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Srujal Nicole Prachi Celina Katie Jaxmaureen Taylor M Shinera Sergio Alexa Nick Sagar Allison Dana Sabrina Rishi Jessica Pierce James. Christian Michal Kristen Ravina Avani Juhi Masaumi Eduardo. C Dec/Jan. A/B (November). D Jan/Feb. Edward Dan Danielle Taylor L

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tentative cna clinical groups

Srujal

  • Nicole
  • Prachi
  • Celina
  • Katie
  • Jaxmaureen
  • Taylor M
  • Shinera
  • Sergio
  • Alexa
  • Nick
  • Sagar
  • Allison
  • Dana
  • Sabrina
  • Rishi
  • Jessica
  • Pierce
  • James
  • Christian
  • Michal
  • Kristen
  • Ravina
  • Avani
  • Juhi
  • Masaumi
  • Eduardo
  • C Dec/Jan

A/B (November)

  • D Jan/Feb
  • Edward
  • Dan
  • Danielle
  • Taylor L
  • Erin
  • Jessica
  • Neil
  • Hubert
  • Bailey
  • Rachel
Tentative CNA clinical Groups
infection control

Infection control involves preventing & controlling the spread of disease in a healthcare facility.

  • All care team members must work to prevent the spread of disease.
  • All facilities have infection control policies.
Infection control
microorganisms

Microorganisms (also called microbes) are tiny living things that can only be viewed through a microscope.

  • Pathogens are harmful organisms that invade the body & multiply.
  • Pathogens cause infections.
Microorganisms
infections

Systemicinfections

    • Infection in the bloodstream spread throughout body.
    • Generalized symptoms: fever, chills, confusion.
  • Localized infections
    • Located in specific part of body.
    • Causes symptoms at site of infection.
  • Healthcare-associated infections (HAIs) are acquired in healthcare settings, as a result of Txfor other conditions. (AKA: nosocomial infections.)
Infections
2 kinds of asepsis

Medical asepsis – process of removing all pathogens.

    • “Clean” – not contaminated with pathogens
    • “Dirty” – contaminated with pathogens
  • Surgical asepsis – process of removing all micoorganisms, not just pathogens.
    • Also called “sterile technique”
2 kinds of asepsis
matching

____Measures practiced in agencies to prevent & control the spread of infection.

  • ____A harmful microbe.
  • ____Infections that are the result of treatment for other conditions.
  • ____Tiny living things that cannot be seen s a microscope.
  • ____Occurs when pathogens invade the body & multiply.
  • ____Infection that is confined to a specific part of the body.
  • Healthcare-associated infection
  • Infection
  • Infection control
  • Localized infection
  • Microorganism or microbe
  • Pathogen
Matching
matching1

____The state of being free of all microbes, not just pathogens.

  • ____The process of removing pathogens, or the state of being free of pathogens.
  • ____When pathogens are in the bloodstream & spread throughout the body.
  • ____In healthcare, objects that have not been contaminated with pathogens.
  • ____In healthcare, objects that have been contaminated with pathogens.
  • Clean
  • Dirty
  • Medical asepsis
  • Surgical asepsis
  • Systemic infection
Matching
chain of infection1
Causative agent (pathogen): can be bacteria, fungi, viruses, or protozoa. May be normal flora in one part of body, pathogenic in another.Chain of infection
chain of infection3
Portal of exit is any opening in the body that allows pathogens to leave (mouth, eyes, wound in skin).Chain of infection
chain of infection4
Mode of transmission describes how the pathogen travels from one person to next person (can be by direct contact or indirect contact).Chain of infection
chain of infection5
Portal of entry is any body opening that allows a pathogen to enter (mouth, eyes, nose, mucous membrane, or break in skin).Chain of infection
chain of infection7
Infection prevention practices & vaccinations break links in the chain of infection to stop the transmission of infection.Chain of infection
matching2

____opening on an infected person that lets pathogens leave.

  • ____opening on uninfected person that lets pathogens enter.
  • ____pathogen, microbe that causes disease.
  • ____place were pathogen lives & grows.
  • ____uninfected person who could get sick.
  • ____how pathogens travel from one person to another.
  • Causative agent
  • Reservoir
  • Portal of exit
  • Mode of transmission
  • Portal of entry
  • Susceptible host
Matching
risk of infection
Elderly are at high risk for infection.

Immune systems are weaker.

