Infection Prevention Basics: Clean Hands, PPE and Precautions
Clean hands at the right times, use gloves and PPE the right way, and follow contact, droplet, airborne and Enhanced Barrier Precautions.
ForNursing home, Home health, Hospice staff
TimeAbout 61–70 minutes
Lessons8, each with a quick check
FinishA quiz (80% to pass) and a printable certificate of completion
What you will learn
Explain why infection prevention matters for the people you care for.
Name the times CDC says to clean your hands.
Use hand sanitizer the right way.
Wear gloves when you expect contact with body fluids or dirty surfaces.
Put on PPE in the right order.
Know the three kinds of transmission-based precautions.
Know which residents need Enhanced Barrier Precautions.
Report your own illness and stay away from residents when your facility's rules say to.
Written by Pact Compliance from federal rules and CDC, CMS, OSHA and NIH guidance (sources under each lesson), checked October 2026. Where your facility's policy is different, follow your facility's policy.
Lesson 1: Why Infection Prevention Matters
In this lesson you will:
Explain why infection prevention matters for the people you care for.
Name the parts of standard precautions.
Know your role in spotting and reporting possible infections.
Germs spread
People get sick
Germs can spread from person to person on hands, on equipment, on surfaces, and through the air. Many of the people you care for are older or sick. An infection that would give you a cold can send them to the hospital. That is why every nursing home must run an infection prevention and control program. Its goal is a safe, clean, comfortable place that helps prevent infections from starting and spreading.
The program
Written rules
The facility's program must have written standards, policies, and procedures. They must cover how the facility watches for infections, and when and to whom possible infections are reported. They must cover the precautions staff follow, and when and how to use isolation. They must cover when sick staff must stay away from residents or their food, and the hand hygiene steps staff follow. Your facility will show you its own rules. This course gives you the basics behind them.
Show the answer
For every person, every time, whether or not they are known to have an infection. CDC says standard precautions are used for all patient care.
Standard precautions
Every person
CDC says standard precautions are used for all patient care. Every person, every time. You do not need to know if someone has an infection. You treat all blood and body fluids as if they could carry germs. Standard precautions include clean hands, the right protective gear, and covering coughs. They also include cleaning equipment and surfaces, handling laundry carefully, and safe needle practices.
Gear by risk
Think ahead
CDC says to use personal protective equipment, or PPE, whenever you expect you might be exposed to infectious material. PPE means gloves, gowns, masks, respirators, goggles, and face shields. So before each task, think: Could I touch blood, stool, urine, vomit, or a wound? Could I get splashed? If yes, put on the right gear first. The next lessons cover when to use each kind.
You are the eyes
Report changes
The facility must have a system to find possible infections early, before they spread. You are a big part of that system. You see residents up close, every day. Tell your nurse about changes you notice. Examples are a new cough, a fever, vomiting or diarrhea, a new rash or wound, or a sudden change in how a person acts or thinks. NIA notes that a sudden change in behavior can be a sign of infection in people with dementia.
The infection preventionist
Your go-to person
Every nursing home must name at least one infection preventionist. This person is trained in infection prevention and runs the program. Find out who yours is. Ask them when you have a question about isolation, PPE, or cleaning. In home health and hospice, ask your supervising nurse. Asking is always better than guessing.
Quick review
Every person, every time
Let's review. Germs spread on hands, equipment, surfaces, and through the air. Your facility has written infection prevention rules, and you must follow them. Standard precautions are for every person, every time. Use PPE whenever you might be exposed to body fluids. Report new signs of possible infection to your nurse. And know who your infection preventionist is.
Clean hands are the most basic way to stop germs from spreading. Hand hygiene means cleaning your hands, either with alcohol-based hand sanitizer or with soap and water. Your facility's rules must include hand hygiene steps for staff who give direct care. Make it easy on yourself. Know where the sanitizer is: at the door, on your cart, or in your pocket if your facility allows it. This lesson is about when to clean your hands. The next lesson is about how.
Before touching
The person
CDC lists the times to clean your hands. First, right before you touch a resident or patient. That means before you help them stand, before you take a pulse, before you fix their pillow, and before you help them eat. Cleaning your hands before you touch them protects them from germs you picked up somewhere else.
Show the answer
Yes. Clean your hands after touching a resident or their surroundings. CDC lists after touching a patient or their surroundings as a time for hand hygiene.
Before clean tasks
Devices too
Second, clean your hands before a clean or sterile task. CDC gives examples like placing a device in the body or handling invasive medical devices. For aides, think about touching a catheter bag or tubing, or helping with a feeding tube or wound care. Germs on your hands can travel into the body through these openings.
