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! In the Know, Inc. Inservice Club presents An Infection Control Module: Understanding Drug Resistant Bacteria We hope you enjoy this Inservice, prepared especially for nursing assistants like you. You work very hard, and we appreciate the effort you make to complete these educational materials. It shows your desire to continue learning and growing in your profession. After finishing this inservice, you will be able to: • Discuss the role that bacteria play in our lives. • Describe how bacteria become resistant to antibiotics. • Name at least three drug-resistant bacteria. • Describe at least six ways to help prevent drug-resistant bacteria from spreading. • Demonstrate proper infection control procedures—including standard precautions and handwashing— in your daily work. Instructions for the Learner ! If you are studying the inservice on your own, please: • Read through all the attached materials. You may find it useful to have a highlighting marker nearby as you read. Highlight any information that is new to you or that you feel is especially important. • If you have questions about anything you read, please ask ______________________________________. • Take the quiz. Think about each statement and circle the best answer. • Check with your supervisor for the right answers. You pass the quiz with at least eight correct answers! Print your name, write in the date, and then sign your name. • Keep the inservice information for yourself, and turn in the quiz page to _______________________________________ no later than _________________. • Show your Inservice Club Membership Card to ______________________________________ so that it can be initialed. ! THANK YOU! In the Know, Inc. In The Know The Inservice Club for Nursing Assistants Words To Know Microbes are invisible organisms such as fungi, viruses and bacteria. Not all microbes cause disease. It’s a Bug’s World! Fungi are tiny molds, mildews, rusts and yeasts. Some fungi can cause health problems. Thousands of different diseases can affect human beings. Some diseases—such as cancer and diabetes—develop on their own. Others—such as sickle cell anemia—are inherited by children from their parents. And, still others—such as pneumonia and tuberculosis infections—are caused by tiny living organisms called bacteria. Viruses are primitive “creatures” that cannot live on their own. But, when attached to living cells, they become “poison factories”. In the early 1900’s, infectious disease was the main cause of death in America. Then, in 1928, penicillin was discovered. By 1941, penicillin was used successfully as an antibiotic. Doctors were thrilled to have a drug that killed bacteria. Bacteria are tiny living organisms made from just one cell. As more and more antibiotics were created, doctors hoped that they could totally wipe out diseases—like small pox, meningitis and typhoid—by making bacteria extinct! For a while, their plan seemed to be working. But now it’s clear that the bacteria are fighting back. Pathogens are microbes that are harmful to human beings. “Germ” is the nickname for disease-causing microbes. Bacteria have been on this earth for 3.5 billion years! And they have spent that time learning how to survive—no matter what. Even though they have been attacked by antibiotic drugs for 60 years, bacteria have not given up. Instead, they have become resistant to the antibiotics. This means that many of our most powerful drugs no longer work. They are powerless against the bacteria they were supposed to destroy! Nosocomial infections are infections that people pick up in the hospital (or other health care setting). Drug-resistant bacteria are not new. The man who discovered penicillin, Sir Alexander Fleming, warned of the dangers of drug resistance in 1929. But scientists had faith that they could develop newer and more powerful antibiotics, so they ignored the warnings. Now, scientists are beginning to wonder just who is smarter...people or bacteria? © 2001 In the Know, Inc. May be copied for use within each physical location that purchases membership in the Inservice Club. All other copying or distribution is strictly prohibited. By learning more about drug-resistant bacteria, you’ll understand the importance of proper infection control procedures. And, you’ll be able to help protect yourself and your clients from dangerous infectious diseases. PAGE 2 I N T H E K N OW Interesting Facts About Bacteria • • • One single bacterium can multiply to 250,000 bacteria in just a few hours. • There are no male or female bacteria. They reproduce by simply dividing in two. • Some bacteria need oxygen. Others die if oxygen is present. Some bacteria like it cold. Others like it hot. Bacteria can live on the surface of the earth—and they can live deep inside the earth. (Scientists know