From the September 22nd edition of Nursing Assistant Trainer: Ambulation 2

Ambulation provides a range of physical and mental benefits to residents, who vary in the degree of assistance they require. Some residents are able to ambulate by themselves, some need assistance from CNAs, and some require assistive devices. CNAs should always make the resident’s safety their number one priority. The following is a general procedure for assisting residents before, during, and after ambulation.

Before ambulation

Obtain needed information from the resident’s care plan.
Check with your immediate supervisor for specific instructions.
Wash your hands.
Assemble necessary equipment and bring it to the bedside.
Identify the resident, introduce yourself, and tell him or her what you plan to do.
Provide for the resident’s privacy.
Make certain that the resident’s bed is lowered and locked in place.
Assist the resident to a sitting position on the side of the bed.
Let the resident sit on the side of the bed for a few minutes.
Take the resident’s pulse.
If pulse rate is outside the normal range for that resident, return him or her to a lying position and notify your supervisor.
Encourage the resident to take a few deep breaths and ask whether he or she feels dizzy or faint.
If resident does not feel dizzy or faint, help put on his or her robe and sturdy shoes.

During ambulation (without assistive devices)

Place one hand under the resident’s arm and the other hand around his or her waist.
Move slowly, at the resident’s pace.
If the resident starts to fall, step quickly behind and allow his or her body to slide slowly down the front of your body. Trying to hold up the resident may result in injury to both of you.

After ambulation

Assist the resident to a chair and make him or her comfortable.
Place a call light within reach.
Leave the area neat and clean.
Clean and return any equipment to its proper place.
Report any significant observations.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the September 15th edition of Nursing Assistant Trainer: Ambulation

Ambulation provides a range of physical and mental benefits to residents, who vary in the degree of assistance they require. Some residents are able to ambulate by themselves, some need assistance from CNAs, and some require assistive devices such as gait belts, canes, and walkers. CNAs should always make the resident’s safety their number one priority. Before you ambulate a resident, you should bear in mind the following:

The number of staff members required to assist
The type of assistive device, if one is required
The distance the resident is to ambulate
The resident’s normal pulse rate
Any possible problems you might encounter

Benefits of ambulation

It helps strengthen the muscles, especially those of the abdomen and legs
It helps joint flexibility, especially that of the hips, knees, and ankles
It stimulates circulation, which helps prevent phlebitis and the development of stroke-causing clots
It helps prevent constipation because the movement of the abdominal muscles stimulates the intestinal tract
It helps prevent osteoporosis due to the mineral loss from the bones when they do not bear weight
It stimulates the appetite
It helps prevent urinary incontinence and infection—when residents are able to go to the bathroom on their own, incontinence is reduced
It relieves pressure on the body and skin, helping to prevent pressure ulcers
It improves self-esteem and the resident’s feelings of independence
It improves the resident’s ability to socialize

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the September 8th edition of Nursing Assistant Trainer: Infection Control 3

CNAs should always be aware of the potential for infection transmission. In last week’s LTC Nursing Assistant Trainer, we discussed how frequent handwashing and changing gloves help CNAs lower that potential.

If and when a resident contracts a communicable disease, isolation precautions become necessary to prevent transmission to other residents and staff. There are three major types of precautions, described below in this last piece of a three-part series on infection transmission.

Contact precautions

Contact precautions require CNAs to wear gloves when entering a resident’s room to provide care. You should always remove your gloves and wash your hands with an antimicrobial agent before leaving the area. You should also wear a gown when entering the room if you anticipate that your clothing could come into contact with the resident, equipment, or contaminated surfaces.

Droplet precautions

Droplet precautions call for wearing a mask when working within three feet of a resident. The policies at some facilities dictate that a CNA must wear a mask whenever entering a resident’s room.

Airborne precautions

When airborne precautions are ordered, the resident should be placed in a room with a special ventilation system—one that changes the air in the room frequently by ventilating it through special filters to the outside. CNAs should always keep the door to that resident’s room closed to prevent the room air from circulating into hallways.

Special respiratory equipment that filters the air should be worn by anyone entering the room. If at all possible, CNAs who have developed an immunity to the disease should be assigned to thosespecific residents.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the September 1st edition of Nursing Assistant Trainer: Infection Control 2

CNAs should always be aware of the potential for infection transmission. Last week, we examined types of diseases and how they are transmitted. CNAs can also reduce the risk of transmission by observing and, if necessary, adjusting their own work habits. Frequent handwashing and changing gloves are the most important control measures a CNA can take to prevent the spread of infection.

When is it vital for a CNA to wash his or her hands?