After touching
Person and space
Third, clean your hands after touching a resident, or after touching the things around them. That includes the bed rails, the bedside table, the call light, the TV remote, and the wheelchair. Germs from the resident and their space can live on these surfaces. If you go straight to the next room, you carry those germs with you.
After body fluids
And surfaces
Fourth, clean your hands after contact with blood, body fluids, or dirty surfaces. Body fluids include urine, stool, vomit, saliva, and drainage from wounds. This applies even if you wore gloves. Gloves can have tiny holes, and hands can get dirty when you take gloves off.
After gloves
Every time
Fifth, clean your hands right after you take off gloves. CDC is clear: gloves are not a substitute for hand hygiene. Always clean your hands after removing gloves. A common mistake is to take off dirty gloves and go straight to the next task. Another is to wear the same gloves from room to room. Take them off, clean your hands, and then move on.
In the home
Same moments
The same moments apply when you work in a patient's home. There may not be a sink near the bed, and the bathroom may be down the hall. Carry the hand sanitizer your agency gives you, so you can clean your hands at every moment, right where you are. If your hands are visibly dirty, wash with soap and water before you do anything else.
Quick review
Five times
Let's review the times to clean your hands. One: right before you touch a resident. Two: before a clean task, like touching a catheter or wound. Three: after touching a resident or their surroundings. Four: after contact with blood, body fluids, or dirty surfaces. Five: right after you take off gloves. When in doubt, clean your hands.
CDC says that unless your hands are visibly dirty, alcohol-based hand sanitizer is the better choice in most care situations. Sanitizer is fast, and you can use it right at the doorway or the bedside. CDC recommends sanitizer with at least 60 percent alcohol. Use the dispensers your facility provides. In home care, carry the sanitizer your agency gives you.
Rub until dry
About 20 seconds
Here is how to use sanitizer. Put the right amount of product on your hands. Rub your hands together, covering all surfaces, until your hands feel dry. CDC says this should take around 20 seconds. Do not wipe it off or shake your hands dry. If your hands are dry in just a few seconds, you probably did not use enough.
Show the answer
You probably did not use enough product. Enough sanitizer to cover all surfaces takes about 20 seconds to rub dry.
Missed spots
Thumbs and tips
CDC warns about places people often miss. They are the thumbs, the fingertips, and the spaces between the fingers. So make it a habit. Rub the backs of your hands. Lace your fingers together. Twist each thumb in the other hand. Rub your fingertips into your other palm. These are the parts that touch residents the most.
Soap and water
When to use it
Use soap and water instead when your hands are visibly dirty. Also use soap and water before you eat, and after you use the restroom. And here is a key rule. CDC says that during outbreaks of C. diff or norovirus, soap and water is the recommended choice. Both of these germs cause diarrhea. Your nurse or the signs on the door will tell you when this applies.
How to wash
At least 15 seconds
Here is how to wash with soap and water. Wet your hands with water. Put on the amount of soap the label says. Rub your hands together hard for at least 15 seconds. Cover all surfaces of your hands and fingers. CDC notes some groups say 20 seconds, and either time is fine. Rinse with water. Dry with a disposable towel. Then use the towel to turn off the faucet, so you don't dirty your clean hands.
Nails and rings
Short and natural
Your nails matter too. CDC says natural nails should not go past the tip of the finger. Do not wear artificial nails or extensions when caring for high-risk patients. Check your facility's policy, which may be stricter. CDC also notes that some studies found more germs on the skin under rings. Follow your facility's rules about rings and jewelry. Use only the hand lotion your facility approves.
Quick review
Do it right
Let's review. Use alcohol sanitizer with at least 60 percent alcohol most of the time. Use enough to cover all surfaces, and rub for about 20 seconds until dry. Don't miss the thumbs, fingertips, and between the fingers. Use soap and water when hands are visibly dirty, before eating, after the restroom, and during C. diff or norovirus outbreaks. Wash for at least 15 to 20 seconds. Keep nails short and natural.
Wear gloves when you expect contact with body fluids or dirty surfaces.
Change gloves at the right times.
Never wear the same gloves for more than one person.
When to glove
Expect contact
Under standard precautions, you wear PPE when you expect you might touch infectious material. CDC says to wear gloves when you can reasonably expect contact with blood or other infectious material, mucous membranes like the mouth, broken skin, or dirty skin or equipment. Examples are pericare, changing a brief, emptying a urinal or catheter bag, mouth care, and cleaning up a spill. Gloves are not needed for everything. You usually do not need them to help someone walk, if there is no contact with fluids.