that there are bacteria alive at least four miles down under your feet.) There are over 10 million bacteria on every square inch of a person’s armpit. Q: What do you call the back door to a cafeteria? Between our toes, we probably have tens of millions of bacteria—even right after a bath! There are about 10 billion bacteria living in your teeth, mouth and gums. • There are more bacteria in one person’s gut than the total number of people who have ever lived! • Doctor: Well, Mrs. Jones, here’s some antibiotics, but you know...exercise kills germs, too. Each of us has about a trillion bacteria on our skin. (That’s 1,000,000,000,000,000 bacteria.) • Unborn babies are bacteria-free. But, by the time they are one day old, babies are covered by a thin film of bacteria. • Scientists have identified about 4000 different types of bacteria—and there are probably millions of others waiting to be identified. • Of the millions of different bacteria, scientists know of only 100 that are harmful to humans. These “harmful” bacteria are not trying to destroy humans. They are just looking for a nice place to live and grow! Here’s a Chuckle... A: A bacteria. • Mrs. Jones: That’s silly, Doctor! How do you expect me to get my germs to exercise? • Most of the bacteria that live on and around us are helpful. They fight off the “bad” bacteria, eat up waste we don’t need, and help produce the air we breathe. In fact, we couldn’t live on this earth without them! • Some bacteria only live in certain parts of the world. We all get used to the germs that live in our own area, but unfamiliar germs are more dangerous to us. This is why many people get sick when they travel to a foreign country—they meet up with germs that their bodies have never had to deal with before. © 2001 In the Know, Inc. PAGE 3 I N T H E K N OW The History of Germs • • • • • In ancient times, people believed that disease was caused by demons or sorcerers. Germs Can Be Dangerous! • By the year 450, people came to believe that “bad blood” caused disease. • During the sixth century, the bubonic plague killed 25% of the people in Northern Africa and Greece. In the 1600’s, a man named Anton van Leeuwenhoek became the first person to see bacteria through a homemade microscope. (He picked his teeth and looked at this “crud” with his microscope!) However, people didn’t make the connection between these tiny microbes and disease for another 200 years. In the 1800’s, two European scientists helped us understand that germs cause infectious diseases. Louis Pasteur’s research led to a vaccine for rabies and a method for pasteurizing milk. Robert Koch identified the bacteria that causes anthrax. For his work, he won the Nobel Prize in 1905. Between the years 1880 and 1925, many deadly germs were identified, including typhoid, tuberculosis, tetanus and scarlet fever. Doctors also discovered that germs and animals like to team up to spread disease. Over the centuries, dangerous germs have “ridden” on flies, mosquitoes, fleas and rats. Together, they have caused serious diseases called “plagues”, wiping out huge numbers of people in short periods of time. • In 762, the same germ killed over half of the people living in one Chinese province . • In 1624, there were about 7500 colonists living in Jamestown, Virginia— until typhoid killed all but 1100 of them. • In 1825, cholera killed over two million people in Russia. • In 1918, right after World War I, a flu germ killed over 21 million people around the world. Infectious or Contagious...What’s the Difference? Infectious diseases can be spread by infected people, animals, food, water or objects. Contagious diseases can only be spread between people. (For example, rabies is an “infectious” disease but it is not “contagious”. This means you can’t get rabies from a person who has the disease—only from the bite of an infected animal.) Nosocomial infections are infectious diseases—many of which are contagious. Nosocomial infections are almost always caused by drug-resistant bacteria. The most common include urinary tract infections, pulmonary infections, surgical wound infections and an infection of the blood called “sepsis”. Nosocomial infections kill more Americans every year than all the soldiers who died in the Vietnam war! © 2001 In the Know, Inc. PAGE 4 I N T H E K N OW The History of Antibiotics In ancient times, people used mixtures of herbs to treat infections. Some of them were actually pretty effective. • In 1928, Alexander Fleming discovered penicillin...almost by accident. He was “growing” some staph bacteria in his laboratory when he noticed that one section of the bacteria seemed to be covered by mold. And those “moldy” bacteria were dying! After some more research, Fleming found a way to use this mold to treat infections in humans. (So, remember, penicillin is a mold...just like the mold