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CNA Training Advisor Volume 11 Issue No. 8 August 2013 Vaccinations are an important part of being healthy, and they become even more important as we grow older. With age, the body s defenses against disease weaken. Vaccinations are injections that contain a weakened form of a given disease. Although this weakened disease is not strong enough to cause a person to get sick, the body s immune system still attacks the disease cells to form antibodies. Then, the next time the body is exposed to the disease, the antibodies will be ready to fight it off. In this lesson, you will learn important basics like the difference between immunization, vaccination, and vaccines. The lesson will describe how vaccines work and what diseases a vaccine can prevent. The lesson will also focus on two diseases that are prevalent in older adults. The Centers for Disease Control and Prevention recommends both pneumonia and influenza (flu) vaccinations for people older than 65 years, so this lesson will take an in-depth look at these vaccines. Have a good day of training, and stay tuned for next month s issue of CNA Training Advisor on time management. A focus on documentation Many people assume they ve gotten all their vaccinations as children. However, this may not be true. Which shots did they get? When? Not everyone knows. You must document any symptoms or reactions a resident may have, either before or after a vaccination. If you document that a resident seems to be developing the flu, it could alert the clinician that the resident may need a flu shot. On the flip side, if a resident has received a shot and doesn t seem well, he or she may be having a reaction. Your documentation of this reaction can ensure the resident doesn t receive the same shot again down the line. Quiz answer key 1. a 2. b 3. a 4. d 5. b 6. a 7. c 8. d 9. b 10. c Program Prep Program time Approximately 30 minutes Learning objectives Participants in this activity will be able to: Describe how a vaccine works Name several diseases that vaccines can prevent Recognize common flu vaccine myths and understand how to dispel them Preparation Review the material on pp. 2 4 Duplicate the CNA Professor insert for participants Gather equipment for participants (e.g., an attendance sheet, pencils, etc.) Method 1. Place a copy of CNA Professor and a pencil at each participant s seat 2. Conduct the questionnaire as a pretest or, if participants reading skills are limited, as an oral posttest 3. Present the program material 4. Review the questionnaire 5. Discuss the answers see also hcpro.com/long-term-care

This document contains privileged, copyrighted information. If you have not purchased it or are not otherwise entitled to it by agreement with HCPro, any use, disclosure, forwarding, copying, or other communication of the contents is prohibited without permission. editorial advisory board Associate Editorial Director Todd Hutlock thutlock@hcpro.com Editor Casey Pickering cpickering@hcpro.com Stay connected Interact with us and the rest of the HCPro community at HCPro.com Become a fan at facebook.com/hcproinc Follow us at twitter.com/hcpro_inc Email us at customerservice@hcpro.com Questions? Comments? Ideas? Contact Editor Casey Pickering at cpickering@ hcpro.com or 781-639-1872, Ext. 3911. Don t miss your next issue If it s been more than six months since you purchased or renewed your subscription to CNA Training Advisor, be sure to check your envelope for your renewal notice or call customer service at 800-650-6787. Renew your subscription early to lock in the current price. Relocating? Taking a new job? If you re relocating or taking a new job and would like to continue receiving CNA Training Advisor, you are eligible for a free trial subscription. Contact customer serv ice with your moving information at 800-650-6787. At the time of your call, please share with us the name of your replacement. CNA Training Advisor (ISSN: 1545-7028 [print]; 1937-7487 [online]) is published monthly by HCPro, Inc., 75 Sylvan Street, Suite A-101, Danvers, MA 01923. Subscription rate: $149/year; back issues are available at $15 each. Copyright 2013 HCPro, Inc. All rights reserved. Printed in the USA. Except where specifically encouraged, no part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro, Inc., or the Copyright Clearance Center at 978-750-8400. Please notify us immediately if you have received an unauthorized copy. For editorial comments or questions, call 781-639-1872 or fax 781-639-7857. For renewal or subscription information, call customer service at 800-650-6787, fax 800-639-8511, or email customerservice@hcpro.com. Visit our website at www.hcpro.com. Occasionally, we make our subscriber list available to selected companies/vendors. If you do not wish to be included on this mailing list, please write to the marketing department at the address above. Opinions expressed are not necessarily those of CTA. Mention of products and serv ices does not constitute en dorsement. Advice given is general, and readers should consult professional counsel for specific legal, ethical, or clinical questions. Disease prevention is key to public health. It is always better to prevent a disease than to treat it. can protect both the people who receive them and those with whom they come in contact. are responsible for the control of many infectious diseases that were once common