Chronic illnesses

Decreased circulation

Slow wound healing

Malnutrition due to difficulties chewing &/or swallowing, appetite & thirst, weakness, medications

Limited mobility

Frequent hospitalizations.

Risk of infection
risk of infection1
Infection is more dangerous for the elderly.

Simple illnesses can turn life-threatening

Recovery takes longer.

Prevention is the key.

Risk of infection
signs symptoms of infection
S & S of local infection.

Fever

Body aches

Pus

Drainage

Swelling

Heat

Signs & symptoms of infection
signs symptoms of infection1
S & S of systemic infection.

Pain

Body aches

Chills

Nausea

Vomiting

Weakness

Headache

Confusion

blood pressure

Signs & symptoms of infection
true or false

____ The elderly have a higher risk for infection than younger people.

  • _____It is normal for a person’s immune system to grow weaker as he or she ages.
  • _____ Blood circulation increases as a person ages.
  • ____ Limited mobility increases the risk of pressure sores as a person ages.
  • _____Nutrition & fluid intake play no part in helping prevent infection.
True or false
true or false1

____ The elderly are less likely than younger people to have HAIs.

  • _____Infections are less dangerous in the elderly than in young people.
  • _____ CNAs play an important role in protecting elderly residents from infections.
  • ____ Redness & swelling are common symptoms of systemic infections.
  • _____Fever, chills, & confusion are symptoms of systemic infection.
True or false
infection control precautions

The CDC (Centers for Disease Control & Prevention) is a government agency that promotes public health of Americans.

    • Recommended new infection control system in 1996 to reduce risk of infectious disease in health care settings.
    • 2 tiers of precautions
      • Standard precautions
      • Transmissions-based (isolation) precautions
Infection control precautions
standard precautions

Standard precautions means to treat all blood, body fluids, & non-intact skin & mucous membranes as if they were infected with an infectious disease.

  • For standard precautions, “body fluids” include saliva, sputum (coughed up mucous), urine, feces, semen, vaginal secretions, pus or wound drainage.They do NOT include sweat.
  • Remember standard precautions should ALWAYS be practiced with everyone.
  • Transmission based precautions are based on how an infection is transmitted & are used in addition to standard precautions.
Standard precautions
standard precautions1

Always practice standard precautions c every person in your care.

  • Wash hands a & p gloving.
  • Do not touch clean objects while wearing gloves.
  • Wear gloves q time you may come into contact with blood or body fluids
    • Includes mouth care, toileting, cleaning up spills or containers that have held body fluids.
Standard precautions
standard precautions2

Remove gloves immediately when finished c procedure

  • Immediately wash all skin surfaces that have been contaminated c blood or body fluids
  • Wear gloves & use caution when handlingsharps (needles, blades, anything that can cut or pierce skin). Discard these objects in a puncture-resistant biohazard container.
Standard precautions
standard precautions3

Never cap a needle or syringe. Dispose of them in a biohazardous waste container.

  • Avoid nicks & cuts when shaving residents.
  • Carefully bag all contaminated supplies & dispose of them according to facility policy.
  • Clearly label body fluids that are saved for a lab specimen. Keep them in a container with a lid & transport them in a biohazard specimen bag.
  • Dispose of contaminated liquid waste in sewer system. Avoid splashing.
Standard precautions
true or false2

____ Standard precautions means treating all blood, body fluids, non-intact skin, & mucous membranes as if they were infected.

  • _____Standard precautions relate to all body fluids except saliva.
  • _____ You can usually tell if someone is infectious by looking at him.
  • _____ The CDC is a government agency that issues information to protect the health of individuals & communities.
True or false
true or false3

____You should wash your hands before putting on gloves.

  • _____Syringes should be re-capped p use.
  • _____Giving mouth care will require you to wear gloves.
  • _____It is a good idea to wear a mask & goggles to empty a bedpan.
  • _____When cleaning a urinal, you don’t need to wear gloves.
True or false
multiple choice

Standard precautions should be practiced

    • Only on people who look like they have a bloodborne disease.
    • On every single person in your care.
    • Only on people who request that you follow them.
    • Only people who have tuberculosis.
Multiple choice
multiple choice1

Standard precautions include the following measures

    • Using your used or soiled gloves to gather clean equipment.
    • Wearing gloves if there is a possibility of contact with blood, body fluids, mucous membranes, or broken skin.
    • Touching body fluids with your bare hands.
    • Putting caps on used needles.
Multiple choice
multiple choice2

Which of the following is true of transmission-based, or isolation precautions?

