Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

I am a new RN in post-acute care. What is one thing I should learn first to help residents, and to help me have a long, rewarding career?

I have thought a lot about your question, and my answer changes every five minutes because there is soooo much to learn. But, the one most important item I could say is hand washing.

If you practice good hand washing and see to it that your staff and residents do the same, I think you would have a happy career. What better way to protect every member of the team, including residents and loved ones? We often forget about the resident and visitors when it comes to teaching good handwashing. Staff also overlook having a resident wash her hands both before and after meals.

The Department of Health & Human Services and Centers for Medicare & Medicaid Services have published “Interpretive Guidelines for Long-Term Care Facilities, Tag F441.”

The guideline outlines dozens of infection control program elements for LTC facilities, and specifies indications for hand hygiene, including but not confined to:

• When hands are visibly soiled (hand washing with soap and water)

• Before and after direct resident contact (for which hand hygiene is indicated by acceptable and professional practice)

• Before and after performing any invasive procedure (e.g., finger stick blood sampling) 

• Before and after entering isolation precaution settings

• Before and after eating or handling food

• Before and after assisting a resident with meals

• Before and after assisting a resident with personal care (e.g., oral care, bathing)

When in doubt … WASH!!