around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, and Haemophilus influenzae type b. also eradicated smallpox, one of the most devastating diseases in history. Over the years, vaccines have prevented countless cases of infectious diseases and saved millions of lives. It is important to keep immunizing against diseases as long as those diseases are present in the population. Even if there are only a few cases of a given disease today, if we stop immunizing ourselves against it, the disease will gradually spread to more and more people, undoing the progress we ve made against it over the years. Important terms Let s start by defining basic terms: Immunization: The process by which a person or animal becomes protected against a disease. This term is often used interchangeably with vaccination or inoculation. Vaccination: Injection of a killed or weakened infectious organism in order to prevent the disease caused by that organism. Vaccine: A product that produces immunity and protects the body from a disease. are administered through needles, by mouth, or by aerosol. How do vaccines work? reduce the risk of infection by working with the body s natural defenses to help it safely develop immunity to disease. When germs, such as bacteria or viruses, invade the body, they attack and multiply. This invasion is called an infection, and the infection is what causes illness. The immune system then has to fight the infection. Once it fights off the infection, the body is left with a supply of cells that help recognize and fight the same infection in the future. help develop immunity by imitating an infection. This imitation infection does not cause illness, but it causes the immune system to respond just as it does to a real infection, thus allowing the body to recognize and fight the infection in the future. Sometimes, after getting a vaccine, the imitation infection can cause minor symptoms, such as fever. Such symptoms are normal and should be expected as the body builds immunity. 2 hcpro.com August 2013 2013 HCPro, Inc. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400.

What diseases can vaccines prevent? are available for all of the following diseases: Anthrax Diphtheria Haemophilus influenzae type b Hepatitis A Hepatitis B Human papillomavirus Influenza (flu) Japanese encephalitis Meningococcal disease Mumps Pertussis Pneumonia Polio Rabies Rotavirus Rubella Shingles (Herpes zoster) Smallpox Tetanus Tuberculosis Typhoid Varicella (chickenpox) Yellow fever Various vaccine-preventable diseases Below is more information about some of the diseases preventable by vaccines. All of these vaccines are delivered through shots. Common side effects for these shots include mild pain, swelling, or redness on the arm where the shot was given. It s a good idea to keep your own shot record listing the types and dates of your shots, as well as any side effects or problems. Tetanus (sometimes called lockjaw) is caused by bacteria found in soil, dust, and manure. It enters the body through cuts in the skin. Diphtheria is also caused by bacteria. It can affect the tonsils, throat, nose, or skin, and can spread from person to person. Diphtheria is a very serious illness. Getting a shot is the best way to keep from getting tetanus and diphtheria. Most people get their first shots for these diseases as children. For adults, a booster shot keeps you protected; it s important to get it every 10 years. Ask your doctor if you need a booster shot. If you had chickenpox when you were young, the virus is still in your body. When you are older, the virus may become active again, and you can develop shingles. Shingles causes a rash or blisters on the body or face and can be very painful, even after the rash disappears. There is a shot for people 50 or older that may prevent shingles. Ask your doctor if you should get the shingles vaccine. Measles, mumps, and rubella are rare thanks to the vaccinations that are given to children. However, when these diseases do occur, they are more serious in adults than in children. You can still get the vaccine even if you re not sure whether you ve already received it. In the next sections, we ll discuss two of the most important vaccinations for adults over 65 years old: influenza and pneumonia. The Centers for Disease Control and Prevention (CDC) recommends both pneumonia and flu vaccinations for people older than 65 years. Additionally, flu shots are recommended for everyone working in healthcare. Influenza Influenza, or flu, is a disease that is community based. This means that it is spread in homes and community settings schools, hospitals, airports, and any other place where people come together. Every year, millions of people in the U.S. get the flu between 5% and 20% of the population. The flu season generally runs from August of one year to April of the next year. (Memory tip: Think A to A August to April to keep track of the flu season.) For most people, flu is a minor problem. A mother might need to stay home to care for her daughter with the flu. A college student might miss some classes. For many, the disease passes in a few days, and people can 2013 HCPro, Inc. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400. August 2013 hcpro.com 3