that grows on old bread!) • By the 1950’s, penicillin was considered a “miracle drug”. However, doctors realized that penicillin only killed certain bacteria. (For example, it was powerless against tuberculosis.) So, researchers worked to discover other antibiotics, such as sulfa drugs, cephalosporin and streptomycin. Each new antibiotic was able to kill different kinds of bacteria. • Doctors began to prescribe antibiotics frequently for their patients—even if their illnesses weren’t caused by bacteria. For example, colds are caused by viruses—not by bacteria—so an antibiotic won’t make a cold go away. But, let’s say Mr. Jones had a bad cold, and his doctor worried that the cold might turn into pneumonia. Just in case, the doctor prescribed an antibiotic for Mr. Jones. (Today, most doctors realize that it’s better to wait until their patients actually need an antibiotic.) • The use of antibiotics has risen dramatically over the years. For example, hospitals across the United States used: • $94 million worth of antibiotics in 1962. • $218 million worth of antibiotics in 1971. • $3 billion worth of antibiotics in 1991. • Over $8 billion worth of antibiotics in 1997. • At least 15% of all the prescriptions written by American doctors are for antibiotics. • There are now over 150 different antibiotics—and some bacteria are resistant to all of them! Developing new antibiotics buys us a little time, but it doesn’t solve the problem of drug resistance. Keep reading to find out why. Laugh... Q: Which country has the most germs? A: Germany. • ...and Learn! Remember...most antibiotics don’t work very well unless a person’s immune system is strong enough to mount an attack against the harmful germ. Certain conditions—such as AIDS—weaken the immune system. So, people with AIDS have a hard time recovering from infections—even when they take antibiotics. Antibiotics kill bacteria by stopping them from using energy or by preventing them from building cell walls. Scientists aren’t giving up...they continue to do research that will help them develop new and different antibiotics. © 2001 In the Know, Inc. PAGE 5 I N T H E K N OW How Do “Bugs” Become Drug-Resistant? • Have you ever heard the expressions “survival of the fittest” or “the strong will survive”? Well, both statements are true about bacteria. Bacteria know how to survive— even when they are attacked by strong antibiotics. • Remember...antibiotics kill enough bacteria to control a person’s infection. And, it’s the weak germs that get wiped out first. Because no antibiotic can destroy every harmful germ in someone’s body, there are always some bacteria left. (This is especially true if the person stops taking the antibiotic before the prescription is finished.) And, it’s the strongest germs that survive! • There are a number of ways that the “leftover” bacteria can become resistant to an antibiotic: • They learn how to produce an enzyme that stops the drug from working. • The bacteria “mutate”, changing their outside structure. This allows them to hide from the antibiotic—since the antibiotic doesn’t recognize them anymore. • By changing on the inside, the bacteria find a new way to produce their harmful toxins. • Unfortunately, that’s not the end of the story. Bacteria that have become drug-resistant can share this information with other bacteria—teaching them how to fight the drugs, too. This means that germs can learn how to fight an antibiotic before they are exposed to it! • But, wait...there’s more. Bacteria can figure out how to fight several different antibiotics after being exposed to only one. This means that a germ can become resistant to every antibiotic we have—by being exposed to only a few! • This process can be a quick one. For example, it only took three years for the first bacteria to become resistant to penicillin. • Taking an antibiotic when it’s not really necessary makes the problem worse because the drug kills lots of friendly bacteria instead of harmful germs. Without these friendly bacteria, a person’s body is at risk of being “taken over” by bad bacteria. Laugh... In biology class, the teacher was explaining that germs always work in large groups. The class clown piped up, "Well, that would explain then why no one ever gets just one measle!” ...and Learn! The following factors have contributed to the development of drug-resistant bacteria: • Using too many antibiotics. • Using antibiotics the wrong way— such as not finishing a prescription. • Giving antibiotics to livestock and poultry. Did you know that you can buy antibacterial soap, lotion, laundry detergent...even kitty litter! Many scientists say that this “fad” of making products antibacterial should stop because it is making drugresistance worse. © 2001 In the Know, Inc. I N T H E K N OW PAGE 6 Super Bug #1: MRSA MRSA stands for Methicillin Resistant