Nursing Diagnosis for Infection: 5 Sample Care Plans & Interventions

Choosing the right nursing diagnosis for infection — and building a clean NANDA-I care plan around it — is something you’ll do almost every clinical day. Every patient with an indwelling line, a surgical wound, an immunosuppressing medication, a Foley, a tracheostomy, a feeding tube, a transplant, chemotherapy, advanced age, diabetes, or chronic lung disease is at higher risk.

The infection care plan is one of the most universally applicable in nursing. This page walks through what to assess, the NANDA-I nursing diagnoses for infection you’ll see most often, and 5 sample care plans you can model your clinical paperwork on for the most common presentations.

It’s written for nursing students, new grads, and any RN who wants a refresher with current CDC HAI prevention bundles, WHO 5 Moments for Hand Hygiene, Surviving Sepsis Campaign 2026 principles, and ACIP vaccine recommendations baked in. Always verify against the most current published edition.

Scope note. This is an educational care plan for nursing students and new graduates. It is not a substitute for facility infection prevention and control (IPC) protocols, provider orders, or specialist clinical judgment. Isolation precautions, antimicrobial choice, sepsis pathway execution, and outbreak responses depend on the pathogen, the patient, and your institution — always follow current local IPC policy.

Quick answer. The most common nursing diagnoses for infection are Risk for Infection (the classic prevention diagnosis), Infection (when the patient has active signs), Hyperthermia, Risk for Sepsis (or suspected sepsis when organ dysfunction is present), and Deficient Knowledge: Infection Prevention. Choose the diagnosis based on the patient’s actual assessment findings.

Common mistakes to avoid. Don’t confuse colonization with infection. Don’t call asymptomatic bacteriuria a UTI just because a urine culture is positive. Don’t use qSOFA alone as the sepsis screen. Don’t treat “suspected sepsis” as a routine risk diagnosis when the patient already has organ-dysfunction warning signs (escalate as actual). Verify exact NANDA-I labels in the licensed 2024–2026 text before submitting graded care plans.

Table of contents

• What is infection?
• The chain of infection
• Risk factors
• Healthcare-associated infections (HAIs)
• Signs and symptoms
• Nursing assessment
• Diagnostic studies
• WHO 5 Moments for Hand Hygiene
• Isolation precautions
• Antimicrobial stewardship
• Vaccines and prevention
• Sepsis pathway (SSC 2026)
• Nursing goals and outcomes
• Nursing interventions
• Nursing diagnosis for infection — 5 sample care plans
• Escalation red flags
• Discharge and patient teaching
• Practice question
• FAQs
• Related resources
• References

What is infection?

Infection is the invasion and multiplication of pathogens (bacteria, viruses, fungi, or parasites) in a host, with resulting tissue damage or host response. It’s distinct from colonization, which is the presence of microorganisms without invasion or response — the difference matters because we treat infection, not colonization.

Infection can be localized (cellulitis, surgical site infection, abscess, UTI confined to bladder) or systemic (bacteremia, sepsis, septic shock). Either can escalate, and the nursing role is to catch the early signs of escalation before the patient decompensates.

The chain of infection

Every nursing intervention for infection works by breaking one or more links in this chain:

1. Infectious agent — the pathogen (bacteria, virus, fungus, parasite)
2. Reservoir — where the agent lives and multiplies (other patients, contaminated equipment, water, air, the patient themselves)
3. Portal of exit — how the agent leaves the reservoir (respiratory secretions, blood, urine, stool, wound drainage)
4. Mode of transmission — how it travels (direct contact, droplet, airborne, vehicle, vector)
5. Portal of entry — how it enters a new host (broken skin, mucous membranes, respiratory tract, indwelling devices)
6. Susceptible host — someone whose defenses are reduced (immunosuppression, chronic disease, advanced age, malnutrition, indwelling lines, broken skin)

Hand hygiene breaks the mode of transmission. PPE breaks both transmission and portal of entry. Vaccines reduce host susceptibility. Aseptic technique with invasive procedures protects the portal of entry. Antimicrobials kill the agent. Each intervention has a target link.

