CNA Proper Hand Hygiene and PPE Usage 3 — Questions and Answers
Question 1: A CNA enters the room of a patient on contact precautions to deliver a meal tray. Which PPE is required?
- No PPE needed for meal delivery only
- Gloves only
- Gloves and gown (Correct answer)
- Gloves, gown, and surgical mask
Correct answer: Gloves and gown
Contact precautions require gloves and gown for all room entries regardless of the nature of the task, to prevent transferring the organism to other patients or surfaces.
Contact precautions (MRSA, VRE, C. diff, scabies, etc.) mandate gloves and gown upon entering the patient's room because the organism lives on surfaces in the environment. Even non-hands-on tasks can contaminate the CNA's clothing and spread pathogens to the next patient.
Question 2: When is the ONLY time gloves may replace handwashing?
- Never — they are complementary, never interchangeable (Correct answer)
- When soap and water is unavailable
- When the patient is not infectious
- When wearing double gloves
Correct answer: Never — they are complementary, never interchangeable
Gloves and hand hygiene are complementary practices. Gloves do not replace handwashing before or after patient contact.
The WHO and CDC are explicit: gloves supplement but never replace hand hygiene. Hands must be cleaned before donning and after removing gloves. Gloves may have micro-perforations, and hands can become contaminated during doffing. The two practices together provide the highest level of protection.
Question 3: A CNA notices that a patient's room has a sign indicating airborne precautions. Which respiratory protection is required?
- Surgical mask
- N95 filtering facepiece respirator (or higher) (Correct answer)
- Cloth face covering
- No respiratory protection needed for a CNA
Correct answer: N95 filtering facepiece respirator (or higher)
Airborne precautions require an N95 respirator or higher to filter particles ≤5 microns that remain suspended in air (e.g., TB, measles, varicella).
Diseases like tuberculosis, measles, and varicella spread via airborne nuclei that remain suspended in room air. A surgical mask does not provide a tight enough seal to filter these particles. An N95 must be fit-tested and properly donned with a nose wire seal. CNAs must be fit-tested before caring for airborne-precaution patients.
Question 4: After removing contaminated gloves, a CNA's hands look clean. Is hand hygiene still required?
- No — if hands look clean they are clean
- Yes — visible soil is not the only indicator of contamination (Correct answer)
- Only if the patient had a known infection
- Only if the CNA will be touching another patient immediately
Correct answer: Yes — visible soil is not the only indicator of contamination
Pathogens are invisible. Hand hygiene is required after glove removal regardless of visible soil because micro-tears and doffing can contaminate hands.
Standard precautions require hand hygiene after removing gloves because gloves can harbor pathogens on their exterior, micro-perforations may have allowed contamination, and the doffing process can contaminate hands. This rule applies universally — not only when caring for infected patients.
Question 5: Which action should a CNA take if their face shield becomes visibly contaminated during patient care?
- Continue using it until the end of the shift
- Wipe it with an alcohol swab and continue
- Remove it using the head strap or earpieces (not the front), discard, and perform hand hygiene (Correct answer)
- Flip the shield to use the clean inside surface
Correct answer: Remove it using the head strap or earpieces (not the front), discard, and perform hand hygiene
Contaminated PPE must be removed properly to avoid transferring pathogens to the face, discarded, and hands cleaned immediately.
The front surface of a face shield is considered contaminated. Touching it during removal transfers pathogens to the hands and then potentially to mucous membranes. Removal by the straps or earpieces, followed by immediate hand hygiene, is the safe technique. Wiping with alcohol may not eliminate all pathogens and does not address structural compromise of the shield.
Question 6: How often should a CNA change gloves when providing care to the same patient?
- Never — changing gloves mid-task wastes supplies
- Only when visibly torn or soiled
- Between tasks on the same patient when moving from a contaminated to a clean body site (Correct answer)
- Only at the start and end of the full care session
Correct answer: Between tasks on the same patient when moving from a contaminated to a clean body site
Gloves should be changed between tasks on the same patient to prevent cross-contamination between body sites (e.g., perineal care to wound care).
Even within a single patient interaction, gloves should be changed when transitioning from a contaminated body site (perineal area, wound) to a clean site (IV site, mucous membranes). Failure to change gloves in this scenario transfers organisms from one site to another, increasing infection risk.
CNA Proper Hand Hygiene and PPE Usage 3
A CNA enters the room of a patient on contact precautions to deliver a meal tray.
Which PPE is required?