Unit 3

The Language of Hygiene and Infection Control

Workplace English for Nursing Assistants

Meet Mr. Reyes

Watch the video about Mr. Reyes. Watch what happens.

Talk about it

1. How could C. diff spread to the workers and to other clients if precautions are not followed?
2. After caring for Mr. Reyes, may you use hand sanitizer? Why or why not?
3. What primary prevention action might have reduced his risk during his stay?
4. Before you transport him for the X-ray, what should you do to protect others?
5. Is there anything you should tell the receiving staff before he arrives? What?

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A germ (microorganism) is a tiny living thing that can cause illness. There are four kinds.

Four kinds of germs

Germ	What it is	Example
Bacteria	Single-celled; some are helpful, some cause illness	Urinary tract infection
Virus	Very tiny; spreads easily person to person	Common cold, flu, HIV
Fungus	Plant-like; more common when the immune system is weak	Athlete's foot, yeast infection
Protozoa	Larger; spread by food or water; affect the gut	Giardia

Practice 1

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The most important idea in the unit. An infection needs all six links. Break one, and it cannot spread. Your job is to break a link.

The six links and how you break each one

Link	What it means	How you break it
Infectious agent	The germ itself	Clean and disinfect; sanitize hands
Reservoir	Where the germ lives	Store food safely; clean surfaces
Portal of exit	How the germ leaves	Cover wounds; contain drainage
Mode of transmission	How the germ travels	Hand hygiene; mask a coughing client
Portal of entry	How it enters the next person	Keep skin intact and unbroken
Susceptible host	A person at risk	Rest, good food, vaccination

Practice 2

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Prevention terms and plain meanings

Term	Plain meaning
Infection control	Preventing or limiting the spread of germs.
Primary prevention	Stopping a disease before it ever starts.
Immunity	Protection from a germ because the body has antibodies.
Antibody	The body's defense against one specific germ (from a vaccine or a past illness).
Hand hygiene	Washing with soap and water OR using hand sanitizer — the single most important prevention.

The procedure: washing your hands

You will do this many times a shift — and you will also teach it, to a new worker, to a client, or to a visiting family. Use time words so each step is clear.

Practice 3

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PPE is equipment that forms a barrier between you and infectious body fluids. Assume any client could be infectious, and wear PPE whenever you might touch blood, body fluids, or broken skin.

Personal protective equipment

PPE item	What it protects / when
Gloves	Protect the hands; whenever you may touch fluids, broken skin, or fomites.
Gown	Protects clothing and arms from splashes.
Mask	Covers the nose and mouth; blocks respiratory droplets.
Goggles / face shield	Protect the eyes when splashing or spraying may occur.

Glove and PPE rules that matter:

• One pair of gloves = one client. Never reuse gloves.
• Work "clean to dirty." Start at cleaner areas (face) and move to soiled areas (perineum) last.

• Hand hygiene right after removing gloves — every time.
• No gloves in hallways or dining rooms (except emergencies). Remove PPE at the doorway.

Practice 4

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The three precautions and their PPE

Precaution	How the germ travels	What you wear
Airborne	Floats far on the air (e.g., TB)	N95 respirator
Droplet	Falls within 3 feet (e.g., flu, whooping cough)	Surgical mask within 3 feet
Contact	Spreads by touch — direct or a fomite	Gown and gloves

Drug-resistant germs to recognize: MRSA, VRE, and C. diff. All use contact precautions.

C. diff is special: hand sanitizer does not kill it — you must wash with soap and water, and clean with bleach.

Practice 5

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Common infection-control abbreviations

Abbreviation	Stands for
PPE	Personal Protective Equipment
N95	A respirator mask that filters 95% of tiny particles
MRSA	A staph germ resistant to many antibiotics
VRE	Another drug-resistant germ found in the intestines
C. diff	Clostridium difficile — a gut infection after antibiotics
MDRO	Multidrug-Resistant Organism — a germ many antibiotics cannot kill
CDC	Centers for Disease Control and Prevention

Practice 6 — Reading Abbreviations (Warm-Up)

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Dialogue Practice

Read these dialogues out loud with a partner.

Dani started today. You are showing her the sink in the utility room.

Dani: I know how to wash my hands... it's just soap, right?

You: Here we do it a certain way. Watch me, then you try. First, wet your hands with warm water.

You: Then add soap. Next, scrub all surfaces for 20 seconds — palms, backs, between the fingers, and the thumbs.