Risk factors

Common patient factors that increase infection risk:

• Immunosuppression — chemotherapy, biologics, chronic steroids, HIV, transplant recipients
• Indwelling devices — central lines, peripheral IVs, urinary catheters, endotracheal tubes, feeding tubes, drains, ventricular shunts
• Broken skin / surgical wounds — surgical sites, pressure injuries, burns, IV insertion sites
• Chronic conditions — diabetes (hyperglycemia impairs neutrophil function), end-stage renal disease, cirrhosis, COPD, heart failure
• Advanced age — immunosenescence; atypical presentations
• Malnutrition — impairs wound healing and immune function
• Hypothermia — perioperatively impairs immune function (a reason normothermia is part of SSI prevention)
• Recent or current antibiotic exposure — increases risk of C. difficile and resistant organisms
• Behavioral / social — substance use, homelessness, crowded living, low health literacy

Healthcare-associated infections (HAIs)

HAIs are infections linked to healthcare exposure. Many are identified after 48 hours of admission, but formal CDC / NHSN surveillance definitions vary by infection type, device, procedure, and organism — use facility surveillance criteria for documentation. The CDC prioritizes prevention bundles for the most common HAIs:

CLABSI — Central Line-Associated Bloodstream Infection

Prevention bundle (CDC):

• Strict hand hygiene before insertion and access
• Maximal barrier precautions during insertion (cap, mask, sterile gown, sterile gloves, full-body drape)
• Chlorhexidine skin prep (allow to fully dry)
• Optimal catheter site selection — subclavian preferred over femoral in adults when not contraindicated
• Daily review of line necessity — remove ASAP
• Aseptic access technique with scrub-the-hub for ≥ 15 seconds before every entry

CAUTI — Catheter-Associated Urinary Tract Infection

Prevention bundle:

• Avoid unnecessary urinary catheters — placement decision is provider-driven and indication-limited (acute retention, accurate I/O in critical illness, perioperative for select surgeries, end-of-life comfort)
• Remove as soon as clinically appropriate — daily review per facility protocol
• Aseptic insertion using sterile technique
• Closed drainage system; never disconnect except as needed
• Drainage bag below bladder level at all times
• Routine perineal care; avoid kinks and dependent loops in the tubing

SSI — Surgical Site Infection

Prevention bundle:

• Appropriate preoperative antimicrobial prophylaxis within 60 minutes of incision (120 minutes for vancomycin and fluoroquinolones)
• Chlorhexidine-alcohol skin prep
• Maintain normothermia perioperatively (immune function and wound healing depend on it)
• Glycemic control — keep glucose in target range perioperatively
• Hair clipping (not shaving) if hair removal is needed
• Sterile technique throughout the procedure

VAP — Ventilator-Associated Pneumonia

Prevention strategies (per SHEA/IDSA/APIC 2022 update):

• Avoid intubation and reintubation when possible — use HFNC or NIPPV when clinically appropriate
• Minimize sedation — daily spontaneous awakening trials (SATs) paired with spontaneous breathing trials (SBTs); assess readiness to extubate
• Early mobility — get patients up as soon as safely possible
• HOB elevation when feasible (often 30–45°)
• Daily oral care with toothbrushing — routine oral chlorhexidine is no longer recommended for VAP prevention
• Subglottic secretion drainage for select patients expected to require prolonged ventilation
• DVT prophylaxis remains standard ICU care but is not a VAP-prevention element. Stress-ulcer prophylaxis is indicated for GI-bleed-risk patients but is not part of the current VAP bundle.

C. difficile infection (CDI)

• Hand hygiene — alcohol-based hand rub remains preferred for routine clinical use per CDC; soap and water is required when hands are visibly soiled and is often preferred or required by facility policy after CDI care (because alcohol does not kill spores). CDC also recommends soap and water as an additional precaution during CDI outbreaks. Follow your facility’s CDI / enteric-contact policy.
• Contact precautions with gowns and gloves
• Dedicated patient equipment when possible
• Sodium hypochlorite (bleach-based) environmental cleaning for spore killing
• Antimicrobial stewardship to reduce CDI incidence — high-risk antibiotics include fluoroquinolones, clindamycin, broad-spectrum cephalosporins, carbapenems

Signs and symptoms

The data below is what to consider. Older adults and the immunocompromised may present atypically (delirium, falls, decreased PO intake) without the classic findings.

