Event ID: 3013872
Event Started: 8/3/2016 2:45:45 PM ET
Please stand by for realtime captions.
Good afternoon and welcome to the seventh of eight sessions of the feeding assistant training.
Just the usual house came -- housekeeping. All the phone lines are muted so use the chat box on
your screen. Also per the state and federal regulations some of your facilities should be tracking
your attendance. We have template form on our website that you can use and if you have
multiple people watching under the same login, it would be helpful if you would fill that out and
send that into us. Today's topic is safety and emergency preaching does procedures and Infection
Control. We are covering a lot of safety topics but we would encourage you to check in with
your staff developer about any facility specific policies your site may have. Hopefully much of
this is a refresher from your orientation and aligns with what you have in your orientation to your
facility but again we encourage you to check back in with your staff developer. At this point I
will hand it over to [name unknown] who is here at the Vanderbilt school admit -- of nursing.
She has clinical and research experience in long-term care and dementia care.
Thanks. Good afternoon everyone. Today as Emily said we will talk about safety measures in
emergency procedures and how to prevent the spread of germs such as bacteria, viruses, other
microorganisms that can lead to infection. The first half of the session will cover the safety
emergency procedures and we will start with general information as Emily said please check
with your facility. They probably have additional training on fire safety in case of fire or severe
weather. You are encouraged to attend the training in many facilities will required you to attend.
It indicates how important this is at the site. First what types of hazards or safety issues are
discussed at your orientation? We will give you a few minutes to respond in the chat box. Did
you have policy -- fire policy, tornado drills for those that might be an area that has problems
with floods. What are other issues. If you take a minute and respond in the chat pane we will
share that with the rest of the group. We want to ask you to share this information but I want you
to think back to the last week or so at your facility. Have you noticed any potential hazards when
you are walking in the hall? Was there equipment or linen carts blocking the path of the
residence? Did you see any spells or leaks? This is important. Your alertness to these hazards are
very important to the residence, visitors and other staff. As we mentioned before everyone at the
facility is very responsible for reporting potential safety issues. During 2014 for the health and
rehab centers the number one survey citation, this is from the state surveyors that go into the
facilities and observe what is happening in the facility. The number one citation make sure that
nursing home area is free from accident hazards and risks and provides provision to prevent
avoidable accidents. That was the number one citation. 35% of the facilities received a tag or bad
mark or grade for this. You can see it's really important to be alert to these hazards which is very
important to your facility as well. Here is the information on those tag numbers if you have
questions. You can check with the nursing supervisor or the administrator. We talked about
reporting information in terms of resident changes but there's also situations that must be
reported immediately. I will -- alert the supervisor but sometimes you may need to make out a
maintenance request. These are pretty self-explanatory. A broken call light that presents -­
prevents a resident from getting help. Think about this from the perspective of the resident who
has limited mobility they are using a wheelchair to get around a linen barrel. It might not be in
the way of the staff but certainly is a -- and impeachment to the resident. I'm seen residence try to
grab a linen barrel as they were walking down the hallway and the use that to help the balance.
