand hygiene after contact with respiratory secretions
• Wear a mask if unable to maintain respiratory hygiene
• Maintain distance (3+ feet) from others if symptomatic

Source Control

Place symptomatic patients in respiratory isolation or have them wear a mask in common areas. This is called source control-containing the infection at its source.

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Safe Injection Practices

Injection safety prevents transmission of bloodborne pathogens:

• Use single-dose vials whenever possible
• Never reuse needles or syringes
• Use aseptic technique when preparing injections
• Dispose of sharps immediately in puncture-resistant containers
• Never recap needles using two-handed technique

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On the NCLEX

Standard precautions questions frequently test:

• When to use soap and water vs. alcohol-based hand rub
• The components of standard precautions
• Proper hand hygiene moments
• Understanding that standard precautions apply to ALL patients

Exam Strategy: When you see a question about infection control with no specific pathogen mentioned, think standard precautions first. These are the baseline for every patient encounter.