RN Nursing · Delegation and Supervision · Practice question
A charge nurse is observing an assistive personnel perform delegated tasks. Which of the following actions by the AP requires the charge nurse to intervene?
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Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile
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Providing postmortem care for a client who has recently died
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Performing a simple dressing change on a client's foot
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Emptying an indwelling urinary catheter bag for a client while wearing clean gloves
Answer & explanation
Correct: Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile
Clostridium difficile produces spores that are not destroyed by alcohol-based hand sanitizers. The only effective hand hygiene method after caring for a client with C. difficile is soap and water, which physically removes the spores from the hands. An assistive personnel using alcohol-based hand rub after bathing a C. difficile-positive client is performing an unsafe practice that requires immediate intervention by the charge nurse. Providing postmortem care is within the scope of an AP and does not require intervention. Performing a simple dressing change is a delegable task appropriate for an AP, particularly on an uncomplicated wound. Emptying an indwelling urinary catheter bag while wearing clean gloves is a standard, appropriate AP task that follows correct infection-control technique. The key distinction in this question is the specific pathogen: C. difficile's spore-forming nature makes alcohol hand rub ineffective, making this the critical safety error that must be corrected. Students often confuse routine hand hygiene standards with pathogen-specific requirements, but C. difficile is one of the most tested exceptions to the rule that alcohol-based products are acceptable.
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