These girls have wheels. They are not stable so down the resident goes to the floor. Spells and
slippery services are hazards that can cause the resident to file or yourself and worse yet could
even cause a head injury or broken or fractured bone. Some residents often have poor vision and
won't even notice if there's a wet area on the four. This bill or leak is hazardous as I mentioned
not only to the residence but also to visitors and your staff. Think about if you slip in something
what you can throw your back out of alignment or cause the twists of an ankle or need. We have
to be careful. Unsafe equipment, oxygen tanks or personal-care lifts, these are things that you
may see in the hallway even though you won't be dealing with them directly. You should know
how to report these issues or if you discover them to be an issue. Mealtime handlers, it's a real
safety issue if a resident it's the wrong try. Take about what could happen if a resident that is
supposed to receive a diet because they have problems with dysphasia actually gets someone
else's regular tray. The resident can show can obviously as we look at food that is too hot a
resident can get burned if it's too hot. These are hazards you should be alerted to. These are some
common emergencies that you might see in the facility although I will have to say I've seen some
of these happen to other staff workers as well. The thing to remember here is that you are not
responsible for knowing how to deal with the medical side but rather you need to know how to
notify vendors and start the emergency response system. This is useful information even when
you are not feeding the residence because you might be walking through the hallways are the
dining room and witness someone else experiencing one of these emergencies. We will cover the
general steps to responding to the emergency before we spend time discussing choking. What
should you do for all of these emergencies? Number one call for help. Call the nursing
supervisor. Call for help. Stay with the resident until help arrives. Seizures are sudden
involuntary muscle movements. The symptoms of a seizure can vary by the type of procedure
such as you may have heard of a grand mal seizure and you may observe they seem to be
shaking violently or throw their head back. You may see they roll their eyes back. With another
Caesar a person just spaces out for a few seconds. You can call the resident's name and if they
don't respond or they become very rigid or collapse because they lose muscle tone, your response
should be call for help. You want to also move obstacles like furniture out of their way,
wheelchairs, anything that can be in the way if they are thrashing around. You don't want them to
be hurt by hitting another object. Stay with the resident which -- until help arrives. Do not stick
any object into the mouth or try to restrain them from jerking. So the person having a stroke, you
can remember the acronym SAST to recognize the symptoms and take action. F stands for face
drooping. Does a resident complained that one side of their face or neck is numb? A stands for
our weakness or numbness. It is typically one side, not both. S stands for speech. Are they
having speech difficulty? Is the speech slurred? Are they unable to speak or are they making
garbled nonsensical comments? Can the person repeat a simple sentence like the sky is blue?
Can they repeat that correctly? Those are all symptoms that you might look for. T stands for
time. If you see the symptoms you need to call for help. The quicker you can get a person to the
hospital, the better their chance for recovery and survival. Now we will talk about the heart
attack. As I said before I've seen another staff member experience a heart attack at work. I want
to make sure I include that for you. A person having a heart attack may complain about feeling
winded, short of breath, they might get apprehensive or they may say I'm not feeling right. You
might observe them rubbing their left arm or even both arms or their job or chest. Sometimes
they will complain of an uncomfortable pressure, squeezing sensation, a fullness or even pain in
the middle of their chest. They could be breaking out in a cold sweat. They can complained of
nausea or lightheadedness. They might even lose consciousness. You need to call for help. For
those that you want to be there for them, reassure them that help is coming. Even if you are
unsure of what's happening, trust your instincts because if you think something is wrong you
need to notify the nursing get some help for further evaluation. -- Nurse to get some further
evaluation. Rules for emergency situations. Stay calm. This is easier said than done. The main
action really is to call for help and if you know what to do that can help you to stay calm her.
Call for help. Use the call button if you are in the residence room. I would also not only to the
call button but I would call and yell for help because sometimes there's nobody at the desk at the
moment you need help. In the dining room hopefully there should be a nurse or someone else but
use your phone to call the nurse, send another staff member. Get help. That's most important.
Evaluate the situation and make sure it is safe for you. For instance, this applies to electrocution
or fire or even severe weather. Just make sure it is safe for you to get help. Quickly take note of
the resident condition. Is there something you are capable of helping with? What details can you
relate to the nurse. Think about that when you go to call for help. When the nurses coming you
want to be able to tell them what were the symptoms you saw or heard? What to the resident
say? Did they have slurred speech, with a breaking out in a cold sweat? Have those details
available to help. Know your limitations. I strongly encourage you all to take a CPR class.
Cardiopulmonary resuscitation training through the American Heart Association or Red Cross or
even your facility may have a trainer that comes in. With the knowledge and skills that you learn
from this class it will help you at work, at home with your family and even when you are out in
the community. Lastly, reassure the resident that you are going to stay with them in that help is
coming. I think we've said that about five times now but it is so important so I want to make sure
you are aware that. Let's go on and talk about choking. Because you are training to -- we wanted
to make sure we address the specific emergency involved with feeding and even though you use
all the correct feeding tech weeks that you learned, a resident can still choked. You also may
notice another resident in the dining room is choking as well. We want you to be sure that you
are aware of what to do in the case of this emergency. You will remember in our last session we
watched a video that explains the mechanism of swallowing. The dietitian discussed what -- that
normally food travels down the esophagus while air travels through the trachea and choking is
something that blocks the airway. We are going to look at that video one more time.
