1 Implicit Bias Describes how our unconscious attitudes or judgements can influence our thoughts decisions or actions Includes involuntary unintentional perceptions made without awareness Occurs as our brains sort information and perceive data to understand our world ID: 1041735
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1. Nailed It: Infection Prevention While Assisting Residents with Grooming1
2. Implicit BiasDescribes how our unconscious attitudes or judgements can influence our thoughts, decisions, or actionsIncludes involuntary, unintentional perceptions made without awarenessOccurs as our brains sort information and perceive data to understand our world Affects our decisions, contributing to societal disparitiesSelf awareness about implicit bias can promote healthcare diversity and equalityLearn more about your own implicit bias at Project Implicit (implicit.harvard.edu/implicit/)2
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5. ObjectivesReview the need for infection prevention during nail care and shaving Describe infection prevention practices for nail care and shaving Discuss injuries that may occur during personal care5
6. Purpose of Nail Care and ShavingReduces germs under the nails to prevent spread to other parts of the bodyPromotes cleanliness and self-esteemPart of skin careImproves appearanceAffects how people feel about themselves6
7. Fingernail and foot care: Shaving:7Personal Protective Equipment (PPE) to Use While Grooming ResidentsGlovesGownGlovesPPE is dependent on the type of grooming you are providing the resident as well as the resident’s condition and isolation status.
8. Fingernail Care8
9. Process for Fingernail Care9Perform hand hygieneGather equipment: emery board, nail stick or soft nail brush, lotion, basin, soap, washcloths, towels, glovesFill basin with warm water (<105°F) Perform hand hygiene and put on glovesSoak residents' hands and nails (>5 minutes)Wash residents' hands and pat dryPlace hands on towel and clean under fingernail with wood stickWash and dry residents' hands again
10. Process for Fingernail Care ContinuedShape nailsMove in one directionFile in a curveApply lotion from fingertips to wristsRemove excess with towel or washclothEmpty, rinse, dry basin (depending on facility policy)Placed soiled linens in proper areaRemove and discard glovesPerform hand hygiene10
11. What would you do if you saw abnormalities when providing nail care?11Reflection: Signs of Infection
12. Report any unusual observations to the nurseDry, flaking skinNonintact or broken skinDiscoloration of the handsBlisters or bruisesBlood or drainageLong, ragged, or ingrown nailsSwellingSoft, fragile, or reddened handsDifferences in temperature of the hands12Possible Signs of Infection
13. Foot Care13
14. Process for Foot CarePerform hand hygieneGather equipment: basin, bath mat, soap, lotion, washcloths, towels, bath thermometer, clean socks, gloves Fill basin with warm water (<105°F) Support ankle and foot throughout procedurePerform hand hygiene and put on glovesSoak residents' feet (>10 minutes)Wash residents' feet and pat dryOne foot at a timeBetween toes and around nail bed14
15. Process for Foot Care ContinuedWarm lotion by rubbing hands togetherMassage lotion into entire foot (top and bottom)Do not rub lotion between the toesRemove excess lotion with towelPut on clean socksEmpty, rinse, and dry basin (per facility policy)Place soiled clothing and linens in proper area (per facility policy)Remove and discard glovesPerform hand hygiene15
16. 16Reflection: Signs of InfectionThink of some signs of infection you may have observed during foot care.