Staphylococcus Aureus. • Staphylococcus Aureus—or “staph”, for short—is commonly found on the skin of healthy people. It is usually a harmless “passenger”, but when it turns toxic, it causes minor illnesses (like pimples and boils) or serious illnesses (like pneumonia and toxic shock syndrome). • Methicillin is an antibiotic, in the same family as penicillin. It has been used for years to treat staph infections, and is still successful in some cases. However, bacteria known as MRSA are staph germs that have learned how to fight back against methicillin. They are drug-resistant! • Staph germs were the first bacteria to become resistant to penicillin. • Elderly and/or very sick people are most at risk for MRSA. If they have an open wound (such as a bedsore) or a tube going into the body (like a Foley catheter), their risk is even higher. • MRSA germs can be found on the skin, in the nose, and in blood or urine. The bacteria are spread between people through physical contact—usually from a health care worker’s hands! MRSA bacteria do not travel through the air. • If you are working with a client who has MRSA, that person might be kept isolated from other people so that the germ doesn’t spread. And, in addition to following standard infection control precautions, you’ll have to follow contact precautions, too. If you are unsure of these procedures, check with your supervisor. • Your client’s doctor may prescribe a special ointment that can remove MRSA from the nose or from a small wound. This ointment is considered a medication and is usually not applied by nursing assistants. Laugh... Q: How do bacteria reproduce? A: They multiply by dividing! • ...and Learn! Drug-resistant bacteria are not just found in hospitals! Clients in other settings— including nursing homes, rest homes, assisted living facilities and even those cared for at home—are at risk for these dangerous infections. The most common drug-resistant bacteria found outside the hospital are MRSA and VRE. Strep infections that are resistant to penicillin and foodborne infections are also common. Three Things to Remember About MRSA: 1. Half of all people carry staph around on their bodies—without getting sick from it. But, if you have staph on your skin and the bacteria “jump” onto your clients, they might get very sick. 2. Clients who are infected with MRSA usually need to be in a room of their own. 3. When working with a client who has MRSA, you should wash your hands and put on gloves before entering the client’s room. © 2001 In the Know, Inc. I N T H E K N OW PAGE 7 Super Bug #2: VRE • VRE stands for Vancomycin Resistant Enterococci. • Enterococci are bacteria that normally live in people’s bowels. They can also live on the skin and in the environment for days—or even weeks. • Vancomycin is an antibiotic that was discovered in 1956, but was rarely used. Why? Doctors believed it was the final defender against certain bacteria. They wanted to save it for special cases when no other antibiotic would do. (Vancomycin is rather toxic itself, with a number of serious—and unpleasant—side effects. So doctors usually give it to seriously ill people only.) But, now, enterococci bacteria have become resistant to the strongest drug we have! • VRE was first reported in the United States in 1987. By 1991, 38 American hospitals had experienced problems with the VRE germ. Now, for every five people that become infected with enterococci bacteria, one of them will VRE—the drug-resistant kind. • The people who are most at risk for VRE include: • Intensive care patients. • People who have recently taken several other antibiotics. • People who are recovering from abdominal surgery. • VRE is spread by unwashed hands or from gloves that are dirty from touching a client or a contaminated environment. • You may be asked to use a special antibacterial soap when bathing your clients to reduce the number of VRE on their skin. If so, follow the directions for using the soap carefully. Learn... Unfortunately, it looks like staph “bugs” are learning from their enterococci buddies. The CDC warned hospitals in January, 2000 of a dangerous new problem. They reported that a 63 year old woman had died from a staph infection that couldn’t be stopped with vancomycin. Over the past 20 years, there has been a 36% increase in the number of nosocomial infections. Scientists believe that if we hadn’t started infection control programs in our health care facilities, three out of four patients would catch an infection while in the hospital. Three Things to Remember About VRE: 1. Healthy people are not at risk for getting VRE, but they can carry it to others. 2. Be sure to wear gloves when dealing with a client’s body excretions. Wash your hands before and after wearing the gloves. 