[video playing] Was take a step back and review what a normal swallow would look like so we
can understand what happens when somebody has difficulty swallowing. Typically you and I
swallow between eight 8 to 10 times per minute. If you add this up over a day that is over 10,000
times per day. Swallowing requires the coordination of many different muscles of the mouth,
throat, and also it involves the nerves sending the right messages to the right places at the right
time. There are four phases to swallowing. Oral prep is the phase where we put food into her
mouth, we chew it makes it with saliva and it's also the most pleasurable part because this is
where we get to taste and savor food. The oral phase of the swallow is when we gather the food
up with her tongue and get it ready to be propelled to the back of her throat. Once there the
syringe of phase of the swallow begins and the soft palate closes off the nose. The epiglottis
closes up the airway and the food or liquid is then propelled into the esophagus. When it gets to
the esophagus, a series of muscles then propelled the food towards the stomach. For those of us
with no swallowing impairments we can often take this process for granted. When someone has
dysphasia sometimes the food, fluid or even their own saliva can go into the lungs instead of into
their stomach. This event is called aspiration. Aspiration can occur before, during or after the
swallow depending on the cause and type of dysphasia that the individual has. Aspiration if it
happens chronically can lead to the development of aspiration pneumonia but not all aspiration
events result in pneumonia.
That was just a review of the anatomy component. As he talked about dysphasia, I just recall that
food that is in the mouth sometimes if that goes down can totally block the airway and of course
that is the choking we are going to discuss further. What we are going to discuss is what causes
someone to choke and how we can minimize the risk and also how you recognize when someone
is choking. The risk for those people, many of them have dysphasia. Pour chewing or eating too
large of bytes can cause large pieces of food to become lodged at the back of the throat or even
poor feeding dentures can happen and I will tell you a story of that that happened to me. One
lady was choking and when I asked her to open up her mouth and I could see that her dentures
had slipped out and they were halfway down her throat. These dentures may not be sitting firmly
enough so that certainly puts someone at risk. Certain illnesses can cause you to choke because
you don't have the coordination of those muscles and nerves such as with Parkinson's, dementia
or even a person that has a stroke can have some problems and get choked easily. We cannot
eliminate all choking risk that we can minimize them in the best way to minimize is by using
those good quality feeding techniques that really describe -- we described earlier. Make sure that
the tray or the snack is the right diet texture. You want to make sure that you are being very
patient and not rushing the resident to finish. Provide a small manageable bite, encourage the
resident to chew properly and thoroughly when they are swallowing. We also talked about
having to prompt them if they were not swallowing or pocketing food in their mouth. Has
anyone ever witnessed someone choking? How did the person react? How did you know they
were choking? Please share this in the chat box. I can share one and it wasn't necessarily in the
health and rehab center. It was my own son who had been eating though she was about eight
years old -- and was eating grapes. As a kid he was playing around and he plopped a bunch in his
mouth and before he could say it he went to swallow and get choked. Literally when it happens
he grabbed instinctively made -- he had his hands around his neck and walked in and fell over
and when he fell the grape popped out. It was very scary because I could see his eyes getting
watery and it was just a very scary moment. He was fine afterwards. He learned a lesson the hard
way I'm afraid. Some of the other signs and symptoms, you may notice they suddenly are unable
to speak. They might even start to get wheezy where they are having what we call [Indiscernible]
but they are having a hard time breathing. You might notice they get a bluish chin or they may
even clutch their throat. If you see someone choking, remember to stay calm and get help
immediately. Our first instinct is often to hit someone on the back, have them raise their arms or
drink something. You should not do any of these because the can actually be more harmful to the
resident. Patting the person on the back, and usually we don't just happen we hit them hard
because our adrenaline is rushing and we want to whack them as an instinct. You don't want to
do that because it caught -- can cause the food or obstruction to become lodged even further
down. Raising his about the had, that was something that I recall everyone saying but there's no
proof that that is effective at all and you are wasting time. You need to do the Heimlich
maneuver and get that out. That is something to consider. The same is true of having someone
drink liquids. It actually can have them aspirate into their lungs. Do not put your fingers back
into their mouth as you might push food further back but it's okay to ask them to open their
mouth and if there is food on the outer section of the tongue or something you can grab them that
is okay to grab it and remove it. Your best course of action is to call for help. Asked the resident
if they are choking and if they can only cough -- usually it is a weak cough. You encourage them
to keep coughing. If they can't, than the airway is probably completely blocked and they need
emergency help. I will emphasize that yelling for help because remember in the dining room it
can be very noisy. You need to be able to get some of -- someone's attention. There should
always be other licensed staff in the main dining room or in the day room if you have special
feeling room. Both rooms there should be someone in there but all of them have call lights in
emergency lights. In your facility when you have time I want you to go back and look at the
location of those call lights so you will know rather than having to hunt for them when the
emergency actually occurs. We're going to talk about the Heimlich maneuver. This is the
emergency assistance that you would use. It would be incredibly rare for you to do in a nursing
home because most instances the nurses will be there to do it but I want to encourage you again
to confirm with your staff developers or the director of nurses what your facility policy is for
non-licensed staff that are assisting residents choking. I think the chances are very slim in fact in
my 40 years as a nurse I've only had to do this twice. It really is fairly slim. In many cases you
will be assisting in activities where there is other licensed clinicians that will be there or other
staff but we want you to know the basic steps of the Heimlich. I think what we will do is watch
the video next and we will go back and review.
