For Students
Infectious Disease Prevention Educational Module
Section 7: Case Studies
The following case studies will help you think about exposures to and prevention of infectious diseases as a health care worker. If, as a student, you believe that you have been placed in an unsafe situation or have questions about procedures at a rotation, discuss your concern and issues with your experiential education director or your preceptor, if you feel comfortable.
Case Study 1
A small, metropolitan clinic has one appropriate container for disposing of sharps. The container is located in the vaccination room, since that is where most injections are usually given. Sometimes patients need to be given injections in different examination rooms, located down the hall from the vaccination room. When this occurs, nurses recap the needles, carry them down the hall to the vaccination room and dispose of them in the sharps disposal container.
What should be done differently to reduce the risk of infections at this clinic?
Answer to Case Study 1
Needlestick injuries are the most common cause of occupational exposure to bloodborne pathogens. Needles should NOT be recapped before disposal. Puncture-resistant sharps containers should be placed in all of the exam rooms where sharps are used. The uncapped needles and attached syringe should be immediately disposed of in a puncture-resistant sharps container.
Case Study 2
As part of her duties, Anna is often asked to draw a few drops of blood from patients' fingers to check their hematocrit. She does not wear gloves during any part of this process but does wash her hands before seeing the next patient.
Is this an appropriate infection prevention process? Why?
Answer to Case Study 2
Anna should always wear gloves whenever she draws blood from a patient. She should also wash her hands after removing the gloves.
Case Study 3
A surgeon lightly brushed the fingertip of one glove on the edge of a table while putting on gloves before surgery. Gloves were in short supply that day and he only quickly brushed just the one fingertip, so he decides not to change his gloves and proceeds with the surgery.
Is the surgical patient at risk of infection? Why or why not? What is the appropriate action for the doctor to take in this situation?
Answer to Case Study 3
The patient is at risk for infection. Even with that limited exposure the glove has become contaminated, and he should change his gloves before proceeding with surgery. There is no such thing as being a little bit contaminated.
Case Study 4
Jerry noticed that Jack, one of his co-workers is always in a hurry at the end of his shift at the hospital and sometimes leaves his protective clothing over a chair or on the floor. When Jerry mentions this to him one day, Jack replies, "Oh, the cleaning crew picks it up."
What is the exposure risk in this case?
Answer to Case Study 4
There is a risk of accidental exposure to anyone who picks up the clothing. The co-worker should remove his garments by grasping the clean side, peeling off the article, and folding it inward. Then he should place the items into a designated container.
Proceed to Section 8: Two-Step Mantoux.