Weber Chapter 3 - Guide to Exam Room Setup, Hand Hygiene, PPE, and Infection Control

Exam setting conditions

Comfortable room temp, private area, quiet environment, adequate lighting, firm exam table/bed, bedside table for equipment.

Action if room is too cold

Provide a warm blanket.

Best lighting for an exam

Sunlight (preferred) or good overhead lighting; use a portable lamp for skin/shadows.

Hand hygiene

Cleaning hands by handwashing, antiseptic handwash, alcohol-based sanitizer, or surgical antisepsis.

Importance of hand hygiene

Reduces spread of deadly germs, lowers risk of provider colonization/infection.

Most effective product for reducing germs

Alcohol-based hand sanitizer.

When to wash hands with soap and water

When visibly soiled, before eating, after restroom use, after caring for infectious diarrhea, after exposure to spores (e.g., C. diff).

When to use sanitizer

Before touching client, before aseptic tasks, after touching client/environment, after contact with blood/fluids, after glove removal.

Duration of sanitizer use

~20 seconds, until hands feel dry.

How to wash hands with soap and water

Wet hands, apply soap, rub ≥15 sec (cover all surfaces), rinse, dry with disposable towel, use towel to turn off faucet.

Recommended handwashing duration

~20 seconds (either 15 or 20 sec acceptable).

Reason to avoid hot water

Prevents skin dryness.

When gloves are required

When anticipating contact with blood, fluids, mucous membranes, nonintact skin, or contaminated equipment.

Are gloves a substitute for hand hygiene?

No.

When to perform hand hygiene with glove use

Before donning gloves, after removing gloves, when changing gloves.

When to change gloves

If damaged, visibly soiled, moving from dirty to clean site, between clients.

How to remove gloves

Carefully, to prevent hand contamination.

Preventing dryness from frequent cleaning

Facility-approved lotions/creams.

Should health care providers wear artificial nails?

No, especially when caring for high-risk clients (ICU, OR).

Length of natural nail tips

< ¼ inch.

Concern with rings

More germs under skin near rings, though more studies are needed.

Respiratory hygiene actions

Cover mouth/nose with tissue when coughing/sneezing, dispose tissue in nearest receptacle, perform hand hygiene.

Facilities support for cough etiquette

Tissues, no-touch waste bins, alcohol-based rub dispensers, sinks with soap/towels.

When to wash hands in relation to the exam

Before starting exam, after accidental blood/fluids contact, after finishing exam, after glove removal.

Reason to wash hands in the client's presence

Reassures client about safety.

When must gloves be worn in exams

With blood/fluids, if examiner or client has open wound, when collecting specimens, handling contaminated equipment, examining mouth, wound, genitalia, vagina, or rectum.

Handling pins used for sensory tests

Discard after use; use new for each client.

When to wear mask and protective goggles

When risk of splashes (e.g., oral exam with client who has productive cough).