Local signs (cardinal signs of inflammation):

• Redness (rubor)
• Warmth (calor)
• Swelling (tumor)
• Pain (dolor)
• Loss of function (functio laesa)
• Purulent drainage, induration, fluctuance (abscess)

Systemic signs:

• Fever or hypothermia (hypothermia is a sepsis red flag in older adults)
• Tachycardia, tachypnea, hypotension
• Leukocytosis or leukopenia
• New confusion / delirium
• Decreased PO intake, functional decline

Site-specific clues:

• UTI: dysuria, frequency, urgency, suprapubic pain, foul-smelling or cloudy urine. Older adults may present atypically with delirium, falls, or functional decline, but do not automatically attribute confusion or falls to UTI — bacteriuria without local urinary symptoms or systemic signs may be asymptomatic bacteriuria, which IDSA recommends against routine antibiotic treatment. Assess for urinary symptoms, fever, hemodynamic instability, leukocytosis, or other systemic signs and follow facility criteria.
• Pneumonia: productive cough, purulent sputum, pleuritic chest pain, dyspnea, hypoxemia (see our pneumonia care plan)
• Cellulitis: spreading erythema with poorly demarcated borders; warmth; tenderness; sometimes lymphangitic streaking and regional lymphadenopathy
• Wound / surgical site infection: purulent drainage, erythema extending beyond incision, increased pain, dehiscence
• Bloodstream infection: fever, chills, rigors, new tachycardia, hypotension — often without localizing signs in immunocompromised patients
• C. difficile infection: new-onset diarrhea (≥ 3 unformed stools / day), abdominal pain, leukocytosis; especially after recent antibiotics

Nursing assessment

Subjective data

• Onset and pattern of fever, chills, pain, drainage, cough, dysuria, diarrhea
• Recent surgery, procedures, hospitalizations, antibiotic exposure
• Immunosuppression — diagnosis, medications, chemotherapy
• Indwelling devices — lines, catheters, tubes, drains
• Recent travel, animal exposure, sick contacts
• Vaccination status — influenza, pneumococcal, RSV, COVID-19, MMR, varicella, Tdap, hepatitis B (especially for healthcare workers)
• Functional baseline and current changes

Objective data

• Vital signs (T, HR, BP, RR, SpO₂); orthostatic vitals if relevant
• Skin and mucous membrane inspection — wounds, lines, IV sites, surgical incisions, pressure injuries, oral / perineal hygiene
• Lung sounds, abdominal exam (tenderness, distention, peritoneal signs)
• Urinary output, color, odor; appearance of any wound drainage
• Mental status — alertness, orientation (new confusion is a red flag)
• Trend lab values — WBC with differential, lactate, blood cultures, urinalysis, sputum / wound cultures
• ANC if neutropenia is suspected (see anemia care plan for neutropenic precautions)

Diagnostic studies

Reference ranges vary by lab — check facility normals.

WHO 5 Moments for Hand Hygiene

The WHO 5 Moments framework is the global standard for hand hygiene compliance. Memorize them:

1. Before patient contact
2. Before aseptic procedure
3. After body fluid exposure risk
4. After patient contact
5. After contact with patient surroundings

Use alcohol-based hand rub by default in most clinical situations per CDC. Use soap and water when hands are visibly soiled, before eating, after using the restroom, and after caring for patients with C. difficile or other spore-forming organisms when facility policy requires it or during CDI outbreaks — alcohol does not kill C. difficile spores, but the broader CDC healthcare-worker recommendation continues to favor alcohol-based hand rub for routine clinical hand hygiene. Follow your facility’s CDI / enteric-contact policy.

Isolation precautions

For neutropenic precautions detail (ANC thresholds, food safety, no rectal procedures), see our anemia care plan.

