Page 1 Safety and Infection Control Study Guide for the NCLEX-PN® exam

How to Prepare for the Safety and Infection Control Questions on the NCLEX-PN® Test

General Information

Approximately 10% to 16% of the questions on the NCLEX-PN® test are allotted to the topics of safety and infection control. Anything from emergency response plans to security issues to standard precautions with regard to infection is fair game for these questions. Read on to see exactly what you need to study, and be sure to consult other sources if you still have questions about any of our content.

Physical Safety

Preventing Errors

Preventing errors in nursing care is a key element to a successful career in healthcare as well as a successful outcome in your patient care. There are important tools to use when implementing safe practices such as patient identifiers and precaution arm bands. It is also vital to think critically when considering physician order appropriateness.

Patient Identity

One of the most important ways to prevent errors is always using patient identifiers with your patient. Usually, two patient identifiers are used to ensure the correct patient is being treated. Date of birth and full name are examples of the most common patient identifiers used. Allergy warning, fall risk, and limb alert bands are used to prevent errors as well. Allergy bands are present to have the nurse verify patient allergies to ensure a preventable reaction does not occur. Fall risk bands alert to unstable patients who are more likely to fall and injure themselves. Limb alert bands alert healthcare members when a particular limb cannot be used for things such as an IV, blood draw, or blood pressure reading. If you are present and see a mistake happening, it is your responsibility as a nurse to speak up and prevent any potential or definite harm to any patient.

Other Factors

Your knowledge of factors such as mental health disorders and altered mental state protects your patients from harm. When physically protecting a patient from themselves or keeping them from harming others, the nurse must assess the level of the threat and determine the appropriate, least restrictive method of protection suitable for that patient. When educating a patient, assessing and understanding his or her level of education and baseline mental status are important during your pre-assessment of baseline knowledge.

Healthcare Order

When noting an order for your patient, it is important to understand the reasoning behind it. If the order doesn’t make sense or seem appropriate for your patient, verify it with the ordering physician and voice your concerns. For example, a new order for your patient comes in and it is a new medication for hypertension. You know your patient is currently on one medication for hypertension and has been running slightly hypotensive. Rather than just giving the new med to the patient without question, you as the nurse should feel empowered to advocate for your patient’s safety and discuss your concerns with the physician before giving the medication.

Preventing Injuries

Preventing patient injuries applies to all ages. This can be accomplished by educating the patient and/or caregiver, creating a safe environment, giving safety tips for the home, and safe use of equipment. These four factors together are the ingredients for patient safety paradise.

Education

Educating your patients and their caregivers on safety tips and techniques empowers them to be in control of their own healthcare. Prior to any education, it is always important to assess the patient’s baseline knowledge of the information needed and build from there. Educate patients on such things such as how to call for help as an inpatient, non-skid footwear for fall risk patients and behaviors/methods that prevent sexually transmitted diseases. Educate caregivers regarding how to use/install a car seat, tips for SIDS prevention, and reducing the risk of choking.

Environment

A safe environment is one that is free from fall risks. For example, removing throw rugs and ensuring flooring isn’t slippery help to prevent falls. A crib that is free from toys, blankets, bumpers to prevent suffocation is a safe environment for an infant. In the hospital, making sure cords are not in the patient’s pathway, ensuring IV lines have slack in order to not accidentally be pulled out, and reporting unsafe situations that you cannot fix yourself are all ways to keep your patient safe while in your care.

Home Safety

Home safety can be achieved by education and home evaluation by a home health nurse. A safe environment, as well as safe practices implemented in patients, can be transitioned to the home. Previously reviewed safety tips about things like removing frayed cords, not leaving a child unattended in the bathtub, and adapting the home to an aging patient are ways to help patients achieve home safety.

Equipment Safety

Using equipment safely applies to the patient as well as to any healthcare team member when working with patients. Teaching patients how to use equipment (crutches, walkers, blood glucose monitors, etc.) correctly and safely is an important responsibility for the nurse. It is also important that the nurse observe carefully to be sure safe procedures are practiced by the patient after this instruction. Following policies/protocols, ensuring equipment is functioning appropriately, and verifying the selected equipment is appropriate for the particular patient task are keys to safety for all.

Safe Equipment

When using any type of equipment, always ensure that it is functioning properly before using it with patients. You should always check the plugs, restart, etc. as well prior to reporting faulty or broken equipment. As a nurse, you should also provide the patient with equipment for his or her safety, such as oxygen, a walker, etc.

Safe Procedures

Regardless of who is using the equipment, it is important that the individual is educated on its proper use. Healthcare team members should review protocols for specific equipment and have an experienced team member check them off on correct use. Nurses should educate patients regarding the use of any new equipment and about any peculiarities that are witnessed with current equipment.

Using Least-Restrictive Option

When using safety equipment such as chemical or physical restraints and seclusion, it is the responsibility of the nurse to assess that the least restrictive option is used first and justifying the use of more restrictive devices with patients. When using physical restraints, the nurse should assess skin for breakdown every 2 hours for nonviolent patients and hourly for violent patients. You must have a physician renew the order every 24 hours, thus assessing the need for restraint(s).

Ergonomic Principles

Using proper body ergonomics is another principle that applies to patients as well as healthcare team members. Educate your patient about, and personally practice, these principles:

  • Lift using your legs and not your back.
  • Use proper posture when sitting.
  • Do not use bending or twisting motions.
  • Use suitable safety equipment when needed, such as earplugs when near loud noises.