Dani: Twenty seconds is long.

You: Sing "Happy Birthday" twice. After that, rinse with your fingers pointing down, so the water runs off the dirty end.

Dani: Down. O.K.

You: Finally, dry with a paper towel, and use that same towel to turn off the tap. Am I making sense?

Dani: Yes, I think so.

You: Can you show me how you would do it?

The charge nurse gives you your assignment on the way past.

Supervisor: Room 14 is an MDRO — VRE in the urine. Contact precautions, and no sanitizer on that one.

You: Excuse me — what does "MDRO" mean?

Supervisor: Multidrug-resistant organism. A germ that most antibiotics can't kill.

You: And "VRE"? What does that mean?

Supervisor: A resistant germ from the intestines. It's in her urine, so watch the catheter bag.

You: So — contact precautions, gown and gloves. Is that right?

Supervisor: Correct.

You: And soap and water for my hands, not the gel — am I correct?

Supervisor: Yes. Soap and water every time you come out.

You: Room 14, contact, gown and gloves, soap and water — I got it.

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Roleplays

Work with a partner.

Situation

A new worker, Tomas, must learn how to take gloves OFF without contaminating his hands: pinch the outside of one glove at the wrist, peel it off inside-out, hold it in the gloved hand, slide a bare finger inside the other cuff, peel that one off over the first, discard both, then perform hand hygiene. Teach him.

Your Goals:

1. Give ONE action per sentence — do not combine steps.
2. Give a reason for at least one step.
3. End with a Checking for Understanding phrase.

Situation

The nurse says quickly: "Bed 6 is C. diff, contact plus, and there's an N95 fit-tested resident in 9 on airborne." You do not know two of these terms and you must not guess. Ask, then read the whole assignment back.

Your Goals:

1. Use at least TWO Clarification Requests for Meaning.
2. Use at least TWO Confirmation Checks, one with a question.
3. Read back BOTH rooms with the correct PPE and the correct hand hygiene.
4. Do not leave until the C. diff hand-hygiene rule is confirmed.

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Cumulative Review

Multiple Choice

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Back to Mr. Reyes

Read the case and answer in complete sentences. Use the sentence starters if you wish.

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For the instructor — not part of the student pages

Instructor Answer Key

Unit 3 — The Language of Hygiene and Infection Control

This unit introduces the language and practices used to prevent infection in healthcare settings. Learners study common types of germs, the chain of infection, hand hygiene, personal protective equipment, transmission-based precautions, and medical abbreviations found on signs and assignments. A case study about Mr. Reyes connects this knowledge to C. diff, strict handwashing, isolation, and safe transport between departments. Through illustrated readings, flashcards, knowledge checks, dialogues, and role-plays, learners practice explaining procedures, sequencing steps, asking for clarification, and confirming PPE and precaution instructions.

Practice 1–6 and Review

Warm-Up: 1-B, 2-D, 3-E, 4-A, 5-C, 6-F.

Practice 1.1: 1-B, 2-D, 3-A, 4-C, 5-E. Practice 1.2: 1. fungus 2. virus.

Practice 2.1: all SIX links; ONE link; the infection stops (cannot spread). Practice 2.2: 1-B, 2-D, 3-E, 4-A, 5-C.

Practice 3.1: 1-B, 2-D, 3-E, 4-A, 5-C. Practice 3.2: 1. Soap 2. Sanitizer 3. Soap 4. Soap.

Practice 4.1: 1-B, 2-D, 3-E, 4-C, 5-A. Practice 4.2: 1. False 2. True 3. True 4. False.

Practice 5.1: 1-B, 2-C, 3-A. Practice 5.2: 1. Airborne 2. Droplet 3. Contact.

R1 Multiple Choice (after the 4→3 revision): 1-b, 2-c, 3-c, 4-b, 5-c, 6-b, 7-c, 8-b, 9-b, 10-b.

Back to Mr. Reyes Case Study (sample): (1) Through unwashed hands or contaminated objects (fomites) touched by workers and then by others. (2) No — sanitizer does not kill C. diff; wash with soap and water. (3) Careful, limited antibiotic use and consistent hand hygiene. (4) Contain drainage / cover the area, change into clean PPE as directed, and perform hand hygiene. (5) Yes — tell the receiving staff he is on contact precautions so they can prepare PPE.

Suggested extension — do it while you say it

Have students narrate the handwashing or glove-removal sequence aloud while miming each step, using First / Then / Next / Finally.