    • You do not need to practice standard precautions if you practice transmission-based precautions.
    • They are exactly the same as standard precautions.
    • They are practiced in addition to standard precautions.
    • They are never practiced at the same time that standard precautions are used.
Multiple choice
hand hygiene

CDC definition of hand hygieneincludes both:

    • handwashing with either plain or antimicrobial soap & water
    • using alcohol-based hand rubs (gel, rinse, or foam).
  • Alcohol-based hand rubs are not a substitute for handwashing.
  • Always use soap & water for visibly soiled hands.
Hand hygiene
hand hygiene1

Consider removing rings while working. They may increase the risk of contamination.

  • Keep fingernails short, smooth, & clean.
  • Artificial nails harbor bacteria & risk contamination.
  • Always wash hands a & p handling food.
  • A & p applying makeup.
  • P contact c pets or pet care items.
  • A you start work & a you leave.
Hand hygiene
multiple choice3

You will come in contact c microbes

    • Only in public areas of the facility.
    • Only during direct contact c residents.
    • Only during personal care procedures.
    • Q time you touch something.
Multiple choice
multiple choice4

You will come in contact c microbes

    • Only in public areas of the facility.
    • Only during direct contact with residents.
    • Only during person care procedures.
    • Every time you touch something.
  • Why is it a bad idea to wear artificial nails to work?
    • Residents may not like them.
    • They may be lost.
    • They harbor bacteria.
    • They may be damaged by frequent handwashing.
Multiple choice
multiple choice5

Alcohol-based hand rubs are used

    • With water for maximum effectiveness.
    • When agency runs out of antimicrobial soap.
    • To prevent dry, cracked skin.
    • In addition to washing c soap & water.
  • The CDC defines hand hygiene as
    • Handwashing c soap & water & using alcohol-based hand rubs.
    • Using only alcohol-based hand rubs.
    • Rinsing ands c water.
    • Not washing hands more often than once per day.
Multiple choice
personal protective equipment ppe

Protects employees from contact with workplace hazards.

  • It is the employers responsibility to provide appropriate PPE to wear
  • Includes gloves, gowns, masks, face shields, & goggles.
Personal protective equipment (PPE)
personal protective equipment ppe1

GLOVES

    • Any time you will be in contact with blood or body fluids
    • Oral care & shaving
    • Personal care on non-intact skin
    • Disposing of soiled bed linens or clothing
    • Any time you have open sores or cuts on your hands (1st cover area c bandage or gauze)
    • Use them only once & discard.
Personal protective equipment (PPE)
personal protective equipment ppe2

Gowns

    • Protect clothing & exposed skin
    • Should fully cover torso
    • Should fit snugly at wrists
    • Remove it if wet or soiled, check clothing & put on a clean gown
Personal protective equipment (PPE)
personal protective equipment ppe3

Masks & goggles

    • Masks are worn c residents who have respiratory illnesses (TB requires special masks)
    • Must fit snugly over nose & mouth to prevent fluid penetration
    • Goggles protect eyes. Glasses are inadequate.
    • Should fit snugly over & around eyes or glasses
Personal protective equipment (PPE)
personal protective equipment ppe4

Face Shields

    • Substitutes for a mask & goggles
    • Should cover forehead & extend below chin
    • Wraps around sides of face
    • Always follow company policy
Personal protective equipment (PPE)
handling equipment linen

Utility rooms

    • There are separate utility rooms for “clean” & “dirty” supplies.
    • Always wash hands a entering the clean utility room & a leaving the dirty utility room.
Handling equipment & linen
handling equipment linen1

Cleaning equipment

    • General cleaning removes microbes, but doesn’t kill them. This is adequate for supplies that only touch intact skin (BP cuff)
    • Sterilization destroys ALL microbes using steam under pressure, chemicals, or dry heat. Used for items that come in contact c normally sterile areas.
    • Disinfection kills all pathogens, but not all microbes, using chemicals or pasteurization.
Handling equipment & linen
handling equipment linen2

Handling equipment & cleaning

    • Always avoid contact c portals of entry/exit
    • Avoid contaminating your clothing
    • Don’t transfer disease between residents
    • Dispose of disposable equipment after use
    • Don’t reuse equipment shared between residents until it has been cleaned
    • Clean all environmental surfaces, freq touched surfaces, beds, rails, & freq touched surfaces
Handling equipment & linen
handling equipment linen3

