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Infection prevention: hands, PPE, sharps and waste

RCSI heading: Infection prevention and control. You get 2 minutes with the descriptor outside the door and 10 inside, marked competent or not competent on every line. RCSI publishes no sample for this station; the descriptor below follows the layout of the two samples it does publish. Check rcsi.com before your date.

Rehearse it

Stand up, say it aloud, use whatever is on your desk as the equipment. The debrief is the competency sheet and the assessor’s questions.

Reading time
Outside the door. Two minutes with the descriptor, then in.
2:00
Purpose

To assess hand hygiene technique and timing, the point of care risk assessment, putting on and taking off PPE in order, and safe handling of sharps and healthcare risk waste.

Situation / scenario

Mr Patrick Byrne, 82, in a single room with confirmed Clostridioides difficile. You are asked to change his soiled sheet and take a blood glucose reading. A sink with an elbow tap, hand gel, PPE, a sharps bin and the waste bins are in the room.

You are required to talk through the PCRA, perform hand hygiene, put on and remove PPE, take the sample safely and dispose of everything correctly.

You are required to
  1. State the PCRA for this contact: what could touch my hands, face, skin and clothing; does the patient have a transmissible infection
  2. Say why soap and water, not alcohol gel, for C. difficile, and demonstrate the wash: 40 to 60 seconds, all surfaces, elbow tap off, paper towel
  3. Put on PPE in order: apron or gown, mask if needed, eye protection if needed, gloves last
  4. Take the glucose reading with a single-use safety lancet and drop it straight into the sharps bin at the point of use, no re-sheathing
  5. Handle the soiled sheet away from your body into the correct linen bag, without shaking
  6. Remove PPE in order: gloves, hand hygiene, apron, hand hygiene, eye protection, mask, hand hygiene
  7. Segregate waste: healthcare risk waste in the yellow bag or rigid bin, non-risk waste in the clear bag, sharps in the yellow sharps bin, sealed at three-quarters full
  8. Name the five moments and where each fell in this task
  9. Say how the room and equipment are decontaminated for C. difficile (chlorine-based product) and what you tell the cleaning team

Throughout: communicate in an accurate, clear and effective manner; demonstrate a level of competence essential for safe practice.

The descriptor, the mistakes and the sources on this page are free to read. The timed run, the competency sheet and the assessor’s questions need the pass. Two stations run free in full: respiratory and observations, INEWS and ISBAR.

The pass: theory and OSCE

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Competencies assessed

Every RCSI descriptor lists the same five domains from the NMBI standards.

  • Professional values and conduct of the nurse
  • Nursing practice and clinical decision-making
  • Knowledge and cognitive competences
  • Communication and interpersonal competences
  • Management and team competences

Mistakes candidates report

  • Reaching for the gel because it is closer. For C. difficile it is soap and water and the assessor is watching for it.
  • Gloves on before the apron, or gloves taken off after the apron.
  • Carrying the lancet across the room to the sharps bin, or putting it down on the tray first.
  • Hand wash under 20 seconds with the fingertips and thumbs missed.
  • Waste in the wrong bag: gloves from an isolation room in the clear bag.

Practise the parts

Sources

This descriptor is a practice piece written to the shape of the RCSI samples. It is not an exam task, and the exam may ask anything from the reading list.

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