[Drifternurse]

YES fire them(if you have that kind of authority) or write up/report those CNAs who don't wash their hands and/or wear gloves--they are further risking an elderly pt's health that is already compromised!!! Most LTCs have a progression of discipline that is followed before termination occurs; I'd recommend following that progression.

I disagree with the suggestion of telling CNAs that a pt (or pts) has herpes as a motivation. Those who REALLY care (to know the dx of pts) will look in their charts and find out you lied about it and there goes your credibility(and many CNAs I've encountered don't think were too credible to begin with!).

[Danianne]

I am sorry I was led to believe that you had to have some sort of education to be a CNA my bad. I get paid very well for what I do and then again there are CNAs who get paid very well to do nothing. Yes tell them that someone has herpes or scabies.


ohhh wait worms...there are more than 15 million people in the U.S. that are infected and don't even know it

[Angie O'Plasty, RN]

Originally Posted by Danianne

I am sorry I was led to believe that you had to have some sort of education to be a CNA my bad. I get paid very well for what I do and then again there are CNAs who get paid very well to do nothing. Yes tell them that someone has herpes or scabies.

The sad part is that in any given population, you will have one or two that have undiagnosed cases of something communicable, so you won't necessarily be untruthful.

[Tessa4RN2B]

Wow, this post actually got my attention. At the LTCF where I work, almost all the cna's and care staff have some degree of difficulty with english. It is very frustrating since all the lead/management staff speak english fluently and they (cna's and care staff) do not. I'm new to the facility (6 months) and I used to take offense to the staff because I speak english fluently. They have tremendous difficulty with the idea of infection control. When I brought it up with our nurse (whom I don't respect) she took offense to my suggestions. Hence the reason I no longer have respect for her. I'm only doing what I'm suppose to do and I get the bad reputation of thinking I'm better than everyone else. I'm hoping to move on to another facility where my attention to infection control/ washing hands/using gloves is appreciated. So yes, I totally understand with the frustration. Basically you can not change people and from what I learned at our LTCF the lead/management staff is totally dependent on their non-english speaking staff.

[buildingmyfaith57]

i would hate to be that cna or any of the cna who doesn't wash their hands or if they are caught by the state they will lose their cna's and the facility itself will be written up also.

[MS._Jen_RN]

Originally Posted by Angie O'Plasty, RN

In addition to the above suggestions, you might also have an education on "Wipe from FRONT to BACK."

I recall my surprise at seeing how many CNAs were never taught that very basic principle, and it is one very common reason for E. Coli UTIs.

Also, the residents sitting in soiled incontinent pads could also be a source of contamination.

Those two are probably the source of the UTI's, not the lack of gloves. (Not that they shouldn't be wearing them anyways for other reasons.)
~Jen
Another thought, maybe just asking them- how do you know that Mrs X doesn't have Hep A? (or insert anyother appropiate Dx)

[DusktilDawn]

Originally Posted by luvmy2angels

Any suggestions on how to enforce the importance of infection control??? Over the past 2 weeks we have had 4 new residents get UTIs the bacteria...e-coli. Some of the aides don't wear gloves at all and don't wash hands, some wear gloves and don't change them between residents. Last week we had an aide going around and cleaning under residents fingernails USING THE SAME ORANGE STICK for all of them! No matter how many times they are reminded to wear gloves and wash hands they DON'T do it!! Is this something that you can write up a CNA for?? I am thinking we need to do something to drive home the point of infection control because talking to them is like talking to a WALL!!! Any suggestions??

Have you suggested to management to have inservices on infection control that focuses on areas where there are the most problems:
1. The importance of handwashing and appropriate use of gloves
2. Appropriate use of gloves, including washing hands and donning a new pair for each pt when used.
3. The importance of not sharing grooming items between patients, including orange sticks, soaps, brushes, etc. (worked at one facility where Staph aureus was a huge problem because the same soap bar was being used)
4. As others have mentioned, front-to-back when cleaning genitals. Also reviewing bedbathing procedures, for example:
fartherst to nearest
distal to proximal
for eyes: inner to outer canthus AND using a separate cloth for this

At these inservice it could also be mentioned that failure to follow infection control protocols can result in disciplinary action. Make the standards clear to to everyone. By reviewing with everyone what is expected and stating what the consequenses are for not following these protocols, the staff can't claim ignorance of what their expectations are and the consequences for not complying.

[RNOTODAY]

Originally Posted by Danianne

EXCUSE ME?

I would appreciate it if you did not lump ALL of the CNAs in with the complete idiots. SOME of us are extremely careful about infection control.

Where did she say or imply ALL? She specifically said some, and was talking about the cna's HER place of work..... relax, or something........

[SmilingBluEyes]

Originally Posted by Danianne

EXCUSE ME?

I would appreciate it if you did not lump ALL of the CNAs in with the complete idiots. SOME of us are extremely careful about infection control.

No one lumped anyone in. The words were "some CNA's"...not all. Try not to be too sensitive here ....

But you do have a point. And it's not just CNA's not doing what they should. I have seen many doctors, RTs and nurses also not wash and/or glove up when they should be. It's an ongoing problem that some infection control depts are taking very seriously and tracking now.

[marilynmom]

Originally Posted by Danianne

EXCUSE ME?

I would appreciate it if you did not lump ALL of the CNAs in with the complete idiots.

She didn't.