Antimicrobial stewardship

The CDC Core Elements of Hospital Antibiotic Stewardship Programs:

1. Hospital leadership commitment — dedicated resources
2. Accountability — appoint a single leader responsible for outcomes
3. Pharmacy expertise — appoint a single pharmacist leader for stewardship
4. Action — implement at least one intervention to improve antibiotic use (e.g., prospective audit and feedback, formulary restriction, antibiotic time-outs at 48–72 h)
5. Tracking — monitor antibiotic use and resistance
6. Reporting — regular reports to prescribers
7. Education — provider, pharmacist, and nursing education

Nursing’s role in stewardship:

• Collect cultures before antibiotics when feasible (don’t delay therapy in severe disease)
• Watch for opportunities to de-escalate based on cultures and clinical course
• Recognize antibiotic side effects and adverse events (C. diff diarrhea, allergic reactions, kidney/liver function)
• Review IV-to-PO conversion eligibility
• Question continuation of antibiotics when courses are reaching standard duration limits
• Engage pharmacy and ID consults early when needed

Vaccines and prevention

Per current CDC / ACIP recommendations (always verify against the most current ACIP schedule):

• Influenza — annually for everyone ≥ 6 months
• Pneumococcal — for adults 50 years and older or risk-based groups (PCV15, PCV20, or PCV21 depending on history)
• RSV vaccine — adults 75+ and adults 50–74 at increased risk
• COVID-19 — per current ACIP shared clinical decision-making guidance for people 6 months and older
• Tdap / Td — Tdap once in adulthood, then Td booster every 10 years (or Tdap booster); Tdap in each pregnancy
• MMR — non-immune adults; especially healthcare workers
• Varicella — non-immune adults; especially healthcare workers
• Hepatitis B — birth dose / infant series; catch-up for unvaccinated children and adolescents; routine for adults 19–59; adults 60+ with risk factors or who request protection; healthcare personnel with reasonably anticipated blood or body-fluid exposure
• HPV — through age 26 routinely; shared decision-making through 45
• Zoster (Shingrix) — adults ≥ 50

Verify pediatric vaccine schedules separately; they follow the ACIP pediatric immunization schedule.

Sepsis pathway (SSC 2026)

Infection is the most common trigger for sepsis. Catching the transition early is one of the highest-impact nursing actions.

Sepsis screening (per Surviving Sepsis Campaign 2026): Use your facility-approved sepsis screening tool (NEWS2, MEWS, SIRS, or your organization’s pathway). qSOFA can support escalation but should not be used alone as a screening tool per SSC 2026. The following bedside cues support escalation but are not a stand-alone screen:

• Respiratory rate ≥ 22
• Altered mental status
• Systolic BP ≤ 100 mm Hg

Sepsis pathway essentials (SSC 2026):

1. Measure lactate; re-measure if initial > 2 mmol/L
2. Obtain blood cultures × 2 before antibiotics when feasible
3. Administer antimicrobials within 1 hour for septic shock or probable/definite sepsis; rapid time-limited investigation is appropriate for possible sepsis without shock
4. Begin 30 mL/kg IV crystalloid within the first 3 hours for sepsis-induced hypoperfusion or septic shock, with reassessment
5. Apply vasopressors for MAP < 65 mm Hg unresponsive to fluids
6. Pursue source control early — when a source requiring control is suspected (abscess, infected device, necrotizing infection, empyema, obstructed urinary tract infection, perforated viscus), escalate early for source-control evaluation. SSC 2026 emphasizes timely source control as a core sepsis principle.
7. Reassess frequently; escalate level of care early

Timing windows start at sepsis recognition, not arrival.

Nursing goals and outcomes

By the end of the shift / hospitalization, the patient will (choose what fits the individual patient):

• Remain free of new signs of infection at all monitored sites (line / wound / surgical / urinary / pulmonary)
• Maintain temperature within an acceptable range
• Mount or maintain WBC and inflammatory markers trending appropriately for the underlying clinical picture
• Demonstrate hand hygiene technique using the WHO 5 Moments framework
• Verbalize three early signs of worsening infection that warrant a call to the provider
• Identify isolation precautions in use and their rationale (when applicable)
• Maintain effective antibiotic course completion adherence
• Show no progression to sepsis (per facility sepsis screen)
• Verbalize vaccine status and confirmed catch-up plan before discharge when relevant

Nursing interventions

Detection and monitoring

• Trend vital signs, mental status, WBC, lactate, procalcitonin, cultures, and inflammatory markers.
• Use the facility sepsis screening tool at the bedside on every shift for at-risk patients.
• Assess wounds, lines, IV sites, surgical incisions, and Foley sites every shift.

