Question

10-8 thinking it through
monica stokes is a volunteer at a local extended care facility. her duties include pushing a cart with books around to the patients’ rooms to ask if they would like to borrow a library book. when she enters mr. haskin’s room, the nurse asks her if she would please take the dirty linens and place them in the linen basket down the hall. she is new and unclear if this is one of her duties, but also desires to be helpful, and surely the nurse would not ask her if it were not appropriate. so she picks up the linens from the floor, carries them close to her, and places them in the linen basket. she notices some stains on her clothes, so she goes to the sink and rinses them off with cold water in the hope there will be no permanent stain. she then returns to her duties of distributing books to patients.

1. was it appropriate for the nurse to ask the volunteer to assist with the linens?
2. are all the links present in the chain of infection?
3. what breaks in standard precautions can you identify?

Explanation:

Question 1

To determine if the nurse's request was appropriate, we analyze the volunteer's role (book distribution) and infection control. Nurses should assign tasks matching volunteer training. Handling linens (a clinical task) without ensuring the volunteer knows infection protocols (like PPE, hygiene) is inappropriate, as it risks infection for the volunteer and others.

The chain of infection has 6 links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Here, the infectious agent (e.g., pathogens on linens), reservoir (patient’s soiled linens), portal of exit (patient’s body), mode of transmission (direct contact with linens), portal of entry (volunteer’s exposed skin/clothes), and susceptible host (volunteer, patients) are all present.

Standard precautions include PPE (gloves for handling linens), hygiene (handwashing before/after), and safe handling. The volunteer didn’t use gloves (direct contact with soiled linens), didn’t wash hands before handling linens, and rinsed clothes (not a proper decontamination method) instead of using appropriate protocols. Also, the nurse didn’t ensure the volunteer used PPE or knew procedures.

Answer:

No, it was not appropriate. The volunteer’s role is book distribution, and handling linens requires infection - control knowledge/training (e.g., PPE, hygiene) that the volunteer likely lacks, risking infection.

Question 2