Handling linen

    • Handled soiled linens & clothing to avoid contact with skin & mucous membranes
    • Hold linen away from uniform
    • Don’t shake linens of clothes
    • Roll dirty linens so soiled area is on inside
    • Bag soiled linen at point of origin
    • Sort soiled linen away from patient care areas.
    • Place wet linen in leak-proof bags
Handling equipment & linen
handling spills

Always wear gloves

  • Absorb spill according to policy
  • Scoop up absorbed spill & dispose according to policy
  • Apply disinfectant & wait 10 minutes
  • Use proper cleaning solution
  • Do not pick up pieces of broken glass. Use dustpan & broom or other tools.
  • Use biohazard containers according to policy.
Handling spills
matching3

____ A measure that destroys all microbes, including pathogens.

  • ____ A process that kills pathogens, but not all microbes.
  • ____ Only to be used once & then discarded.
  • Disinfection
  • Disposable
  • Sterilization
Matching
true of false

____You do not need to wear gloves to clean up a small spill.

  • ____Place a disinfectant directly on the spilled fluid a absorbing & removing the fluid
  • ____It’s okay to use your hands to pick up large pieces of glass & use a broom & dustpan for smaller pieces.
  • ____Waste containing body fluids may be disposed of in the trash can in the cafeteria.
  • ____An absorbing powder may be used to absorb a spill before removing it.
True of false
transmission based isolation precautions

CDC has established 2nd level of precautions (beyond standard precautions )for persons who are infected or suspected of being infected.

  • Transmission-based precautions will always be listed on the care plan & assignment sheet.
Transmission-based (isolation) precautions
transmission based isolation precautions1

3 categories of transmission-based precautions

    • Airborne precautions
    • Droplet precautions
    • Contact precautions
  • Category depends on the disease & how it spreads
  • May be used in combination for diseases c multiple routes of transmission
Transmission-based (isolation) precautions
transmission based isolation precautions2

Multidrug resistant organisms (MDROs) may require additional isolation procedures

    • MRSA –methacillin-resistant staph aureus
    • VRE – vancomycin-resistant enterococcus
    • C-diff – clostridium difficile
    • Scabies
    • Lice
    • Influenza (during outbreak)
Transmission-based (isolation) precautions
airborne precautions

Used for diseases transmitted through expelled air

  • Pathogens are so small they remain floating for a long time
  • May require you to wear a special mask (N-95 or HEPA mask) to avoid infection
  • Includes: tuberculosis, measles, chickenpox
Airborne precautions
droplet precautions

Used for diseases transmitted by coughing, sneezing, talking, laughing, or suctioning

  • Pathogens don’t stay suspended in air, usually don’t travel more than 3 feet
  • Require face mask during care & restricted visits from uninfected people
  • Infected residents must wear masks when out of their room
  • Includes: mumps, influenza, scarlet fever
Droplet precautions
contact precautions

Used when there is a risk of transmitting an infection by touching an infected object or person

  • Includes wearing PPE & resident isolation
  • Requires washing c antimicrobial soap & not touching infected surfaces c ungloved hands or uninfected surfaces c contaminated gloves
  • Examples: hepatitis, VRE, MRSA, lice, scabies
Contact precautions
isolation guidelines

PPE may be outside room, or inside room

  • Used PPE should be disposed ofin appropriate container a leaving resident’s room
  • Hand sanitizer or handwashing area should be available where PPE is removed
  • Don’t share supplies between residents. Use disposable supplies whenever possible, or dedicated supplies that don’t leave the resident’s room
Isolation guidelines
isolation guidelines1

Wear PPE when serving food & drink. Do not leave uncovered food in resident’s room. Remove tray to designated area.

  • Body waste must be disposed of to minimize splashing & spraying. Gown & goggles may be indicated.
  • Do not contaminate outside of specimen containers.
  • Do not avoid resident or rush through tasks.
Isolation guidelines
transmission based precautions

Indicate “A” for airborne, “D” for droplet, “C” for contact.

  • ___Transmission occurs c skin to skin contact during bathing & transfers.
  • ___Used when there is risk from touching an infected object or person
  • ___Used to guard against tuberculosis & measles.
  • ___Helps prevent the spread of lice & bacterial conjunctivitis (“pink eye”).
Transmission-based precautions
transmission based precautions1

Indicate “A” for airborne, “D” for droplet, “C” for contact.