[video playing]
What you do when someone is choking? Say you and a friend are out in a restaurant and all of a
sudden they start choking. I will have my friend Hannah come over here. We are out and having
a good time in eating and all of a sudden she seems like she's choking. First ask if you are okay.
Oftentimes the international sign is this. I can't breathe or something's going on. If you are
around other people you want to get them to help you. If you are in a restaurant or at a place of
business have someone call out for help and have people help you out. Tell them what you are
doing. Don't attack them because that will heighten their anxiety and panic. What you will do is
stand behind them and you will wrap your and -- arms around. You want to find her belly button
with your pinky and make a fist. At the pinky in the belly button and roll it up so your -- the
knuckle of your son is right there and then you thrust. Pull it in and out. In and up until they can
dislodge what is in there and they can breathe again. Don't go crazy like in the movies and start
slapping their back. People get carried away and they just end up hurting you. If the person is
pregnant or a larger person, and you cannot get your arms around you will want to go higher up
to their breastbone. Say Hannah is pregnant, congratulations. Wrap around and find their
breastbone and then just do the same thing, in and up until the dislodge whatever is in their throat
and they can breathe again. If the person is so big who is choking and you can't even do that you
can assist them to doing a self Heimlich maneuver on a chair. We move over, stayed calm -- stay
calm, if they lose consciousness and fall to the floor -­
That was a quick demonstration of the Heimlich maneuver. I wanted to go over some of those
points again. It wasn't really clear on the video but if you see somebody that is choking or you
are questioning, asked them if you are -- are you choking? If they are coughing hard, it's okay.
Let them cough. If they have that weak cough or they have any other symptoms of turning blue
then obviously they need your assistance immediately. Stand behind the resident with your arms
around their waist and make a fast. Thumb side down just above the navel. You can practice this
with another coworker. We are not going to -- don't actually practice the thrust because you can
cause injury. You can put your hand over the fast and quickly thrusted upward and inward.
Continue this until the resident was able to breathe again or they would lose consciousness. At
that point in time you will have to turn it over to someone who is there to help you. There are
two special situations which you need to be aware of. It was mentioned in the video. What you
do if you have resident that is obese and you are unable to wrap your arms around her waist. In
this situation you would wrap your arms around her chest and use that same fast in the inward
and upward thrust. That will help them. If you have a resident that is in a wheelchair, you want to
position yourself behind the wheelchair to be able to perform the Heimlich maneuver. If the
resident is able to stand up and lean over a chair or even if it is a tall enough table or they are
short enough they can do that yourself or you can do it. I would really like what she did mention,
don't panic because the more you panic the more the person will panic. They are already in panic
mode anyway. It is really important here again to try to stay as calm as pop -- possible. Here is
another clip to give you another viewpoint. We will watch this next video.
[video playing]
In this video you will learn how to release choking on an adult and on a child. Use abdominal
thrusts to relief choking in a response victim one year of age or older. Do not use abdominal
thrust to really choking [Indiscernible]. If you see someone clutching their throat with their
thumb and fingers this is the universal sign for choking. You should ask them are you choking?
If they cannot respond or simply nod yes, stand or kneel behind the victim and wrap your arms
around the victims waist. Make a fist with one hand, placed the thumb side of your fist against
the victim's abdomen in the midline slightly above enable and well below the breastbone. Press
your fist with your other hand and press your fist into the victim's abdomen with a forceful
upward thrust. We keep -- thrust until the object is expelled or the victim becomes unresponsive.
