Communication, Documentation, and Infection Control
Therapeutic communication
Use open-ended questions, active listening, a calm tone, and plain words. Avoid "why" questions, medical jargon, false reassurance ("you'll be fine"), and giving personal advice. Use the resident's preferred name. With hearing loss, face the person and lower your pitch rather than shouting. With aphasia, ask yes-or-no questions and allow time to answer. With dementia, use short sentences, one step at a time, and redirect rather than argue. Report what you observe.
Documentation
Chart objective facts and direct quotes, in black ink, at the time of care - never before it. Write "resident stated, 'My left hip hurts,' rated 7/10" rather than "resident is being difficult." Never erase or use correction fluid; draw a single line through an error, write "error," and initial and date it. Mark late entries as late entries and use only approved abbreviations.
Infection control
The chain of infection has six links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Hand hygiene is the single most effective way to break it - before and after every resident contact, even when gloves are worn.
PPE order: donning is gown, mask, goggles, then gloves. Removing is gloves, goggles, gown, then mask - gloves go on last and come off first.
Contact precautions cover MRSA, C. difficile, and scabies; droplet covers influenza; airborne covers TB and measles and requires an N95. C. difficile requires soap and water rather than alcohol rub.
Traps
- Wearing gloves instead of washing hands.
- Shaking linens or carrying soiled linen through the hallway.
- Reusing a razor or failing to bag linen at the point of use.
Rule of thumb
Gloves do not replace hand washing.