One person
One pair
CDC says do not use the same pair of gloves for the care of more than one patient. That also goes for gowns. Wearing the same gloves down the hall spreads germs from room to room. It is one of the most common ways germs move in a building. One person, one pair, every time.
Show the answer
Take off your gloves and clean your hands. Change gloves and clean hands when moving from a soiled body site to a clean one.
Dirty to clean
Change gloves
Change your gloves and clean your hands when you move from a dirty body site to a clean one on the same person. For example, after pericare, take off your gloves and clean your hands before you touch their face, their clothes, or their call light. Germs from stool or urine on your gloves can spread to clean areas, and to the things around them. Plan your care so you do clean areas first, then dirty areas, when you can.
Soiled or torn
Change them
Also change your gloves if they get dirty with blood or body fluids after a task. Change them if they tear, rip, or get a hole. And take them off before you leave the resident's room. Do not walk into the hall in gloves. Do not touch door handles, carts, or the med cart with gloves you used for care.
Take off carefully
Then clean hands
CDC says to remove gloves carefully so you do not get germs on your hands. CDC shows one way. With one gloved hand, grab the palm area of the other glove and peel it off. Hold it in your gloved hand. Slide the fingers of your bare hand under the other glove at the wrist, and peel it off over the first one. Throw them away. Then clean your hands right away.
Not a shield
Still clean hands
Gloves help, but they are not perfect. They can have tiny holes you can't see. Your hands can get dirty when you take them off. That is why CDC says gloves are not a substitute for hand hygiene. Clean hands before you put gloves on for a clean task, and always after you take them off.
Quick review
Gloves done right
Let's review. Wear gloves when you expect contact with blood, body fluids, broken skin, or dirty surfaces. Never use the same gloves for more than one person. Change gloves when going from a dirty site to a clean site, when they get soiled, when they tear, and before leaving the room. Take them off carefully, inside out. Clean your hands every time you take gloves off.
Take off PPE in the right order without contaminating yourself.
Clean your hands right after removing all PPE.
The right order
Matters
When you need a gown, a mask, eye protection, and gloves, the order you put them on and take them off matters. The outside of used PPE is dirty. The goal is to never touch the dirty outside with your bare hands or your face. CDC gives an example order. Your facility may have its own steps or a poster at each isolation room. Follow your facility's steps. Practice this with your nurse or infection preventionist until it feels natural.
Putting on
Gown first
Before you start, clean your hands. Gather what you need. CDC's order for putting on PPE is: One, the gown. Fasten it at the back of the neck and the waist. Two, the mask or respirator. Three, goggles or a face shield. Four, gloves last. Pull the gloves up to cover the wrists of the gown. Put PPE on before you enter the room.
Show the answer
Gloves. CDC's example order puts gloves on last, over the gown cuffs.
Taking off
Gloves first
CDC's example order for taking PPE off is: One, gloves. They are usually the dirtiest. Two, goggles or face shield. Handle them by the strap or ear pieces, not the front. Three, the gown. Untie it, pull it away from your body, and roll it inside out. Four, the mask or respirator. Grab the bottom ties or elastics, then the top ones, and never touch the front.
Where to take off
Before you leave
CDC says to remove and discard PPE, other than respirators, when you finish a task and before you leave the room or care area. So take off your gloves, eye protection, and gown inside the room, near the door. Put them in the trash or the laundry bin there. If you are wearing a respirator, like an N95, take it off after you leave the room and close the door. Your facility will show you where to do this.
Clean hands
Right after
CDC says to clean your hands immediately after removing all PPE. If your hands get dirty at any point while taking off PPE, stop and clean them before you go on. Do not touch your face, your hair, your phone, or your badge until your hands are clean. This is the moment when many people contaminate themselves without knowing it.
Common mistakes
Avoid these
Watch out for these common mistakes. Wearing a mask under the nose or on the chin. Pulling the mask down to talk, then back up. Wearing the same gown into another room. CDC says do not use the same gown or gloves for more than one patient. Touching the front of the mask or the goggles when taking them off. And forgetting to clean your hands at the end.
Quick review
On and off
Let's review. Clean your hands first. Put on: gown, then mask or respirator, then goggles or face shield, then gloves. Take off: gloves, then goggles or face shield, then gown, then mask or respirator. Take off everything except a respirator before leaving the room. Take off a respirator after you leave. Clean your hands right after removing all PPE.
Lesson 6: Contact, Droplet and Airborne Precautions
In this lesson you will:
Know the three kinds of transmission-based precautions.
Choose the right PPE for each kind.
Read and follow the sign on the door.