Hand hygiene and PPE

• Apply the WHO 5 Moments for Hand Hygiene universally.
• Use soap and water (not alcohol-based hand rub) for visibly soiled hands and for C. difficile care.
• PPE selection based on anticipated exposure (Standard precautions) plus transmission-based precautions for known organisms.

Aseptic technique

• Sterile technique for central line and urinary catheter insertion.
• Scrub the hub for ≥ 15 seconds before every IV access.
• Dressing changes per facility protocol with sterile technique.
• Maintain closed urinary drainage systems; bag below bladder level.

HAI prevention bundles

• Apply the CLABSI, CAUTI, SSI, VAP, and C. difficile bundles outlined above for every applicable patient.
• Advocate for daily review and removal of indwelling devices.

Medication administration

• Administer empiric antibiotics per provider order — within 1 hour for septic shock or probable/definite sepsis per SSC 2026.
• Coordinate cultures before antibiotics when feasible (don’t delay therapy in severe disease).
• Review any home medications that may affect immune status (chronic steroids, biologics, immunosuppressants) and notify the provider; hold per provider order, facility protocol, or active standing order set.
• Watch for antibiotic adverse effects — anaphylaxis, nephrotoxicity, ototoxicity, C. diff diarrhea, red-man syndrome with vancomycin infusion rate.

Skin and wound care

• Maintain skin integrity — pressure-injury prevention, regular repositioning per facility schedule, moisture management.
• Wound assessment per facility protocol; document drainage character, periwound condition, and dressing change interval.

Vaccines

• Review vaccination status; coordinate inpatient vaccine administration before discharge when eligible.

Education

• WHO 5 Moments for Hand Hygiene; isolation precaution rationale; wound care at home; antibiotic adherence; vaccine catch-up.
• For deeper foundational reading, see our nursing diagnosis guide and nursing interventions overview.

Nursing diagnosis for infection — 5 sample care plans

These five care plans cover the nursing diagnoses for infection you’ll see most often. Each uses NANDA-I–aligned educational language, current CDC, SSC 2026, and ACIP guidance, and the standard student template (diagnosis → defining characteristics / risk factors → goals → interventions with rationales → evaluation).

NANDA-I label verification. These examples use NANDA-I–aligned educational language. Verify exact diagnosis labels, definitions, defining characteristics, and related / risk factors in the licensed NANDA-I 2024–2026 text required by your school or facility before using these for graded paperwork or institutional documentation.

Care Plan #1 — Risk for Infection

The classic prevention-focused nursing diagnosis for infection. Applies to almost any patient with a portal of entry, immune compromise, or healthcare exposure.

Scenario. A 62-year-old patient post-op day 2 from CABG. Sternal incision intact and dressed. Two chest tubes, mediastinal drain, three peripheral IVs, central line, indwelling Foley, NGT. WBC 13 (post-surgical), T 37.9 °C, lungs clear, no signs of infection. On insulin for stress hyperglycemia (glucose 145).

Diagnosis (NANDA-I–aligned)

Risk for Infection related to multiple invasive devices (central line, peripheral IVs, mediastinal drain, chest tubes, indwelling urinary catheter, NGT), surgical wound, post-operative immune stress, perioperative hyperglycemia, and prolonged hospital stay.

(Risk-for diagnoses use “related to” only — no “as evidenced by.”)

Goals

• Throughout admission, the patient remains free of healthcare-associated infection (CLABSI, CAUTI, SSI, VAP, C. diff).
• Vital signs and inflammatory markers trend toward expected post-op recovery — no unexplained fever > 38.3 °C, WBC trending down, no new tachycardia or hypotension.
• Pre-discharge, the patient verbalizes incision care, hand hygiene, signs of wound infection, and when to call the provider.

Interventions and rationales

Evaluation

• Did the patient remain free of HAI through discharge?
• Were all indwelling devices removed at the earliest clinical opportunity?
• Did the patient teach back incision care and red flags?

Care Plan #2 — Active Infection (Cellulitis)

This scenario is built around an active soft-tissue infection. Verify the exact NANDA-I label required by your program. Depending on the patient’s defining characteristics, students may document a diagnosis such as Hyperthermia, Acute Pain, Impaired Skin Integrity / Impaired Tissue Integrity, or another NANDA-I-aligned label supported by the assessment. The interventions below apply regardless of the label chosen.