With each new stress -- thrust [Indiscernible].
We wanted you to see the second one. Gave you a good visual of the hand position. I wanted for
you to be able to see that. Just as a quick review, if a person is coughing forcefully and not
turning blue, what would your next step be? Just to encourage them to keep coughing. I would
call for help just in case. The universal sign for choking is both hands around the neck or even
one hand. I've seen a person that only had one hand they could use do that. You should always
give a choking victim fluids to drink to help wash down the foreign object? I know you are all
saying false. We definitely don't want to do that. That would increase the likelihood they would
aspirate. That would make it worse. If a person is able to answer your question when you ask
them if they are chat -- choking, what you do? Here again you want to encourage them to keep
coughing and stay with the person and assure them that you are going to stay with them. Please
don't get anxious about choking occurring frequently and how you should react. As I said this is
not a frequent experience that you will deal with but it is an emergency that we want you to be
aware of in case it happens.
I would echo Linda in that. I spent the last five years providing cleaning assistance or monitoring
feeding assistance in the long-term care setting and I cannot recall a time where the Heimlich
maneuver was required. We like to spend a lot of time in drill it into you so if something were to
happen you would feel comfortable and well prepared. Don't be nervous. We just want to make
sure all our bases are covered.
We're going to go next into inspection control. Really this is one of the issues that as we
mentioned before surveyors look at when they come to inspect your facility. Your second most
common citation across the US for long-term care facilities was having a program that
investigates controls and keeps infections from spreading. It's really hard to do so we're going to
talk today about the different types of transitions, methods you can do to prevent spreading
infection and particularly those measures around the mealtime. On the right side you can see this
is a definition of infection prevention and control and this is from the World Health
Organization. The aim is to ensure that there is adequate protection of those that might be
vulnerable to acquiring an infection both in the general community and while receiving care due
to health problems. The basic principle of infection prevention and control is good hygiene.
We're going to discuss that in more detail. Essentially the intent of these policies is really to
protect the residence and you from the spread of infection and that could be from resident to
resident transmission or staff to resident transmission vice versa. Long-term care facilities have
lots of opportunities for germs and infection transmission because bacteria in microorganisms are
opportunistic and they will multiply easily on most any service. Just think about all the surfaces
that can be in your facility. The human body is a natural host for many bacteria in the body's
immune system keeps us healthy even while we have bacteria. It's important to remember for the
residence that are not always healthy and they are even more susceptible to infections because as
they age they have weaker immune system and they can't fight off those infections as well as we
can. A simple cold or flu while it might keep us from work a couple days it can really make them
seriously sick enough that they could get what we call septic to appoint that the entire body is
sick than they would be required to go to the hospital and possibly even into ICU. It's very
important for our residents. The term a sepsis is a term you might hear around many of the
changes. We talk about aseptic technique -- techniques. Keeping bacteria and viruses and other
microorganisms. We want to keep them in a minimal mobile and bacteria grows quickly as do
viruses. The types of infections, how do these infections spread. We're talking about germs being
bacteria, viruses and other microorganisms that are transferred. Direct contact is something that
is as simple as shaking hands with one another. Bacteria passes from one person's hand to
another or if you happen to touch wound secretions or stool or urine from someone that is
incontinent or a resident that might have colostomy or catheter. We were gloves to keep -- and
wash her hands. Indirect contact is maybe touching the bed sheets that had secretions or drainage
on them. Touching dishes that the residents have touched. Airborne transmission particularly you
will see this from the viruses such as measles, chickenpox and tuberculosis. It can travel through
the air. Just by simply sharing the same air it can transfer. Typically this is not seen in long-term.