When arriving at or leaving work
Before and after touching a resident
Before and after meals
Before and after using the restroom
After sneezing or blowing the nose
After touching an item used by or for a resident
After removing gloves
After removing personal protective equipment
After working on a surface that may be contaminated with body fluids or other substances
When is it vital for a CNA to change his or her gloves?

Between contact with each resident
When leaving a resident’s room to obtain equipment

It may also be necessary to change gloves and wash hands when providing care to more than one part of a resident’s body, in order to prevent the spread of infection from one part of the body to another.

In general, CNAs can also reduce the risk of infection to themselves by not eating, drinking, touching contact lenses, or applying lipstick or lip balm when in an area where blood or body fluids might be present.

Next week, in the last of our three-part look at infection transmission, we will examine isolation precautions.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the August 25th edition of Nursing Assistant Trainer: Infection Control, 1

CNAs should be aware of the five major types of infection transmissions, and which diseases and infections are commonly associated with each. Knowing ahead will attune you to a better, cleaner, and healthier environment for your residents. Next week, we’ll review housekeeping practices and when it is vital to change your gloves.

The types of infection transmission and their commonly associated infections are as follows.

Contact transmission occurs when an infected person transfers microorganisms to another person. This may occur through direct physical contact, or through contact with an object that has been contaminated by the infected person. Common types of infections or diseases include

gastrointestinal
respiratory
skin or wound
impetigo
scabies

Droplet transmission occurs when microorganisms travel on droplets, such as from a cough or a sneeze, and then come into contact with the eyes, nose, or mouth of another person. Common diseases include

Pertussis (whooping cough)
cold
influenza
Rubella
pneumonia
mumps

Airborne transmission occurs when dried microorganisms or dust particles containing the microorganisms travel through the air and are inhaled. Common diseases include measles and tuberculosis.

Common vehicle transmission is the transmission of pathogens by contaminated items, such as food or equipment. Common diseases include salmonella and botulism.

Vectorborne transmission occurs when insects, rats, or other animals carry the microorganisms to people. Common diseases include Lyme disease, Rocky Mountain spotted fever, Eastern equine encephalitis, and malaria.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the August 18th edition of Nursing Assistant Trainer: Stoma Care

The medical term “ostomy” refers to any surgical procedure that creates an artificial opening, also known as a stoma, into the body. Some of the most common types of ostomies include tracheostomies (trachea), ileostomies (small intestine), colostomies (colon), and urostomies (bladder). When caring for a resident with an ostomy, CNAs should assess the following:

Stoma color: The stoma should appear red, similar to the lining of the inner cheek. Very pale or darker stomas with a bluish color indicate that circulation to the area may be impaired. Report any abnormal coloring of the stoma.

Stoma size and shape: Most stomas stick out slightly from the abdomen. New stomas appear swollen. The swelling should decrease over a period of three to six weeks, but a failure to subside may indicate a deeper problem.

Stoma bleeding: Slight bleeding is usual for about a day following surgery when the stoma is touched. After that, CNAs should report any additional bleeding.

Skin status: CNAs should note and report any redness of the skin surrounding the stoma. Temporary redness after an adhesive is removed is normal.

Infection: Check the stoma for signs of infection, redness, warmth, tenderness, or foul-smelling drainage.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the August 11th edition of Nursing Assistant Trainer: Sleep Deprivation

Studies indicate that much of the American population is sleep-deprived. Residents are among the many who have trouble falling asleep or keeping to a normal sleep schedule. The following are some tips for CNAs to help promote good sleep in their residents:

Establish a regular bedtime routine. Following a bedtime routine is one of the best ways to promote sleep. Set a regular time for going to bed and follow a regular pattern in preparing for bed.

Do not rush the resident. Rushing is stimulating. Most likely the time saved by hurrying patients to bed is spent in answering call lights later in the night.

Provide soothing activity. Reading, listening to music, or watching television are good activities for either before or after the resident gets into bed.

Encourage daily exercise. Exercise promotes a deeper level of sleep at night. However, exercise should be avoided for about two hours before bedtime because of its stimulating effects.

Provide a bedtime snack. We often feel sleepy after meals, especially if they contain certain carbohydrates, such as those found in bread and pasta. Providing bread or warm milk before bedtime can help residents sleep more easily, because a chemical is released in the brain that promotes sleepiness.

Avoid caffeine. The stimulating effects of caffeine can last for 10 hours or even longer, and some people find that even if they can get to sleep, caffeine causes them to awaken during the night. People also become more sensitive to the effects of caffeine and other stimulants as they grow older.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.