  • ___Covering mouth & nose when coughing or sneezing & washing hands afterward.
  • ___Used when microbes don’t stay suspended in air, traveling not more than 3 feet.
  • ___Microbes are transmitted by coughing, sneezing, laughing, talking, or suctioning.
  • ___Helps prevent the spread of illnesses transmitted through air.
Transmission-based precautions
transmission based precautions2

Indicate “A” for airborne, “D” for droplet, “C” for contact.

  • ___Helps prevent the spread of mumps.
  • ___May require the use of a special mask, such as N-95 or HEPA.
Transmission-based precautions
multiple choice6

Transmission-based precautions are used

    • Every day on the job
    • In addition to standard precautions
    • Instead of standard precautions
    • When treating all residents c terminal illnesses
  • Dedicated equipment is
    • Used by multiple residents.
    • Donated to a resident by another resident.
    • Disposable.
    • Only used by one resident.
Multiple choice
multiple choice7

Which is true of wearing PPE while caring for residents in isolation

    • CNAs will have to decide for themselves which PPE they must wear while caring for residents in isolation.
    • CNAs should remove PPE a exiting a resident’s room.
    • CNAs will always wear the same PPE while caring for all residents in isolation.
    • CNAs should remove PPE p exiting a resident’s room.
Multiple choice
multiple choice8

When a resident is in isolation,

    • The person should be avoided untilisolation is completed.
    • CNAs must perform all tasks requested of them, even if they are outside the scope of practice.
    • The resident still has the same basic human needs.
    • CNAs should leave uneaten food in the room for 24 hours to see if the resident will eat it.
Multiple choice
bloodborne pathogens

Bloodborne pathogensare microbes found in human blood that cause disease in humans.

  • The same organisms are found in body fluids, draining wounds, & mucous membranes.
  • They are transmitted by infected blood entering the bloodstream, or infected body fluids coming in contact c mucous membranes.
  • They are also transmitted by shared needles, through the placenta, & during birth.
Bloodborne pathogens
bloodborne pathogens1

Employers are required by law to help prevent exposure to bloodborne diseases.

  • They must follow federal standards established for health agencies by OSHA (Occupational Safety & Health Administration)
  • They must have a written exposure control plan that tells employees what to do if exposed to infectious material.
  • Plan must be accessible to all employees.
  • Employees must receive training.
Bloodborne pathogens
bloodborne pathogens2

Employers must provide needed PPE, free of charge, to all employees, residents, & visitors.

  • Puncture-resistant, leakproof, & well marked biohazard containers must be available for disposal of biohazardous waste & sharps.
  • Free hepatitis B vaccination must be provided for all employees after hire.
  • Warning labels must be affixed to waste containers & refrigerators/freezers that contain potentially infectious material.
Bloodborne pathogens
slide68

HIV -Weakens the immune system so that people can’t fight infection, can develop AIDS

  • Hepatitis – inflammation of the liver caused by viral infection.
  • Hepatitis – initially resembles flu-symptoms (fever, fatigue, nausea, vomiting), then jaundice (yellow skin, mucous membranes, & eyes). Can cause permanent liver damage.
HIV
hiv hepatitis

Hepatitis A –Transmitted by fecal-oral contamination.

  • HepatitisB (HBV)– bloodborne or needle transmission. Vaccine is available – TAKE IT!
  • HBV – short-term illness leads to loss of appetite, diarrhea, vomiting, jaundice, pain in muscles, joints, & stomach
  • HBV – long-term illness leads to liver cancer, cirrhosis, death.
  • Hepatitis C, D, E – less common, no vaccine
HIV & Hepatitis
multiple choice9

Bloodborne diseases can be transmitted by

    • Infected blood entering the bloodstream.
    • Hugging an infected person.
    • Being in the same room c an infected person.
    • Talking to an infected person.
  • Your employer must offer a free vaccine for
    • HIV/AIDS
    • Hepatitis B
    • Hepatitis A
    • All bloodborne diseases
Multiple choice
multiple choice10

How does HIV affect the body?

    • It cuts off blood supply to the brain.
    • It causes hearing impairment.
    • It causes diabetes in otherwise healthy people.
    • It weakens the immune system.
  • Which is true of Hepatitis B?
    • HBV is caused by fecal oral contamination.
    • There is no vaccine for HBV.
    • HBV is caused by jaundice.
    • HBV can be transmitted in blood.
Multiple choice