-- Care facilities. Someone that has an airborne disease is usually in a special room to protect
them and you. Viruses in a few bacteria will travel be a moisture such as saliva, sputum and they
will spread by coughing or sneezing. Did you know that droplets from a cough or sneeze can
travel 20 feet? Think about that. That's a long way away. I just wanted to say if you happen to
notice on the residence door it says isolation, check with a nurse. This is a sign to alert you of the
possibility of infection trends vision from the resident to someone else. Please heed what the
signs communicate and check with the nurse before you enter the residence room. You probably
won't be asked to do that. I just wanted to give you that information so you will know what's
there. Now that you know how germs are spread, let's talk about how we can prevent this from
happening. Proper hand hygiene and other precautions are most important. It includes staying
home if you are sick. Covering your mouth and nose if you sneeze or cough. Encourage the
residence another staff to do the same. That's really important. Particularly around those holiday
times or like in the fall when people have more and more colds. We have to be extra alert. You
don't want to sit on the residence bed because there is indirect -- you have to be careful. All of
this being said the number one way that you can prevent this sort of infection from any setting is
to practice proper hand hygiene. We are going to show a video of how to best do this.
[video playing]
[Indiscernible]. At the Centers for Disease Control and Prevention we're very interested in
preventing transmission of disease in our community. People are not washing their hands as
often as they say they are or as often as they should. Researchers in London estimate that if
everyone routinely wash their hands 1 million deaths a year could be prevented in the germs can
live on our hands for quite some time unless we clean them. If we don't clean them and we go in
touch something in the meantime we can spread those terms to other places or people and disease
can be spread this way. Animals carry germs that can make people sick and these terms can be
not only on the animal but can be in areas where the animals live as well.
When people do regular handwashing especially with children that you server -- supervise that
handwashing to make sure the children are doing it properly and for the length of time that's
necessary.
Their coughing and sneezing on their hands and touching doorknobs. They are using shared
objects like pencils or twice. Diseases pass easily from one child to the next. Try to avoid seizing
at your hand because you just condemn -- contaminate them and spread posters everywhere
focus on sneezing at your elbow like this and then you don't contaminate your hand. Turn on the
water, what your hands, apply good amount of soap and lather up and focus on washing your
hands for about 20 seconds. Focus on washing the front of your hands, the back come in between
the fingers and around the nails. Rinse everything off. You something to wipe your hands after
that preferably something disposable like a paper towel and then use that to turn off the tap as
well. If you get a chance, use that to open the door to the bathroom as you're leaving. The best
way to wash her hands is using running water and soap but sometimes we don't have that
available so think about carrying a hand sanitizer. That should have at least 60% alcohol content.
It's important to realize those agents don't remove soil and other materials that might be on your
hands. In that case you really need to use soap and water. If you've been touching objects all
around you all day long, just the spoon you are handling is contaminated and make sure before
you prepare food you wash your hands. Before you eat, wash her hands. You can't emphasize
hand hygiene enough. Clean hands save lives. Keeper hands going. It's a very important activity.
At home, school, work and in the healthcare setting. Hand hygiene or handwashing is the single
most important thing that you can do to help prevent the spread of infection and to stay healthy.
I hope -- I thought that was a really well developed video and it gave a lot of excellent points. If
you -- you should wash your hands before assisting a resident but while you are handling food
and drink. Cluster not a substitute for handwashing. Make sure that if you are wearing gloves to
do something you should discard them in wash her hands. Also wash your hands after using the
restroom, after sneezing, touching your face and hair, after you eat or drink, smoking, handling
garbage. Any contact with the residence mouth or body and anytime that you are assisting the
residence you should also wash your hands. They mention you can wash your hands singing
happy birthday a couple times. That's a good way to get enough time that you are able to really
get the majority of the bacteria in one thing they didn't talk about but under your fingernails we
harbor lots of bacteria. You want to make sure you also clean under your nails while you are
washing her hands and if you don't like the happy birthday song you can sing the ABC song that
we learned in kindergarten. I want to say I think they did a good job of explaining the importance
of handwashing and we really cannot emphasize this enough. I recall one day that I was observed
-- I observed a person in the bathroom. They turned the water on, ran their hands under the water
and then they touched their hands and face and went to the door and touch the handle. I think
they were just distracted and we had to call them back in and say we need to really -- you to
really wash her hands currently. Please make sure that you wash your hands because that is the
number one way that we trans-that germs and bacteria to one another. Proper handwashing really
needs to become a habit. It is something you can teach your family members as well. Let's go on
to food related Infection Control. There's a number of ways that you can practice Infection
Control when you are assisting the residence at mealtime. Remember you want to touch only the
handles on the outside. You don't want to ever touch the part that goes into their mouth. If you
replace a dropped utensil, get a clean one. There's no such thing as the five second rule. If you
have cops, make sure you carry one in each hand. I've seen people try to carry two or three
glasses and they put their fingers in the top of the class to hold it because their handgrip is too
weak. We've seen all things. I've also seen someone tried to put their fingers in the super coffee
mugs to check the temperature. That is a no-no as well. If you are assisting a resident with
dementia, also prevent them to -- from eating from other residents plates and glasses. These are
all important reasons to make sure you stay with the resident when you are assisting them during
the meals. These they seem very obvious and common sense, we list them specifically because
we've seen these during our work in facilities. There are some very obvious things. You don't
want to open something with your mouth, teeth or handle something with your bare hands. You
can use a napkin to pick something up.