17. Report any unusual observations to the nurse:Dry, flaking skinNonintact or broken skinDiscoloration of the handsBlisters or bruisesBlood or drainageLong, ragged, or ingrown toenailsSwellingSoft, fragile, or reddened heelsDifferences in temperature of the feet17Possible Signs of Infection
18. 18Why Don’t We Use Nail Clippers?May cause cuts on fingers and toesGerms can enter an open cut and cause an infectionReport to the nurse if clipping is needed
19. SHAVING19
20. Process for ShavingPerform hand hygieneGather equipment: electric razor or clipper, 2 towels, washcloth, mirror, after-shave lotion, gloves, and gownPlace a towel across chest, under chin (if in bed)Perform hand hygiene and put on gloves and gownDo not use an electric razor near any water source or when oxygen is in useHold skin taut; use smooth, even movementsApply after-shave lotion (per facility policy)Remove towelClean razorRemove gloves and perform hand hygiene20
21. Choose a shaver for a wet or dry shaveFollow manufacturer’s instructionsShave in the direction of hair growthWash skin with soap and water after shavingStore razor in a wet areaTry to shave off facial acneShare razorsUse the same razor on different parts of the body21Shaving and Infection PreventionDOsDON’Ts
22. Why Don’t We Use Traditional Razor Blades?Risk to residentMay lead to more cuts Cuts act as an entry point for an infection 22Risk to staffPotential for sharps related injuryInjury may lead to a bloodborne infection (such as HIV and Hepatitis B or C)
23. Knowledge Check23What are the infection prevention practices that should be followed when shaving with a clipper? (Select all that apply) Hand hygienePPE (gloves and gown)Cleaning the environmentCleaning and disinfection of shaving equipmentAll the above
24. Knowledge Check24What are the infection prevention practices that should be followed when shaving with a clipper? (Select all that apply) Hand hygienePPE (gloves and gown)Cleaning the environmentCleaning and disinfection of shaving equipmentAll the above
25. Scenario1. CNA performs hand hygiene and enters a resident’s room2. CNA dons gloves3. CNA cleans the side table4. CNA performs hand hygiene after doffing and/or before donning gloves5. CNA passes remote control per resident’s request6. CNA gathers clipper to start shaving25
26. Scenario1. CNA performs hand hygiene and enters a resident’s room2. CNA dons gloves3. CNA cleans the side table4. CNA performs hand hygiene after doffing and/or before donning gloves5. CNA passes remote control per resident’s request6. CNA gathers clipper to start shavingDiscard glovesPerform hand hygieneDon gloves26
27. Knowledge Check27Why should CNAs assist residents with nail care and shaving? (Select all that apply) Prevents bacterial and fungal growth under nailsMakes residents feel good by improving their appearancePromotes cleanlinessAll the above
28. Knowledge Check28Why should CNAs assist residents with nail care and shaving? (Select all that apply) Prevents bacterial and fungal growth under nailsMakes residents feel good by improving their appearancePromotes cleanlinessAll the above
29. HighlightsPerform hand hygiene before and after shaving, fingernail care, and foot care proceduresProvide nail care to reduce bacterial or fungal growth under the nails that may contribute to infectionShave residents to promote skin care and cleanlinessLook for any signs and symptoms of infection and immediately report them to a nurseDisinfect personal care equipment according to facility policy and manufacturer’s guidelines immediately after use29
30. References 30Environmental Cleaning and Disinfection |Centers for Disease Control and Prevention (CDC) (www.train.org/cdctrain/course/1081815/)Healthcare Settings: Preventing the Spread of MRSA | CDC(www.cdc.gov/mrsa/healthcare/index.html)Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes | CDC(www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html)Reprocessing Reusable Resident Care Equipment | CDC(www.train.org/cdctrain/course/1081814/)
31. Questions and Discussion31
32. Project Firstline ResourcesVisit the Project Firstline Website (www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/ProjectFirstline.aspx)Subscribe to CNA Today – A Newsletter for CNA!(cdph-marketing.powerappsportals.com/HAI/HAI-Registration/)Email the Project Firstline AskBoxProjectFirstline@cdph.ca.gov Project Firstline is a national collaborative led by the U.S. Centers for Disease Control and Prevention (CDC) to provide infection control training and education to frontline healthcare workers and public health personnel. The California Department of Public Health Healthcare-Associated Infections (HAI) Program is proud to partner with Project Firstline, as supported through Strengthening HAI/AR Program Capacity (SHARP) funding. CDC is an agency within the Department of Health and Human Services (HHS). The contents of this presentation do not necessarily represent the policies of CDC or HHS and should not be considered an endorsement by the Federal Government. 32