then resume their daily activities. However, flu can be dangerous and even fatal. The CDC warns that more than 90% of the deaths from flu occur in persons older than age 65. Older people are more susceptible to the flu because their immune systems are not as strong as they once were. This means that if they get the flu, older people might take longer to get well. They can also develop other medical problems brought on by the flu, such as pneumonia, bronchitis, and sinus or ear infections. There are several myths about the flu. A myth is something that people believe even though it is not true, such as young children believing in the tooth fairy. Adults can believe in myths, too. The following are some myths about the flu and the truth behind each myth: 1. Getting a flu shot will give you the flu. The virus in the flu shot is dead and cannot cause the flu. The virus is inactivated, or killed, before being made into a vaccine. 2. It is okay to wait until everyone is getting the flu before getting a flu shot. The flu vaccination is not instantly effective. It takes about two weeks after getting the vaccine for the body to build antibodies. 3. Older people should get two flu shots to boost their protection. Studies do not show that getting two flu shots protects better than one shot. In 2009, two shots were needed because of the H1N1 outbreak, but this is rare; in most years a single injection is all that s needed. If multiple shots are necessary, the CDC will advise as appropriate. 4. If you don t get the flu vaccine by Thanksgiving, it s too late. Not true. A flu shot can protect from flu outbreaks that occur as late as May. Most years, the flu season peaks in January and February, but it can vary from year to year. 5. If you got a flu shot last year, you don t need one this year. The flu virus mutates, or changes, almost every year, so a new flu shot is needed every year to fight the changed virus. Research shows that flu shots reduce the number of people who get flu. In healthcare, more flu shots means fewer people miss work, which keeps the quality of patient care high (staff members who fill in for sick employees may not know the patients as well). The patients being treated do not get flu as often, which also cuts down on flu complications for elderly and very young patients: pneumonia, bronchitis, and ear infections. There are also fewer deaths from flu and its complications. Getting a flu shot can be a lifesaver for your patients. Rhode Island started requiring flu shots for healthcare workers in 2012. Some agencies, hospitals, and other healthcare providers also require staff to get flu shots. Pneumonia Pneumonia is an infection in the lungs. Around the world, pneumonia kills more people every year than malaria, AIDS, or tuberculosis. The CDC reports that more than 50,000 people in the U.S. die each year from pneumonia, making it one of the country s top 10 causes of death. Over a million people are hospitalized every year, for an average of five days, with pneumonia diagnoses. At any one time, more than 20,000 home health care patients are being seen for pneumonia-related problems. Although the flu does not cause pneumonia, it weakens the immune system, which allows for the spread of infection. Some people get pneumonia by breathing in disease-causing microbes from another person s sneeze or cough. The microbes infect the lungs and cause inflammation, and pneumonia may be the result if the person s immune system cannot fight off the infection. The microbes living in people s own bodies can sometimes cause a pneumonia infection. Everyone carries microbes in their mouth, nose, and throat. Normally, the body maintains a balance between helpful microbes and those that cause disease. But for a person with an impaired immune system, these microbes can enter the lungs and grow to become pneumonia. The CDC recommends a pneumonia vaccine for all persons older than age 65. Young people can receive a pneumonia vaccine that is sprayed into the nose, but older people must receive the vaccine via injection. H 4 hcpro.com August 2013 2013 HCPro, Inc. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400.

August 2013 Volume 11 Issue No. 8 CNA Professor vaccines Mark the correct response. Name: Date: 1. What disease has been eradicated through vaccines? a. Smallpox b. Measles c. Rubella d. Mumps 6. Who should get a flu vaccination? a. Everyone older than 65 and healthcare workers b. People in high-risk areas such as schools c. Everyone d. Everyone older than six months 2. An injection with a weakened form of a disease that helps the body build antibodies to prevent that disease in the future is called a(n). a. antigen b. vaccination c. immune response d. antibody 3. reduce the risk of infection by working with the body s natural defenses to help it safely develop immunity to disease. 4. Which of these is a disease that is preventable through a vaccine? a. Rabies b. Influenza c. Tetanus d. All of the above 5. The Centers for Disease Control and Prevention recommends both pneumonia and influenza shots for people over 40 years old. 7. Which of these is a myth about flu? a. Many people die of the flu every year b. Anyone can get the flu regardless of age c. Getting a flu shot will give you the flu d. Flu can lead to pneumonia in older people 8. Who should get a pneumonia vaccination? a. Everyone b. Everyone older than six months c. Everyone older than 21 years d. Everyone older than 65 years 9. Once you have had a vaccine for something, you can never get the same vaccine again. 10. When is flu season? a. January to September b. Only in winter months c. August to April d. All year round A supplement to CNA Training Advisor