Extra steps
Some germs
Standard precautions are for everyone. Some germs need extra steps. These are called transmission-based precautions. There are three kinds: contact, droplet, and airborne. They are added on top of standard precautions, not used instead of them. Your facility's rules must say when and how to use isolation. The type and how long it lasts depend on the germ.
Read the sign
Before you enter
When a resident needs extra precautions, there will usually be a sign outside their door. CDC offers these signs in English and Spanish. The sign tells you what PPE to wear. Stop and read it every time, before you go in. If you are not sure what it means, ask your nurse before you enter. PPE is often kept in a cart or caddy right by the door.
Show the answer
A gown and gloves, because you will touch the resident's environment. CDC says gown and gloves for interactions with the patient or the patient's environment.
Contact
Gown and gloves
Contact precautions are for germs that spread by touch. That means touching the person, or touching things in their room. CDC says to wear a gown and gloves for all interactions that may involve contact with the patient or the patient's environment. Put them on when you enter the room. Take them off and throw them away before you leave. Clean your hands before you take a resident on contact precautions out of the room.
Droplet
Mask on entry
Droplet precautions are for germs that spread in drops from coughing, sneezing, or talking. These drops travel a short distance. CDC says to put on a mask when you enter the room or the resident's space. Your facility may also ask you to wear eye protection. CDC says to limit trips out of the room to medical needs. If the resident must leave, CDC says they should wear a mask and cover coughs. Follow your nurse's instructions.
Airborne
N95 respirator
Airborne precautions are for germs that float in the air for a long time. Examples are tuberculosis and measles. CDC says staff need a fit-tested, NIOSH-approved N95 or higher-level respirator. Fit-tested means the respirator was checked to fit your face. Ask your facility if you have been fit-tested. These residents should be in a special airborne infection isolation room. Keep the door closed.
Least restrictive
Still a person
Isolation can be lonely and scary. The federal rule says isolation must be the least restrictive possible for the resident. Isolation is about the germ, not the person. Do not avoid the resident or rush through care. Explain why you are wearing PPE. Smile with your eyes and your voice. Help them stay connected with phone or video calls. Tell your nurse if a resident in isolation seems sad, anxious, or lonely.
Quick review
Three kinds
Let's review. Transmission-based precautions are added on top of standard precautions. Read the sign on the door every time. Contact: gown and gloves for contact with the person or their room. Droplet: a mask when you enter. Airborne: a fit-tested N95 respirator, and a closed door. Keep isolation as least restrictive as possible, and keep caring for the whole person.
Lesson 7: Enhanced Barrier Precautions in Nursing Homes
For: Nursing home
In this lesson you will:
Know which residents need Enhanced Barrier Precautions.
Name the high-contact care tasks that need a gown and gloves.
Know these residents are not restricted to their rooms.
Enhanced Barrier
Precautions
Nursing homes use a type of precaution called Enhanced Barrier Precautions, or EBP for short. CDC describes EBP as using a gown and gloves during high-contact care activities. It is used to stop the spread of germs that are hard to treat with antibiotics. These are called multidrug-resistant organisms, or MDROs. EBP is not the same as contact precautions. You do not wear a gown for every room entry.
Who needs it
Wounds and devices
CDC says EBP is used for nursing home residents with wounds or indwelling medical devices. This applies whether or not they are known to carry an MDRO, when contact precautions do not otherwise apply. An indwelling device is something that stays in the body, like a urinary catheter, a feeding tube, a central line, or a trach. EBP is also used for residents known to carry or be infected with certain MDROs. The sign on the door or the care plan will tell you.
Show the answer
A gown and gloves, because a transfer is high-contact care. CDC lists transferring as a high-contact activity under EBP.
High-contact care
Gown and gloves
CDC lists the high-contact care activities that need a gown and gloves under EBP. They are: dressing, bathing or showering, transferring, giving hygiene, changing linens, and changing briefs or helping with toileting. They also include device care or use, like a urinary catheter, feeding tube, central line, or trach. And wound care, for any skin opening that needs a dressing.
Not for everything
Think task
For other tasks, standard precautions apply. For example, dropping off a meal tray, or chatting with the resident, usually does not need a gown under EBP. So think about the task, not just the room. Ask yourself: Am I about to do one of the high-contact tasks on the list? If yes, gown and gloves. If you're not sure, ask your nurse.
Free to move
Group activities
Here is an important difference from contact precautions. CDC says residents on EBP are not restricted to their rooms. They are not kept from group activities. So a resident with a catheter can still go to bingo, the dining room, and therapy. Do not tell residents on EBP that they must stay in their rooms. That takes away their rights and is not what EBP means.