3. VRE have not been shown to travel through the air. So, wearing a mask when working with a client who has VRE is not necessary. © 2001 In the Know, Inc. I N T H E K N OW PAGE 8 Super Bug #3: Multi-Drug Resistant TB • Tuberculosis is a bacteria that usually infects a person’s lungs. People can be infected with tuberculosis bacteria and not get sick. It’s common for healthy people to test “positive” on a TB test. Most of these people will never come down with TB disease. • But, in 1937, tuberculosis was the number one cause of death in the United States. If someone came down with TB back then, he had a 50% chance of dying. • That situation changed with the discovery of special antibiotics that could destroy the TB germ. By the 1980’s, people with tuberculosis had a 98% chance of being cured. • However, anti-tuberculosis drugs aren’t prescribed for just a week or ten days. They need to be taken every day for six months! Because so many people with TB stopped taking their medication before the six months was up, we now face a real problem with drug-resistant tuberculosis. • This dangerous strain of TB bacteria is common in places where people are confined and overcrowded— such as prisons. • Drug-resistant TB is also a big risk for people with HIV or AIDS. Since they have weakened immune systems, their bodies aren’t able to fight the TB germs. • Many doctors feel that the best way to control the spread of drugresistant TB is to watch people take their anti-TB medication. They would like it to be the law—around the world—that all people with TB have to be observed while they swallow their pills. • TB germs are spread through the air. People with active TB may be kept in a room with a special air filter in it. Learn... The microbes that cause tuberculosis will never stop evolving. If doctors come up with a new drug, the TB bacteria will eventually learn how to resist it, too. There are other bacteria that are becoming “superbugs”, including the bacteria that cause: • Gonorrhea • Malaria • Strep throat • Pneumonia (Remember Jim Henson, the creator of Kermit the Frog and the other Muppets? He died from a strep infection that was resistant to antibiotics.) Three Things to Remember About TB: 1. If you work with TB clients, you must be fitted for a special mask. And you must use the mask properly—to protect yourself and your other clients. 2. If you are asked to watch your client swallow anti-TB pills, be sure you know what to watch for and what to document. 3. Be sure to report if your client has symptoms of TB, including: fever, night sweats and a hacking cough—which often produces mucus and/or blood. © 2001 In the Know, Inc. I N T H E K N OW PAGE 9 Super Bugs #4 & 5: Salmonella & E Coli • Back in the 1950’s, scientists discovered that if they gave antibiotics to animals, they grew faster and bigger. (This also helped prevent infections.) So, since then, the livestock and poultry animals that we use for food have been fed antibiotics. (For example, the average chicken lives for 45 days...and is given antibiotics for 42 of them.) • Of course, the bacteria that live in and on animals have also learned to resist antibiotics. These bacteria can be passed on to the people who eat the meat or poultry. • At the same time, the bacteria have learned how to survive inside a refrigerator and even the high temperatures used in cooking! • Two of the most harmful germs are called Salmonella and E. Coli. Salmonella live in the ovaries of most chickens, so people are most at risk when they eat raw or undercooked eggs. The E. Coli germs live in the intestines of most animals (and humans). It shows up most often in raw milk and undercooked beef. Both germs can cause serious cases of food poisoning— and may even be fatal. • The problem is getting worse. In 1963, there were only 723 cases of Salmonella poisoning in the United States. By 1986, there were nearly 19,000. Today, there are millions of cases every year. (And, 9,000 people die every year from infected food.) • You may have heard that ground beef is a real problem. The reason is that if there are bacteria on the outside of a steak, they are killed when the steak is cooked. They don’t get inside the steak. But, if that same steak is ground up, the germs from the outside get spread throughout the meat. That’s why hamburgers need to be cooked until well done. • It’s important to handle, store and cook food properly to avoid problems with food poisoning. This includes washing raw fruits and vegetables before eating, getting foods into the refrigerator quickly, and cooking foods for the recommended time. Laugh... Have you heard about the guy who is so afraid of bacteria, that he even cooks his ice cubes before he puts them in his drink? ...and Laugh Again! Mike, age 4, was playing with his friend, Pete. Pete’s mother invited Mike to stay for dinner. She asked both boys to wash their hands before sitting down to eat. “Why?” asked Mike. “Germs from our hands can get on our food while we are eating," Pete’s mother explained. "Oh, I don't need to worry about that at home, " Mike told her. "We use forks.” Three Things to Remember About Salmonella & E. Coli: 1. To avoid food poisoning, always wash your hands before handling food...and after handling raw meat. 2. Always clean any surface that has touched raw meat with soap and hot water. 