Scenario. A 54-year-old patient with diabetes presents with right lower leg cellulitis — spreading erythema with poorly demarcated borders, warmth, tenderness, edema. T 38.5 °C, HR 102, BP 124/76, WBC 14.2. Glucose 268. Started on IV antibiotics in the ED, admitted for monitoring.

Diagnosis (NANDA-I–aligned)

Infection related to bacterial invasion of the lower extremity soft tissue (cellulitis) in the setting of diabetes and likely hyperglycemia-impaired immune function, as evidenced by spreading erythema with warmth and tenderness on the right lower leg, T 38.5 °C, WBC 14.2, tachycardia, and elevated blood glucose.

Goals

• Within 48 hours of starting antibiotics, fever resolves and the patient reports decreasing pain.
• Erythema border does not expand; ideally retracts (mark the border to track).
• Pre-discharge, the patient verbalizes the full antibiotic course, return precautions, and diabetes-related infection-risk teaching.

Interventions and rationales

Evaluation

• Did fever resolve and erythema stop expanding?
• Did the patient transition to PO antibiotics safely?
• Did the patient teach back recurrence signs and diabetes-infection teaching?

Care Plan #3 — Hyperthermia

When fever is the dominant problem, hyperthermia is the priority diagnosis. Common in infection but also in heat illness, neuroleptic malignant syndrome, thyroid storm, and serotonin syndrome — context matters.

Scenario. A 34-year-old patient admitted with influenza A and bacterial superinfection. T 39.6 °C, HR 118, BP 116/72, RR 24, rigors, dry mucous membranes. Antibiotics started, antipyretics given. Patient reports feeling “freezing” with chills.

Diagnosis (NANDA-I–aligned)

Hyperthermia related to active infection (influenza A with bacterial superinfection) and systemic inflammatory response, as evidenced by T 39.6 °C, tachycardia, rigors, dry mucous membranes, and patient-reported chills.

Goals

• Within 4 hours of antipyretic administration, temperature decreases by at least 1 °C with improved comfort.
• Throughout admission, the patient maintains adequate hydration without evidence of dehydration.
• The patient verbalizes that fever is part of the immune response — comfort, not zero fever, is the goal.

Interventions and rationales

Evaluation

• Did temperature respond to antipyretics?
• Did hydration remain adequate?
• Did the patient teach back the fever-comfort principle?

Care Plan #4 — Risk for Sepsis (or Suspected Sepsis)

Infection that is escalating toward sepsis is one of the highest-impact deterioration scenarios on a med-surg floor.

Scenario. A 70-year-old patient with active CAUTI, day 2 of admission. New confusion (baseline alert), T 38.4 °C, HR 114, BP 102/64, RR 22, SpO₂ 93% on room air. Lactate 2.6. Facility sepsis screen positive. Bedside RN escalates.

Diagnosis (NANDA-I–aligned)

Priority problem: suspected sepsis requiring immediate escalation. Whether your school or facility documents this as a NANDA-I–aligned Risk for Sepsis label (when used as a deterioration-watch problem) or as an actual nursing diagnosis (when defining characteristics like new confusion, hypotension, oliguria, or lactate elevation are present), the priority is the same — activate the sepsis pathway. Suggested educational language: Risk for Sepsis Progression (or Suspected Sepsis) related to active urinary tract infection in an older adult with hemodynamic and laboratory warning signs (HR > 110, SBP < 100, lactate 2.6, RR ≥ 22) and new altered mental status.

Goals

• Within 1 hour of recognition, the facility sepsis pathway is activated — lactate, blood cultures × 2 when feasible, antimicrobials per severity-based timing (within 1 hour for septic shock or probable/definite sepsis per SSC 2026), IV crystalloid for sepsis-induced hypoperfusion (30 mL/kg within first 3 hours) with reassessment, vasopressors for MAP < 65 mm Hg not responding to fluids.
• Within 6 hours, the patient maintains MAP ≥ 65 mm Hg, lactate trends down, and organ function stabilizes.
• The patient is upgraded to a higher level of care per facility criteria and provider order.

