03 Patient Safety and Infection Prevention
Learn practical procedures for preventing infection, verifying patient identity, reducing fall and transfer risks, responding to emergencies, and reporting safety events.
Core safety priorities
Safe nursing care depends on recognizing hazards early, following established procedures, and communicating clearly. When an immediate threat arises, protect the patient first, summon help, and follow facility policy and your training.
Infection prevention
Apply to every patient, whether or not an infection is suspected. Perform hand hygiene; choose personal protective equipment (PPE) based on anticipated exposure; practice respiratory hygiene; use safe injection and sharps practices; and clean or disinfect equipment and surfaces appropriately. Gloves do not replace hand hygiene. Use soap and water when hands are visibly soiled, and follow facility guidance for situations in which soap and water are preferred.
Add when an infection is known or suspected to spread by contact, droplets, or airborne routes. Follow the patient’s precautions signage and facility policy. Airborne precautions generally require an appropriate respirator and an airborne infection isolation room; droplet precautions generally require a mask; and contact precautions generally require a gown and gloves for relevant interactions. Use the required PPE, limit nonessential transport, and clean shared equipment between patients.
For example, before assisting a patient with a draining wound, perform hand hygiene and use the indicated gown and gloves. Remove PPE as directed before leaving the care area, then clean your hands.
Before providing care, confirm identity using at least two approved identifiers, such as full name and date of birth or an assigned identification number. When possible, ask the patient to state the identifiers, then match them to the identification band and care record. Do not use the room number or location as an identifier.
Recheck identity before medication administration, specimen collection, blood administration, treatment, or a procedure. Label specimens in the patient’s presence according to policy. A statement such as “I’m in room 12” does not verify identity; ask the patient to state their name and another approved identifier, then compare both with the wristband and order.
Assess fall risk and reassess when the patient’s condition, mobility, or medications change. Individualize prevention measures according to the patient’s plan:
Keep the bed low and locked.
Place the call light and needed items within reach.
Keep pathways clear and well lit.
Provide suitable nonskid footwear.
Assist with transfers or toileting as directed by the patient’s plan.
Explain how to request help and communicate the prevention plan to the care team. Do not assume that a patient who was independent at home can safely walk while weakened or in an unfamiliar setting.
If a patient falls, stay with them, call for help, and assess responsiveness, breathing, pain, visible injury, and vital signs as appropriate. Do not move the patient if a serious injury is possible unless there is an immediate danger. Follow facility procedures for assessment, escalation, monitoring, documentation, and event reporting.
Check the patient’s mobility and transfer plan before moving them. Explain the task, invite the patient’s participation, and prepare the route and destination. Use the appropriate number of staff and assistive equipment. Lock bed, wheelchair, or stretcher wheels as appropriate, and use gait belts, transfer devices, or mechanical lifts according to training and the care plan.
Do not attempt an unsafe manual lift. Pause and obtain help or equipment. These practices protect both the patient and caregiver.
Recognize urgent changes such as unresponsiveness, severe breathing difficulty, sudden deterioration, uncontrolled bleeding, or suspected cardiac arrest. Check that the scene is safe, stay with the patient, activate the facility’s or rapid-response system, and communicate the location and observed problem.
Begin actions within your training and role. For suspected cardiac arrest, follow current basic life support (BLS) training and facility procedures, including CPR and AED use when indicated. Do not delay calling for help while trying to manage a serious emergency alone.
Promptly report harm, near misses, falls, medication or identification errors, equipment problems, and unsafe conditions through the facility’s reporting process. First address immediate clinical needs and notify the appropriate clinician or supervisor.
Record objective clinical facts and care provided in the health record according to policy, and submit a separate event report as required. Use specific, factual language rather than blame or speculation. Do not document in the patient’s chart that an incident report was filed. Reporting helps organizations investigate hazards and reduce the chance of recurrence.