For information and reference only – not to be submitted as your own work.
This model-answer extract shows how a strong response to the Open Polytechnic STE404 Foundations of Sterilising Practice Assessment 1 can be structured: hand hygiene, personal protective equipment (PPE), the chain of infection and a clause from AS/NZS 5369:2023. It is built around the assessment described on the STE404 Assessment 1 question page, and our step-by-step guide to answering STE404 Assessment 1 explains the planning behind it. The sibling task is covered separately on the STE404 Assessment 2 question page.
Planning table
| Task and question | What the marker looks for | Suggested words (illustrative) |
|---|---|---|
| Task 1, Q1 (15 marks) | Hand hygiene before and after handling contaminated items, and why timing matters | 110 |
| Task 1, Q2 (15 marks) | PPE selection plus donning and doffing sequence | 110 |
| Task 1, Q3 (10 marks) | Every breach, each linked to blood-borne exposure and spread | 100 |
| Task 1, Q4 (10 marks) | One AS/NZS 5369:2023 clause tied to the breaches | 80 |
| Task 2, Q1 (10 marks) | Unsafe PPE practices linked to the chain of infection | 150 |
| Task 2, Q2 (20 marks) | Professional, in-the-moment responses | 220 |
| Task 2, Q3 (20 marks) | Personal reflection and learning | 230 |
Task 1: Breaking the chain of infection during manual cleaning
Question 1: Hand hygiene and timing
Hand hygiene is the single most reliable barrier between contaminated instruments and the next person or surface that hands touch. Before handling contaminated items, hands and forearms should be clean, nails short and free of polish, and jewellery removed, so that gloves can be donned over intact, decontaminated skin. After handling contaminated items, and immediately after removing gloves, hands must be cleaned again, because gloves can have microscopic defects and hands are easily contaminated during removal (World Health Organization [WHO], 2009; Siegel et al., 2007). When hands are visibly soiled, soap and water is required rather than an alcohol-based rub.
Timing matters because microorganisms are transferred at specific moments. Cleaning hands before a task protects the instrument and the clean environment from the worker’s flora, while cleaning after the task and after glove removal protects the worker, colleagues and clean areas from blood and body fluid residue. The Health Quality & Safety Commission (n.d.-a) notes that New Zealand’s national hand hygiene programme applies the WHO multimodal strategy, which reflects this moment-based approach.
Question 2: PPE selection, donning and doffing
PPE must match the exposure expected, not the habit of the day. Manual cleaning of contaminated forceps generates splashes and aerosols, so the worker needs a fluid-resistant gown or apron, impervious gloves of suitable length, a mask and eye or face protection. PPE is worn whenever exposure to infectious material is anticipated (Health Quality & Safety Commission, n.d.-b).
Sequence matters because the outside of PPE becomes contaminated during use. Donning in a planned order (gown, mask, eye protection, then gloves over the gown cuffs) leaves no gaps, and doffing in a controlled order (gloves, eye protection, gown, mask, followed by hand hygiene) keeps contaminated surfaces away from skin, hair and clothing (Siegel et al., 2007). A mistake in either sequence converts protective equipment into a source of exposure.
Question 3: Breaches in the scenario
| Breach | Link to blood-borne exposure | Spread in sterile services |
|---|---|---|
| Gloves worn without eye protection while scrubbing forceps | Splashes can reach the conjunctivae, a recognised route for blood-borne pathogens | Contaminated hands then touch face, equipment and clean surfaces |
| Gloves removed for a phone call | Bare hands may contact contaminated surfaces or residual soil, and the phone becomes contaminated | The phone carries organisms between dirty and clean zones |
| Same gloves put back on | Contaminated outer surfaces touch the hands and possible skin breaks | Organisms are transferred to instruments and surfaces still to be handled |
| No hand hygiene on glove removal or before re-gloving | Skin retains contamination | Cross-contamination continues through each touched surface |
Together the breaches interrupt several links in the chain of infection: they open a portal of exit from the reservoir (contaminated instruments), allow transmission by contact, and provide a portal of entry through mucous membranes or non-intact skin.
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Question 4: AS/NZS 5369:2023
AS/NZS 5369:2023 sets out requirements for reprocessing reusable medical devices, including the protection of personnel through safe work practices, appropriate PPE and hand hygiene in the decontamination area (Standards New Zealand, 2023). The clause on personnel protection in the decontamination area directly supports the analysis above: it expects PPE suited to the task and safe handling of contaminated devices, which the scenario does not meet when eye protection is omitted and gloves are removed and reused. When writing your own answer, quote the exact clause number from the copy of the standard supplied by your provider and explain one breach against it in your own words.
Task 2: PPE use to break the chain of infection
Question 1: Unsafe PPE practices
Gloves and gowns without face shields leave the mucous membranes of the eyes, nose and mouth exposed to splash during loading of a washer-disinfector, creating a portal of entry for blood-borne viruses. A mobile phone in a pocket is a fomite: it is handled with gloved or clean hands, cannot be effectively disinfected by the user during work and may carry organisms into clean areas. A gown that is not tied at the back exposes the uniform and skin to contaminated load material and may drag on surfaces, so the worker becomes a means of transmission to colleagues and to clean instruments (Siegel et al., 2007; Standards New Zealand, 2023).
Question 2: Responding in the moment
I would raise each issue immediately, privately and respectfully, because the risk is ongoing. For the missing face shields, I would quietly offer a clean shield and say that I am putting mine on before reloading, which models the behaviour without blame. For the phone, I would ask the colleague to leave it in a locker or designated clean area, offering to check that it is safe to do so, and suggest hand hygiene if it has been touched. For the untied gown, I would offer to retie it, or ask the colleague to pause and redress. If a colleague disagreed or the practice continued, I would escalate calmly to the shift supervisor or infection prevention and control lead, and record the event according to local reporting procedures. The aim is a learning conversation rather than a reprimand, consistent with a just culture in which staff feel safe to speak up.
Question 3: Reflection (illustrative wording only)
Use your own genuine experience here. As an illustrative structure: describe the situation briefly, state what you felt unsure about (for example, whether to change gloves between a clean and a dirty task), explain what you did (stopped, checked the procedure and asked a senior colleague), and state what you learned (to check local policy before starting and to do hand hygiene on every glove change). End with a commitment to practice, such as reviewing the donning and doffing sequence at the start of every shift.
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References
Health Quality & Safety Commission. (n.d.-a). Hand hygiene [Web page]. Te Tāhū Hauora. https://hqsc.govt.nz/our-work/infection-prevention-and-control/topics/hand-hygiene
Health Quality & Safety Commission. (n.d.-b). Standard and transmission-based precautions [Web page]. Te Tāhū Hauora. https://www.hqsc.govt.nz/our-work/infection-prevention-and-control/ipc-practices/precautions-standard-and-transmission-based
Siegel, J. D., Rhinehart, E., Jackson, M., Chiarello, L., & the Healthcare Infection Control Practices Advisory Committee. (2007). 2007 guideline for isolation precautions: Preventing transmission of infectious agents in health care settings. American Journal of Infection Control, 35(10, Suppl. 2), S65–S164.
Standards New Zealand. (2023). AS/NZS 5369:2023 Reprocessing of reusable medical devices and other devices in health and non-health related facilities. https://www.standards.govt.nz/shop/ASNZS-53692023
World Health Organization. (2009). WHO guidelines on hand hygiene in health care: First global patient safety challenge, clean care is safer care. WHO Press.
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