Interventions and rationales

Evaluation

• Was the facility sepsis pathway activated with severity-appropriate antimicrobial timing?
• Did MAP, lactate, urine output, and mental status meet goals?
• Was the source identified and addressed?

Care Plan #5 — Deficient Knowledge: Infection Prevention

Patient and family education is one of the highest-leverage nursing interventions — and one of the most commonly graded care-plan diagnoses.

Scenario. A 56-year-old patient newly diagnosed with type 2 diabetes during admission for a soft-tissue infection. Reports she doesn’t routinely wash her hands before meals “unless they look dirty,” doesn’t track vaccines, and last had any vaccine 10+ years ago. She’s about to be discharged on oral antibiotics for 7 more days.

Diagnosis (NANDA-I–aligned)

Deficient Knowledge: Infection Prevention related to newly diagnosed type 2 diabetes, limited prior exposure to infection-prevention education, and self-reported gaps in hand hygiene and vaccine status, as evidenced by patient-reported infrequent hand hygiene, ≥ 10 years since last vaccine, and inability to verbalize medication adherence rationale on initial teaching.

Goals

• By discharge, the patient demonstrates the WHO 5 Moments for Hand Hygiene with teach-back.
• By discharge, the patient verbalizes the antibiotic course (drug, dose, duration, when to call) and demonstrates correct technique for any home wound care.
• Within 30 days of discharge, the patient establishes primary care follow-up, completes pneumococcal and influenza vaccination per ACIP, and verbalizes diabetes-specific infection prevention behaviors.

Interventions and rationales

Evaluation

• Did the patient demonstrate hand hygiene technique with teach-back?
• Did the patient verbalize the antibiotic course and home wound care?
• Were primary care follow-up, vaccine catch-up, and diabetes education referrals placed and confirmed?

Escalation red flags

Discharge and patient teaching

Practice question

A nurse is caring for a patient post-op day 1 with a central line, indwelling Foley, and a surgical wound. Which actions reflect appropriate infection-prevention nursing care? (Select all that apply.)

• A. Perform hand hygiene before and after every patient contact per the WHO 5 Moments
• B. Use alcohol-based hand rub as the sole hand hygiene method after caring for a patient with C. difficile
• C. Disinfect the central-line hub / needleless connector with the facility-approved antiseptic and allow it to dry before every access
• D. Review the necessity of the indwelling Foley each day and advocate for removal as soon as clinically appropriate
• E. Scrub the central line hub for at least 15 seconds before every IV access

Answer: A, C, D, E.

• A — WHO 5 Moments is the universal hand-hygiene standard.
• C — Disinfecting the hub / needleless connector with the facility-approved antiseptic and letting it dry is the correct nursing action before each access.
• D — Daily review and prompt removal is the most impactful single CAUTI prevention behavior.
• E — Scrub-the-hub for ≥ 15 seconds before every access reduces CLABSI risk.
• B — Incorrect. Alcohol-based hand rub does not kill C. difficile spores. Use soap and water after caring for patients with C. difficile infection per facility CDI policy.

FAQs

What is the most common nursing diagnosis for infection?

Risk for Infection is the most commonly used NANDA-I–aligned label for patients at risk but without current infection signs (post-op patients, immunocompromised, those with indwelling devices). When active infection signs are present, Infection is used as an actual diagnosis. Hyperthermia, Risk for Sepsis (or suspected sepsis when organ dysfunction is present), and Deficient Knowledge: Infection Prevention are also commonly used depending on the patient’s presentation. Verify exact wording against your licensed NANDA-I 2024–2026 text.

What’s the difference between Risk for Infection and Infection?

Risk for Infection applies when the patient has risk factors (immunosuppression, devices, broken skin) but no current evidence of infection. Infection applies when the patient has confirmed local signs (redness, warmth, swelling, pain, purulent drainage) or systemic signs (fever, leukocytosis, positive cultures). Risk-for diagnoses use “related to” only; actual diagnoses use both “related to” and “as evidenced by.”

What are the WHO 5 Moments for Hand Hygiene?

(1) Before patient contact; (2) Before aseptic procedure; (3) After body fluid exposure risk; (4) After patient contact; (5) After contact with patient surroundings. It’s the global standard for hand hygiene compliance and a core nursing intervention.

