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

luvmy2angels · Aug 10, 2006

I thank you all for your wonderful ideas. I met with my RN supervisor last night and she had a meeting with the CNAs and then met privately with some of the aides we are having specific problems with. They were told AGAIN about our infection control policy and that if after this meeting they were seen not following proper protocol we would start issuing verbal and written warnings. We already had to give a verbal last night ( about 3 hour after the meeting). Hopefully things will go a little better tonight!!

rjf59 · Aug 10, 2006

I told the CNA's on my floor over and over to please not wear their gloves from room to room and to change them during care etc. They gave me a horrible time until I told them about a resident (un-named, of course) who had herpes of the eye. They got grossed out as I not only told them about that resident but also about some of the illness/disease that can be spread. Then I told them that IF I saw any of them from that point on, coming out of a resident's room with a pair of gloves on their hands, I'd write them up... They argued about how they'd bring the soiled linens out and I told them to bag it in the room and bring it out...It worked!!!

DusktilDawn · Aug 10, 2006

i think what also needs to be stressed when dealing with a co-worker who may not be following proper handwashing and gloving policies is this:

we not only follow these protocols to protect the patients, it is also to protect ourselves, someone may have something we don't about, and it may be what we don't know that causes the most harm.

rach_nc_03 · Aug 10, 2006

At one large hospital, my general orientation included a powerpoint presentation by the infection control nurse. She included GRAPHIC photos (identifying information removed, of course) illustrating various infections with comments on how they happened, and how they should be treated. Some were caused by hospital staff having poor hand hygiene, some by inadequate care, and a few were related to the condition being treated. She also read a few first-hand accounts from healthcare workers who had contracted diseases when treating a patient with ungloved hands, or because of improper disposal of sharps.

I think this would work- I've used examples of what I heard in this class when I've given infection control inservices, and they made lasting impressions. One of the examples we were given involved a CNA in a nursery where all the babies were ending up with MRSA infections; they finally traced it back to her- she had a chronic open sore on her forearm and wore a sweater over her scrubs to cover it. The sweater stayed at work and was obviously never washed, and bacteria from the sore had spread down to the cuff of her sleeve. :barf02:

peds4now, RN · Aug 10, 2006

A higher up should make sur ethe policies are clearly posted, an emergency intervention needs to be done, but definitely follow up with an in-service-somewhere where you sit down with refreshments and go over the cycle of infection transmission, tell some gross horror stories, and communicate expectations and repercussions clearly. This is good for any population, but particularly for CNAs, who work hard and always seem to have a "get no respect" attitude (perhaps for good reason? Anyways, I always try to show a bit extra)

raksha · Aug 10, 2006

It is good to see so many people behind handwashing. As a relativly new CNA at a LTC facility i was horrified to see how few of the staff ever wore gloves or washed their hands (even with purell). I was routinley mocked by nurses and other aides for my "addiction" to purrell and gloves!

Writing people up is one option, but may cause hard feelings. Something that worked for me at getting other aides to wash hands was simply to mention it "Oh, i left the water running for you!" or "Here have some of my sanitizer" or simply handing them the gloves before reaching the patient. It's not a perfect solution since it only works when your in the room with them, but might help some.

Marie_LPN, RN, LPN, RN · Aug 11, 2006

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.

Gross.

I'd run out of incident report sheets in that facility.

jb2u, ASN, RN · Aug 12, 2006

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??

First, as a cna, I'd like to say that I take no offense to what you are saying. Second, I'm sure we can all agree that there are problems with infection control by all types of care givers, including the pt's family members. I've witnessed plenty of nurses doing procedures without gloves, going into isolation rooms to give pt care without following precautions, and yes, I don't believe that doctors follow the basics either. How many clean the bell of their stethoscopes between pts. I know I do and I'm sure some doctors/nurses do, but not all.

That being said, I agree with you, talking to the cna's in question is like talking to a wall....and talk is cheap. I say write up then fire. The pt is every nurses concern. If pt's are in danger of getting an infection because of improper cleaning or not washing their hands in between pts, then it is the nurses job to see to it this threat is dealt with. I saw the thread where you stated that management is behind you on this and I hope it remains so. The shortage of cna's makes it harder to replace/fire bad ones. Sad, but true!

Good luck and keep taking care of those pts.

Jay

jb2u, ASN, RN · Aug 12, 2006

What drives me nuts is when I see a transport person pushing a patient down a hallway in the hospital wearing gloves!!?!!

I've worked as a transporter and when transporting a pt with, let's say MRSA/VRE/CDIFF, I wore gloves while transporting said pt. Contact precautions does not end when one leaves the room to go to x-ray.

I also carried gloves with me because you never know what is going to happen. I had a foley bag drop and break on me. If it were not for my gloves in my pocket I'd be in trouble and if someone saw me wearing them they would probably THINK that I should not be doing that instead of seeing me as the prepared person that I am. It's all about perspective....if you walk in a room and see someone leaning over the balcony and a man has his hands towards the person leaning...........is he pushing the person over the balcony or is he trying to save the person. You just don't know.