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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Performing a simple dressing change on a client's foot
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Providing postmortem care for a client who has recently died
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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 (C. diff) is a spore-forming organism, and alcohol-based hand rubs are ineffective against bacterial spores. The only effective method for removing C. diff spores from hands is soap-and-water handwashing with thorough friction. Therefore, the assistive personnel using alcohol-based hand rub after caring for a client with C. diff is performing an unsafe practice that requires immediate intervention by the charge nurse. Performing a simple dressing change is within the scope of an AP when properly delegated and trained, so this does not require intervention. Providing postmortem care is appropriate for an AP and does not require intervention. Emptying an indwelling urinary catheter bag while wearing clean gloves is correct standard practice — clean gloves are appropriate for this task, not sterile gloves. The critical safety issue here is the failure to use soap and water with a C. diff client, as continuing to use alcohol hand rub puts other clients and staff at risk of spore transmission. This is a fundamental infection control principle that must be corrected immediately.
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