Why use soap and water instead of alcohol-based hand rub for C. difficile?

Alcohol does not kill C. difficile spores. Soap and water mechanically removes spores from the hands. For patients with C. difficile infection (CDI), use soap and water hand hygiene plus contact precautions with gowns and gloves. Sodium hypochlorite (bleach-based) cleaners are used for environmental surfaces.

What are the main healthcare-associated infections (HAIs)?

The CDC focuses on CLABSI (central line-associated bloodstream infection), CAUTI (catheter-associated urinary tract infection), SSI (surgical site infection), VAP (ventilator-associated pneumonia), and C. difficile infection (CDI). Each has a CDC-recommended prevention bundle that should be applied universally to applicable patients.

When should I escalate for sepsis?

Use your facility’s sepsis screening tool (NEWS2, MEWS, SIRS, or your organization’s pathway) per Surviving Sepsis Campaign 2026 — qSOFA can support escalation but should not be the sole screening tool. Bedside cues include RR ≥ 22, altered mental status, and SBP ≤ 100 mm Hg. Activate the facility sepsis pathway when criteria are met: lactate, blood cultures × 2, antimicrobials within 1 hour for septic shock or probable/definite sepsis, 30 mL/kg crystalloid within 3 hours for sepsis-induced hypoperfusion with reassessment, vasopressors for MAP < 65 unresponsive to fluids.

Related resources

• Nursing Diagnosis — full NANDA-I guide
• Nursing Interventions — independent, dependent, collaborative interventions explained
• Nursing Care Plan Template — fillable template you can adapt for any patient
• Nursing Process — the 5-step framework refresher
• ADPIE — Assessment, Diagnosis, Planning, Implementation, Evaluation
• Pneumonia Nursing Care Plan — companion care plan with deeper respiratory infection and sepsis-pathway detail
• Anemia Nursing Care Plan — companion care plan with neutropenic precautions and aplastic anemia infection-risk care
• Ineffective Tissue Perfusion Nursing Care Plan — companion care plan for sepsis hemodynamics
• Diabetes Nursing Care Plan — companion care plan for hyperglycemia-related infection risk

References

1. Herdman TH, Kamitsuru S, Lopes CT (eds). NANDA International Nursing Diagnoses: Definitions and Classification, 13th ed., 2024–2026. Thieme. https://nanda.org/
2. Centers for Disease Control and Prevention. Healthcare-Associated Infections (HAIs). https://www.cdc.gov/hai/index.html
3. Centers for Disease Control and Prevention. Core Elements of Hospital Antibiotic Stewardship Programs. https://www.cdc.gov/antibiotic-use/core-elements/hospital.html
4. World Health Organization. 5 Moments for Hand Hygiene. https://www.who.int/teams/integrated-health-services/infection-prevention-control/hand-hygiene
5. Siegel JD, Rhinehart E, Jackson M, Chiarello L, HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. CDC / HICPAC. https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html
6. Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 (with 2026 update). Critical Care Medicine. https://journals.lww.com/ccmjournal/Fulltext/2021/11000/Surviving_Sepsis_Campaign__International.21.aspx
7. Centers for Disease Control and Prevention / ACIP. Recommended Adult Immunization Schedule. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
8. Stevens DL, Bisno AL, Chambers HF, et al. IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections (2014). Clinical Infectious Diseases. https://academic.oup.com/cid/article/59/2/e10/2895845
9. McDonald LC, Gerding DN, Johnson S, et al. Clinical Practice Guidelines for C. difficile Infection in Adults and Children: 2017 Update by the IDSA and SHEA. Clinical Infectious Diseases. https://academic.oup.com/cid/article/66/7/e1/4855081
10. National Institute for Health and Care Excellence (NICE). Sepsis: Recognition, Diagnosis and Early Management (NG51). https://www.nice.org.uk/guidance/ng51
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Source notes. NANDA-I diagnoses, definitions, defining characteristics, and related / risk factors should be verified in the licensed NANDA-I 2024–2026 text before clinical documentation. CDC HAI prevention bundles, SHEA / IDSA antimicrobial guidance, WHO Hand Hygiene materials, Surviving Sepsis Campaign, and ACIP recommendations are updated periodically — cite the most current edition.