3. Report any symptoms of food poisoning: nausea and cramps (usually within 12 to 48 hours after eating the bad food), diarrhea, fever and vomiting. © 2001 In the Know, Inc. I N T H E K N OW PAGE 10 Infection Control Tips • Remember that older people “catch” infections more easily than younger people. (They tend to get sicker, too.) Encourage your elderly clients to prevent infections by getting vaccines for flu and pneumonia. • Help your clients keep strong immune systems by encouraging them to eat nutritious foods. The following foods provide the immune system with important vitamins: • Carrots and other yellow-orange vegetables. (Vitamin A) • Leafy greens. (Folate) • Kidney beans, bananas, meat and whole grain breads. (Vitamin B6) • Citrus fruits and juices. (Vitamin C) • Sunflower seeds and wheat germ. (Vitamin E) • Dark meat turkey, spinach. (Iron) • Beef, seafood and pumpkin seeds. (Zinc) • Regular exercise and a positive attitude also help keep the immune system strong. Encourage your clients to move their bodies and to keep a smile on their faces! • If you cook meat for your clients, be sure to cook it until the juices run clear—not pink! • If you use a knife to cut raw meat, don’t cut anything else with it until you have washed the knife with soap and hot water. • If a client has diarrhea, be extra careful with washing your hands before and after client care. Also, help the client wash his or her hands after each bowel movement. • Remember eating raw cookie dough as a kid? Don’t allow any client to eat raw cookie dough— or any other product that contains raw eggs. They could become very sick. • Help your clients wash their hands before every meal. • If you have questions about whether a particular food is safe for your clients to eat, discuss the issue with your supervisor. Laugh... To prevent the plague: • Keep the streets clear of garbage. • Keep your body clean. • Avoid overeating, drunkenness and too much sex. • Suck on pomegranates or sour plums. Eat pickled onions for breakfast. • Cover your windows—unless they face north. • Drink the following mixture: chopped snakes, wine, powdered emeralds and gold dust. (Tips from the year 1345!) ...and Learn! Vaccines work by forcing the body to develop an “army” of cells that are “trained” to fight off a certain disease. © 2001 In the Know, Inc. I N T H E K N OW PAGE 11 More Infection Control Tips • If your clients are taking antibiotics, encourage them to take them properly. This includes: • Taking each dose on time. (Some antibiotics are given only once a day, but most are two, three or even four times a day. Help your clients remember to take each dose.) • Following instructions for taking the medication. (Some antibiotics work best on an empty stomach and some need to be taken with food or milk.) • Finishing the medication as prescribed—even after they start feeling better. • Not sharing antibiotics with others or taking someone else’s leftover pills. • For your female clients who are taking an antibiotic, watch for signs of a vaginal yeast infection such as vaginal itching and a white, smelly discharge. (Because friendly bacteria are also killed when people take antibiotics, there aren’t enough left to fight off yeast. So, the yeast are able to “take over” the vaginal area, causing an infection.) Report the problem right away. • When working with clients who have MRSA or VRE, follow these tips: • • • • • • • Make sure the toilet and bathroom stay very clean, using a household disinfectant. Help the client to bathe regularly. Dry their skin well. The client’s dishes do not have to be separated from other people’s. They may be washed in hot water and regular dishwashing liquid—or in a dishwasher. The client’s linens and clothes do not have to be separated either—unless they are very soiled with feces. Cleansers such as Lysol, Pine-Sol and Mr. Clean all kill MRSA and VRE germs. But, be sure to let the disinfectant air dry! Disinfect all shared equipment such as stethoscopes, blood pressure cuffs and thermometers. To reduce your risk of becoming a carrier of MRSA or VRE, follow proper infection control procedures at all times!! Learn... In 1941, someone with pneumonia could be cured by taking 10,000 units of penicillin. Today, even 24 million units may not save the person’s life! Some scientists are studying herbs and spices to see if they could be used as a “natural” antibiotic. Here’s what they found out during one