Getting CNAs to WEAR GLOVES & WASH HANDS?!?!

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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??

Specializes in Utilization Management.
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.

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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. :o

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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.

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Specializes in Orthosurgery, Rehab, Homecare.
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.

:yeahthat:

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)

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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.

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Specializes in NICU, ER, OR.
[evil]EXCUSE ME?[/evil] 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........:uhoh3:

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
[EVIL]EXCUSE ME?[/EVIL] 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.

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Specializes in Adolescent Psych, PICU.
[EVIL]EXCUSE ME?[/EVIL] I would appreciate it if you did not lump ALL of the CNAs in with the complete idiots.

She didn't.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Tell them that a resident/patient has herpes, but don't tell them which one. HSV is pretty common (many people have it but never get a flare-up), so it prolly wouldn't be a total lie. While I was working LTC, a resident did have herpes, which made me doubly careful, and I'd tell new people that there were some residents that had herpes, but didn't tell them which ones. That tended to help, especially since diaper rash looks like herpes to the untrained eye. However, if there's people who won't learn, you just have to report them. This is hard, as you'll be seen as a nasty tattletale and you'll be shortstaffed if the CNA gets fired (this is the eternal catch-22 of nursing homes).

I know what you mean about CNAs not washing their hands or wearing gloves. I worked as a CNA in a nursing home, and it was disgusting. I distinctly remember this one woman who had these long nasty acrylics and ornate jewelry, and she NEVER WORE GLOVES, even when I offered her gloves. She barely spoke English, and I don't know how she got her CNA license. The problem with CNAs is that a chunk of them are uneducated and sadly, it doesn't take much to be a CNA. In a perfect world, LTC facilities could afford to be picky. I did meet some great CNAs, but most of them left b/c the ones who cared had to do the work of the people who didn't care, and it was a stressful, strenuous, low-paying job.

Not a good idea. Better one would be to notify your manager, infection control nurse or risk mgt department about this ongoing problem, if you can't seem to get them to do what they should yourself.

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Specializes in orthopaedics.

i am agreeing with dusktildawn. there needs to be a mandatory inservice reviewing the basics of hand hygeine and pericare. it would be hard to police everybody, but something needs to be done.

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Our LTCF regularly runs out of gloves!! This is just amazing to me that they can't keep adequately stocked on such things.

From what I can observe, the CNA's there are good about hand-washing. But some of them have been around a long time, and think that these sweet old folks could never have anything nasty come from their bodies.:o

I have to say that some nurses are just as bad - I was trained to use gloves when instilling eye gtts, but most of the nurses don't use gloves or wash their hands when doing that. :uhoh3:

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I worked in a LTC (as a social worker, not a nurse) and that home had a fiercely enforced policy about gloves. The CNA was not allowed to don gloves until ready for patient care and had to take them off immediately after patient care. Any CNA caught "traveling" with gloves on was instantly written up even if they just forgot to remove them before leaving a patient room.

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