I was referring some survey data last week from -- just pulling miscellaneous facilities and this
was the facility that was tagged. The staff was consistently handling bread with their bare hands.
It seems obvious but people still do it. It's a no-no. You can hold the bread in place with a fork to
moderate or you can use a napkin or use gloves but it still happens.
Thanks, Emily. If you think the residence food is too hot. You can look to see if there's any
steam rising. You can put your hand over the top that you don't want to touch the top of the class
where the person's mouth may come in contact with it. Do not put your fingers in the food as I
mentioned before and think about if you are in a restaurant would you want the server to do that?
If there is steam and you think it's too hot, you don't want to blow on the food. There again you
can transmit the germs in the mouth. There are 30 different species of bacteria in the mouth
normally. You could be sending bacteria onto someone else's food. Do not blow on the food.
Instead stir it. That will help incorporate the air and help it cool down a bit. Also you can just
wait. Offer the resident something else on their trade. Avoid touching the residence food. Avoid
touching your hair or face while you are assisting someone. Don't chew gum. There are germs in
your mouth and when you are chewing, we have what we call spittle. Spittle is saliva that comes
out when you are talking or when you are chewing. That also can transmit bacteria to someone
else into their food.
We have come to the end and we are about five minutes early. As we've covered, there may be
cases of emergencies that occur within your facility and you want to know what to do in case
they occur. Stay calm and use the training that you've had and make sure you continue with your
training at the facility. Know the policy at that facility that you are working. Proper hand
hygiene. I cannot stress this enough. It is the best way that you can prevent infection. Also
knowing how to handle food properly. You will be able to demonstrate this when you are doing
your check off or final certification. This is what we covered today. At this time we got a little
extra time. If you have anything, any questions that we didn't cover, anything you've observed
that relates to the training session today. We invite you to put that in the chat pod right now. We
love to hear more about what's going on with you and how things are going. We really encourage
you to communicate that with us.
Emily?
You can always send the messages to me if you don't want to send them to the whole group and
we will answer them. Our next session will be our final session. Next week at the same time and
same place. If you have missed the previous session, they should all be posted on learning ondemand. The link is on our website and you can see it here. People have been having trouble
walking in and I spent some time with our Qsource people this morning trying to figure that out.
I will do my best to explain it. I'm not too tech savvy but they been uploading the videos with a
secure YouTube link. Once you login it will give you that link and there are a couple of caveats.
One, do not share the link because if you try to copy and paste it and send it to someone else they
will not be able to access it so that might be one problem. The other problem is if -- we figured
out if your facility blocks certain sites, YouTube maybe one of them. You will need to talk to
your IT people to get them to remove that so you can view the webinar. YouTube is a platform
through which they upload. If you would have problems logging in, please contact me. I can put
you in touch with the Qsource people and they could probably talk you through better than I can.
A reminder about our website, on the right-hand side you will see the link to the learning ondemand as well as the YouTube channel where we have the clips posted. On the left-hand side, if
you click on the session summary link the slides for every session are posted as well as the links.
The CD set clip will be posted there. Other helpful information. The training toolkit page is
really for your staff developer, nursing director. It has a full copy of the curriculum, written
evaluation for tracking for attendance. Everything that would be required for you to have for
your state survey. Those are really the two most important pages within our website. If you
complete all eight hours and we have proof of your attendance and someone from your facility
census proof that you completed an evaluation, we well send you a training certificate that you
can keep for your personal self or for your employer to show you've done the training. We don't
necessarily giving up -- give out continuing education hours but if you complete all eight hours
you will have that certificate and be certified. -- To feed.
We will hang on the line if there are any other questions but if not, we will see you next week for
our final session on resident rights.
[Event Concluded]