Hand hygiene is the single most important intervention for preventing infection transmission. The WHO Five Moments include before patient contact, before aseptic tasks, after body fluid exposure, after patient contact, and after contact with patient surroundings. Alcohol-based rubs are effective for most organisms but do not kill Clostridioides difficile spores, so soap-and-water handwashing is required for enteric infections.
Standard precautions apply to every patient and include hand hygiene plus personal protective equipment (PPE) as needed based on anticipated exposure. Contact precautions add gown and gloves for organisms transmitted by direct or indirect contact, such as MRSA, C. difficile, and vancomycin-resistant enterococcus. Droplet precautions require a surgical mask within three feet (one meter) of the patient, and are used for influenza, pertussis, meningococcal disease, mumps, and rubella. Airborne precautions require a negative-pressure isolation room, N95 respirator (or PAPR), and patient masking during transport for measles, varicella, and pulmonary tuberculosis.
The order of donning PPE is gown, mask or respirator, goggles or face shield, and gloves last, with hand hygiene before and after. Removal begins with gloves because they are most contaminated, followed by goggles, gown, and finally mask, with hand hygiene after each step. Sharps containers must be replaced when two-thirds to three-quarters full, and needles should never be recapped using two hands; if recapping is unavoidable, the one-handed scoop method is used. Safety Data Sheets provide hazard, handling, spill, and first-aid information for chemicals, and nurses should review them before handling chemotherapeutic or cleaning agents.
Environmental and emergency safety protocols include universal fall precautions such as orienting the patient, keeping the call light within reach, lowering the bed, providing non-slip footwear, and ensuring clutter-free surroundings. Restraint use requires a physician's order, the least restrictive option, renewal at intervals, and documentation of attempts at less restrictive alternatives; PRN restraint orders are prohibited. Fire response follows RACE: Rescue, Activate the alarm, Contain the fire, and Evacuate or Extinguish using PASS (Pull, Aim, Squeeze, Sweep) for small contained fires only.