study done at Cornell University: • Garlic, onions, allspice and oregano are able to kill nearly all kinds of bacteria. • Cinnamon, cumin, cloves and mustard can kill up to 90% of bacteria. • Caraway, mint, sage and nutmeg destroy up to 70% of bacteria. • Pepper, ginger and celery seed can kill up to 48% of bacteria. So, someday, our “new” antibiotics may be made from plants—just like in ancient times! © 2001 In the Know, Inc. I N T H E K N OW PAGE 12 Even More Infection Control Tips • Keeping your clients’ skin clean, dry and intact will go a long way toward preventing infections. (The skin is the body’s first line of defense against germs.) • Remember that some favorite areas for bacteria are places that are warm and moist—like the face, neck, armpits and genital area. Make sure your clients wash these areas with soap and water...and dry them carefully before getting dressed. • The key to washing your hands is not the kind of soap or the temperature of the water. It’s the energy you put into scrubbing your hands. Friction gets rid of bacteria, not soap. • To really clean your hands, you need to scrub them for at least 30 seconds. Studies have shown that most health care workers only wash their hands for 10 seconds! Take your time and do it right. • Studies have found that up to 75% of health care workers don’t wash their hands between patients. Don’t be one of them!! Wash your hands according to your workplace policy. • Teach your clients to ask you if you have washed your hands. (They should also ask everyone else who works with them.) And, then, when they do ask you, don’t get defensive. Just be grateful for the reminder! • Remember that gloves primarily protect you—not the client. If you have dirty hands when you pick up a pair of gloves, you’ll contaminate them—and your client. It’s important to wash your hands before you put on gloves! • Follow your workplace policy for cleaning any equipment you use for more than one client—like a stethoscope. Infection control officials recommend swabbing stethoscopes with alcohol after each use to prevent spreading germs. (Keep this in mind...one study of 200 stethoscopes used in four different hospitals found that 160 of them were contaminated with harmful bacteria!) Learn... Did you know that in the early 1800’s, many surgeons wore their regular clothes while they operated? Others wore long coats that they didn’t bother to wash in between operations. In fact, surgeons with a lot of blood stains on their coats were proud— since it showed they had lots of surgical experience! The first bar of soap was made in 600 B.C. by boiling goat fat in water and adding ash. In the Middle Ages, people didn’t take many baths. Most people thought that bathing once a year was enough. Others believed that bathing was dangerous...and could even be fatal! Remember… The single most important thing you can do to help control the spread of drug-resistant bacteria is to wash your hands! For your own safety, follow your workplace procedure for handwashing. The safety of your clients, your coworkers and your family depends on it, too! © 2001 In the Know, Inc. Are You “In the Know” About Drug Resistant Bacteria? Circle the best choice and then check your answers with your supervisor! 1. Bacteria are: A. Molds and mildews. B. Tiny one-celled creatures. C. Rare in the United States. D. Always harmful to the human body. 2. True or False Antibiotics are powerful drugs that help wipe out viruses. 3. MRSA is: A. Only a problem in hospitals. B. Rare among elderly people. C. A drug-resistant strep germ. D. A risk for people with open wounds. 4. True or False If a disease is contagious, it means that you can catch it from another person. 5. Bacteria have become drug-resistant because: A. Most antibiotics are contaminated. B. People in modern times bathe too often. C. People eat too much beef. D. Antibiotics have been used too often. 6. VRE is: A. A drug-resistant intestinal germ. B. An infection that healthy people get. C. Spread through the air. D. Spread in contaminated food. 7. True or False People with tuberculosis shouldn’t take antibiotics. 8. True or False Salmonella and E. Coli are bacteria that can cause food poisoning. 9. True or False It’s safer to eat a rare hamburger than it is to eat a rare steak. 10. True or False Washing your hands for 10 seconds is okay if you use antibacterial soap. EMPLOYEE NAME________________________________________ DATE______________________ I understand the information presented in this inservice. I have completed this inservice and answered at least eight of the test questions correctly. Employee Signature____________________________________________ Inservice Credit: 60 minutes Supervisor Signature____________________________________________ Self Study File competed test in employee’s personnel file. Group Study _____ _____