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Infection Control During Medication Administration for Medication Aides

1 Contact Hour
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This peer reviewed course is applicable for the following professions:
Certified Medication Assistant (CMA), Medication Aide
This course will be updated or discontinued on or before Friday, May 1, 2026

Nationally Accredited

CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.


92% Participants will know the principles to prevent the spread of infection during medication administration.


After completing this continuing education course, the learner will be able to:

  1. Discuss bloodborne pathogens and disease.
  2. Describe principles to prevent the spread of infection.
  3. Describe infectious waste management standards.
  4. Discuss antibiotic stewardship.
  5. Define cleaning, disinfection, and sterilization processes.
CEUFast Inc. and the course planners for this educational activity do not have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Infection Control During Medication Administration for Medication Aides
To earn of certificate of completion you have one of two options:
  1. Take test and pass with a score of at least 80%
  2. Reflect on practice impact by completing self-reflection, self-assessment and course evaluation.
    (NOTE: Some approval agencies and organizations require you to take a test and self reflection is NOT an option.)
Author:    Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Bloodborne Pathogens and Diseases


  • Bloodborne pathogens are germs that cause infection and live in blood and body fluids.
  • Body fluids are liquids from a resident. Blood may or may not be seen in the body fluid. Sweat is the only body fluid that does not transmit bloodborne pathogens.
  • Cleaning removes visible and surface contamination from an object. It can be done by scrubbing and with cleaners. Cleaning is not intended to kill pathogens or other germs.
  • Colonized means a resident has germs that could cause infections but does not have an active infection.
  • Contact means touching body fluids with bare skin or getting it on mucus membranes.
  • Contamination means getting visible body fluids on something.
  • Disinfection destroys germs. It does not eliminate all pathogens.
  • Droplets are tiny drops of liquid that can sometimes be seen when a person coughs or sneezes. Most droplets cannot be seen.
  • Environmental surfaces are the furniture, floor, and equipment in a resident's area.
  • Exposure means contact with pathogens that may be infected.
  • Immunocompromised means the resident cannot fight off infections like normal people.
  • Impermeable means liquid does not soak through.
  • Mucus membranes are in the eyes, mouth, nose, and vagina.
  • Non-intact skin means skin with an opening like a scratch, rash, or cracks.
  • Occupational transmission means a person gets an infection at work.
  • Pathogen means germs that can cause disease and infection.
  • Percutaneous injury means a puncture into the skin like a needlestick or a cut from a sharp object.
  • Transmission means germs have moved from an infected person or surface to infect another person.
  • Transmission-based precautions put residents in a situation where other people are protected from infections. This term used to be called isolation.

Healthcare workers are exposed to infections. Sometimes, one cannot tell if a resident has an infection just by looking at them. So, standard precautions should be used routinely to protect from all sources of possible infection. Additionally, healthcare workers can transmit germs from a resident to objects in the room, where another worker may touch contaminated objects. This act is how infections spread.

Exposure to a bloodborne pathogen can occur through:

  1. A percutaneous injury.
  2. Contact of a mucous membrane or non-intact skin with blood, tissue, or other possibly infectious body fluids.
  3. Direct contact with blood or body fluid from a resident with HIV, hepatitis B, or hepatitis C.

Exposures can occur through needlesticks or cuts from other sharp instruments contaminated with an infected resident's blood or through contact of the eye, nose, mouth, or skin with a resident's blood. The most common cause of percutaneous injuries is puncture wounds from needles. Most exposures do not result in infection; however, following exposure precautions and prevention steps is always best.

Principles to Prevent the Spread of Infection

Hand Washing Guidelines

Centers for Disease Control (CDC) handwashing guidelines say washing hands with soap and water is to be done whenever the hands are visibly dirty. If not visibly soiled, rubbing hands with an alcohol hand rub is the main means of hand hygiene for routinely removing contamination of the hands during routine resident care. Alcohol-based hand rubs increase compliance with hand hygiene because hand rubbing needs less time, results in less skin irritation, and does not need proximity to a sink. Hand hygiene is needed before:

  • Resident Contact
  • Donning gloves
  • After removing gloves

Standard Precautions

Standard precautions are to help healthcare workers protect themselves from occupational transmission germs. Standard precautions apply to all body fluids, secretions, and excretions except sweat, regardless of whether they contain visible blood, non-intact skin, and mucous membranes. Additional precautions are based on highly transmissible or epidemiologically important pathogens. Transmission Based Precautions are airborne, droplet, and contact.

