Infection Prevention for CNAs

Essential guidelines for maintaining compliance and resident safety at CAL ACE partner Facility sites.

1. Hand Hygiene & PPE

• Standard Hygiene: Perform hand hygiene before and after every resident interaction and immediately after removing gloves.
• Soap vs. Sanitizer: Use alcohol-based sanitizer unless hands are visibly soiled. Soap and water (minimum 20 seconds) is mandatory after restroom use and when caring for residents with C. difficile or norovirus.
• PPE Selection: Base PPE (gloves, gowns, masks) on the task being performed, not the resident’s diagnosis.
  • Gloves: Use for contact with blood, body fluids, or contaminated surfaces.
  • Gowns: Use when clothing may be exposed or when entering Contact Precaution rooms.

2. Transmission-Based Precautions

• Contact: Used for MRSA, VRE, and C. diff. Wear gown and gloves for every entry. Use dedicated equipment (BP cuffs, etc.).
• Droplet: Used for Flu, RSV, and Meningitis. Wear a surgical mask when within 6 feet of the resident.
• Airborne: Used for COVID, TB, and Measles. Requires N95 masks and restricted entry per facility policy.

3. Resident Care & Environment

• Perineal Care: Always wipe front to back (clean to dirty).
• Catheter Care: Keep the bag below the bladder, avoid kinks, and never tug.
• Feeding: Perform hand hygiene for yourself and the resident. Avoid touching the inside of cups or lids. Gloves are not required for feeding unless the resident is in isolation.
• Linens: Hold away from your uniform and never shake them.
• Disinfectants:
  • Yellow Top (Bleach): 4-minute contact time (required for C. diff).
  • Purple Top (Alcohol): 2-minute contact time.

4. Enhanced Barrier Precautions (EBP)

• When to use Gown + Gloves: High-contact tasks including bathing, dressing changes, transferring, repositioning, changing linens, and toileting.
• Resident Freedom: Residents on EBP can participate in group activities and are not restricted to their rooms.
• Signage: Look for the "EBP" sign; this is different from a standard isolation sign.

5. When to Report to the Nurse

EBP vs. Contact Precautions