Same habits
Every time
All the habits from this course still apply. Clean your hands before you put on the gown and gloves, and after you take them off. Use a new gown and gloves for each resident. CDC says do not use the same gown or pair of gloves for more than one patient. Take them off before you leave the room. These steps protect the resident, the next resident you care for, and you.
Quick review
EBP
Let's review. Enhanced Barrier Precautions mean gown and gloves for high-contact care. They are used for residents with wounds or indwelling devices, and for residents with certain MDROs. High-contact care includes dressing, bathing, transfers, hygiene, changing linens, brief changes and toileting, device care, and wound care. Residents on EBP are not restricted to their rooms. Clean hands, and a new gown and gloves for each resident.
Report your own illness and stay away from residents when your facility's rules say to.
Handle soiled linens and spills safely.
Use respiratory hygiene and cough etiquette.
When you are sick
Speak up
You can carry germs to the people you care for. The federal rule says the facility must have rules for when staff with a contagious illness or infected skin sores must stay away from residents or their food. CMS says infection control training must cover when to self-report illness, and when to report exposure to infectious material. So if you have a fever, vomiting, diarrhea, a new rash, or a sore that is draining, tell your supervisor before your shift.
Stay home
When told
CDC tells healthcare facilities to have sick leave policies that encourage sick staff to stay home. Coming to work sick can start an outbreak. For example, CDC's norovirus guidance says to keep ill staff out of work until at least 48 hours after their symptoms end. Follow your facility's rules on when you may return. If you are not sure whether to come in, call and ask.
Show the answer
Call your supervisor before your shift and follow the facility's rules on staying home. Ill staff can spread infection. CDC recommends policies that keep sick staff home.
Exposures
Report right away
If you get blood or body fluid in your eyes, nose, or mouth, or on broken skin, or you get stuck by a used needle, report it right away. CDC says to wash the skin right away, report the exposure, and get medical care right away. Some treatment after an exposure must start within 72 hours, and sooner is better. Your facility has steps to follow. Do not wait until the end of your shift.
Linens
Don't shake
The rule says staff must handle, store, and carry linens in a way that prevents the spread of infection. CDC's norovirus guidance says to handle soiled linens carefully, without shaking them, so germs do not spread into the air. Hold dirty linens away from your uniform. Roll them up with the dirty side in. Do not put dirty linens on the floor, on chairs, or on the bedside table. Put them right into the laundry bag or bin.
Spills
Clean promptly
CDC says to clean and decontaminate spills of blood or other body fluids promptly. For vomit or stool, CDC's norovirus guidance says to clean it up right away, and to clean surfaces before you disinfect them. Wear gloves, and a gown if you might get splashed. Use the cleaning products your facility provides, the way the label says. If it is a big spill, call housekeeping and keep people away until it is clean.
Coughs
Cover them
Respiratory hygiene, or cough etiquette, is part of standard precautions. Cover your mouth and nose with a tissue when you cough or sneeze, or use your elbow. Throw the tissue away and clean your hands. Help residents do the same. Offer tissues and a trash can within reach. If your facility asks you to wear a mask, wear it over both your nose and mouth.
Quick review
Protect everyone
Let's review. Report your own illness before your shift, and follow your facility's rules about staying home. Report exposures to blood or body fluids right away. Handle dirty linens gently, without shaking, and never put them on the floor. Clean spills promptly with the right products. Cover coughs and help residents do the same.
Answer every question. You need 80% to pass. You can try again as many times as you like.
Your quiz covers the lessons for: Nursing home ( questions). Change your setting
Please read
This free course gives you a certificate of completion from Pact Compliance. It is not continuing education (CE) credit and is not approved by any state.
Your employer decides whether it counts toward required in-service hours. Home health and hospice aide training must be given or supervised by the agency's registered nurse.
California: it does not count toward CNA or HHA renewal hours.
Your name and quiz answers stay in your browser and are never sent to Pact.
Pact Compliance LLC, Cordova, TN
Certificate of Completion
This certifies that
completed the online in-service course
Infection Prevention Basics: Clean Hands, PPE and Precautions
Setting
Completed
Seat time
Quiz score
Certificate ID
This free course gives you a certificate of completion from Pact Compliance. It is not continuing education (CE) credit and is not approved by any state. Your employer decides whether it counts toward required in-service hours. Home health and hospice aide training must be given or supervised by the agency's registered nurse. California: it does not count toward CNA or HHA renewal hours.
Part of this topic needs a hands-on check with your supervisor; this online course does not cover that part.
Pact does not keep a record of this certificate. Print it or save it as a PDF and give a copy to your supervisor. pactcompliance.com/free-training/infection-control/
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