Personal Protective Equipment (PPE)

The appropriate use of PPE is an important element of standard infection prevention precautions. Gloves provide a protective barrier between the resident and the healthcare worker and prevent gross contamination of the hands. Gloves do not replace the need for handwashing because gloves may have small defects, may be torn during use, and hands may become contaminated during glove removal.

Masks, goggles, or face shields should be used to protect the mucous membranes of the eyes, nose, and mouth during situations where there is a likelihood of splashes or sprays. Healthcare workers wear surgical masks to protect against large-particle droplets during close resident contact. When tuberculosis is known or possible, healthcare workers should wear an N95 respirator, a high-efficiency particulate air (HEPA) filter respirator, or a powered air-purifying respirator (PAPR).

Gowns are worn to prevent clothing contamination and protect the healthcare worker's skin from exposure to blood and body fluids. Impermeable gowns, leg coverings, boots, or shoe covers provide additional protection when a large amount of blood or body fluids may be splashed. Gowns are also worn as a part of some transmission-based precautions. Mouthpieces, resuscitation bags, or other air circulation devices should be used instead of mouth-to-mouth resuscitation.

Transmission Based Precautions

Transmission-based precautions and PPE are terms used to direct protective actions that need to be used for infected groups of residents. Residents who need transmission-based precautions need a private room. Residents infected with the same pathogens can share a room. The doctor and nurses work together to plan resident placement and isolation.

Contact Precautions

Contact precautions are used for residents with infections or possible infections or who are colonized with germs that can be transmitted by direct or indirect contact. The residents should be in a private room. Standard precautions should be used, and a gown should be worn if there is likely to be in contact with the resident or environmental surfaces.

Airborne Precautions

Airborne precautions are implemented for diseases transmitted by germs in airborne droplet pathogens. Droplet pathogens are left on surfaces when droplets evaporate. Droplet pathogens remain suspended in the air and can spread widely by air currents. Early identification and triage of possible cases of airborne transmitted diseases should be done, and possibly infectious residents should be separated from others. When a resident in airborne precautions needs to be moved or transported, they should wear a surgical mask from when they leave the isolation room until they return.

Airborne precautions need a specially ventilated room to pull the air out of the building or through a HEPA-filtered system. The door to the room must be kept closed. Health workers use an N-95 mask or a powered air-purifying respirator (PAPR) in airborne precaution settings (CDC, 2021).

These masks and respirators should be labeled and stored in a paper bag between uses. These masks and respirators should be discarded if soiled or if they no longer maintain their ability to work. The N-95 mask should also be discarded at the end of each work shift. The disposable respirator should be discarded at the end of 2 weeks.

Droplet Precautions

Droplet precautions are used for residents known or possibly infected with germs transmitted by droplets generated during coughing, sneezing, talking, or performing procedures. Droplet precautions need a private room, but no special air circulation is necessary, and the door may remain open. Masks should be used when entering the room, especially if working within three feet of the resident. The resident should be masked if transported.

Neutropenic Precautions

Neutropenic precautions (reverse isolation) are implemented to protect immunocompromised residents. They need a private room with positive air pressure relative to the air pressure in the hall. Other precautions may range from standard precautions and traffic limitations to very strict precautions using gloves, gowns, and masks. This varies depending on the reason for the precautions and the degree of the resident's immunosuppression.

Infectious Waste Management

In healthcare, everyone is responsible for properly disposing of biohazardous material. One negligent act can result in biohazardous exposure. Biohazard materials include blood and body fluids. If in doubt, use a biohazard container to dispose of the material. All biohazardous containers should be red and have the following biohazard symbol.

biohazard label

Biohazard Label

Biohazard sharps containers come in varied sizes. Biohazardous sharps containers are made to store small glass objects and anything capable of puncturing the skin, whether it is contaminated or not. Even if a sharp object is not contaminated, if it is put in regular garbage, someone may be stuck with that sharp object and not know whether it was contaminated or not. The common examples are needles, sutures, scalpels, disposable instruments, and lancets. Replace sharps containers when they are three-quarters full. Failure to do so may result in someone being contaminated because sharps are close to the top or the closure device does not swing freely.

Biohazardous bags are red and are to be used for biohazardous material that is not sharp and may be contaminated with blood or other body fluid. These bags are also used for the disposal of chemotherapy drugs and chemicals, even though they are not infectious.

biohazard bag

Biohazard Trash

General waste bags are used for general trash and some body fluids and equipment if there is no visible blood, urine, or feces, including disposable pads or chux pads, PPE, used gloves, respiratory care items, and suction canisters. However, if in doubt, use a biohazardous bag.

Cleaning, Disinfection, and Sterilization

Keep the medication preparation area clean. Clean the counter surfaces often and wipe up spills right away. Keep liquid medication bottles clean by wiping up drips and cleaning around the neck of the bottle with a clean, wet cloth. The areas where medications are stored and given should be well organized, with no clutter. The area should be quiet, well-lit, and away from places where people gather. A clean, uncluttered area is more sanitary and more free of germs. It also helps to prevent medication errors.

Cleaning, disinfection, and sterilization are needed for infection control and maintaining a safe environment. Sterilization kills all germs. Disinfection will kill or remove most germs. Cleaning removes contamination.

Reusable medical devices or resident-care equipment that enters the body should be sterilized before each use. Medical devices needing sterilization or disinfection must be thoroughly cleaned to reduce tissue, blood, and body fluids before using germicide. The directions on the germicide should be followed closely. Use the device manufacturer's instructions.

Items that do not ordinarily touch the resident or touch only intact skin are part of disease transmission. They do not need disinfection between uses on different residents. These include crutches, bedboards, blood pressure cuffs, and other medical accessories. Depending on the particular equipment or item, washing with a detergent or using a low-level disinfectant may be sufficient when removing contamination is needed. If non-critical items are grossly soiled with blood or other body fluids, a higher level of disinfection is needed.

Remove visible tissue, blood, and body fluids by cleaning them. Clean medical devices as soon as practical after use because contamination becomes dried onto the instruments. Dried contamination makes removal more difficult. The disinfection or sterilization process does not work when an object is not clean. Ensure that the rinse step is adequate to remove the disinfectant. Discard or repair equipment that no longer works as intended or cannot be thoroughly cleaned, disinfected, or sterilized.

Cleaning and disinfecting environmental surfaces and resident rooms have been shown to decrease the incidence of hospital-acquired infections and reduce environmental contamination with possibly dangerous germs. Clean housekeeping surfaces (e.g., floors, tabletops) regularly when spills occur and when these surfaces are visibly soiled. Disinfect or clean environmental surfaces regularly (e.g., daily, three times per week) and when surfaces are visibly soiled.

Antibiotic-Resistant Pathogens and Antibiotic Stewardship

Germs that can cause disease can develop resistance to antibiotics used to treat infections. This resistance means the pathogen changed, so the antibiotic no longer kills that pathogen.Resistance is partly due to the overuse of antibiotics or the infected person not completing all the medication that was prescribed. The entire amount of antibiotics prescribed needs to be completed. This action is antibiotic stewardship. Antibiotic-resistant pathogens have become an increasingly severe problem. Some of the more common ones are:

  • Carbapenem-Resistant Enteropathogensceae
  • Drug-resistant Staphylococcus Aureus
  • Vancomycin-resistant Enterococcus (VRE)
  • Multidrug-Resistant Tuberculosis (MDR-TB) and Extensively Drug-Resistant Tuberculosis (XDR-TB)
  • Drug-resistant Streptococcus pneumoniae
  • Drug-Resistant Acinetobacter
  • Methicillin-resistant staphylococcus Aureus (Bhatta et al., 2022)

Most of these drug-resistant germs are spread on the hands of healthcare workers and the environmental surfaces in the facility. The elderly and sick residents catch these infections more easily, and it can be more severe for those residents.

Case Study

Jane is having a busy day. One of her residents is in airborne precautions. There is only one oral medication to give. Jane is tempted to enter and exit quickly without putting on the PPE for that precaution. Jane remembers that airborne precautions are implemented for diseases transmitted by germs in airborne droplet pathogens. So, if she does not put on the PPE, she will be exposed to infection. Jane decided to follow the airborne precautions even though she was busy.

Jane made the right decision. She would have exposed herself to infection and might have transmitted infection to her other residents.


Bloodborne pathogens and diseases are in the healthcare setting. However, there are ways to prevent infection from spreading. One way is using correct infectious waste management. Another way to prevent the spread of infection is to follow cleaning, disinfection, and sterilization processes. Drug-resistant diseases can be prevented by practicing antibiotic stewardship.

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Implicit Bias Statement

CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.


  • Bhatta, D. R., Koirala, S., Baral, A., Amatya, N. M., Parajuli, S., Shrestha, R., Hamal, D.,Nayak, N., & Gokhale, S. (2022). Methicillin-Resistant Staphylococcus aureus Contamination of Frequently Touched Objects in Intensive Care Units: Potential Threat of Nosocomial Infections.Canadian Journal of Infectious Diseases and Medical Microbiology, 2022, 16.Visit Source.
  • Centers for Disease Control and Prevention. (2023). Types of Masks and Respirators. Visit Source.