Infection Control and Hand Hygiene Deficiencies
Penalty
Summary
The facility failed to adhere to proper hand hygiene protocols during medication administration and respiratory treatments for two residents. One resident, who was cognitively intact and diagnosed with Chronic Obstructive Pulmonary Disease, was observed receiving respiratory treatment via nebulizer without the staff performing hand hygiene before or after handling the nebulizer mask and medications. The staff member acknowledged the lapse in hand hygiene during the medication administration process. Another resident, with diagnoses including Cerebral Infarction and Major Depressive Disorder, was observed receiving medication from a nurse who directly touched oral capsules and pills with gloved hands instead of using a cap to transfer them to a medication cup. The nurse acknowledged the improper handling of medications, and the Director of Nursing confirmed that the medications should not have been touched directly with gloved hands. Additionally, the facility did not follow sanitary procedures during the disconnection of dialysis treatment for a resident with End Stage Renal Disease. The staff member performing the disconnection touched a hand sanitizing bottle and then proceeded to disconnect the dialysis access site without changing gloves or performing hand hygiene again. This failure to maintain proper infection control practices was acknowledged by the staff involved.
Plan Of Correction
Boca Circle Rehabilitation Center failed to properly follow hygiene protocol and handle medications in a sanitary manner. Disconnecting treatment in an unsanitary manner. Actions Taken: 1) Residents #90 no longer resides at the center. Resident #101 was seen by MD on and remains at baseline without signs or symptoms of. Resident #79 was seen by MD on and remains at baseline without signs or symptoms of. Staff C, LPN/Unit manager, was reeducated on by hygiene protocol during treatments. Staff D, RN, was reeducated on by DON/Designee on handling medications in a sanitary manner while dispensing medications. Staff M, patient care tech, was reeducated on by Karen Castelloni, to follow sanitary procedures for disconnecting treatment. Others Identified: 2) A full house audit of nurses doing medication administration and performing hygiene was initiated by the DON/Designee on. Any concerns identified were immediately addressed. DON/Designee conducted an audit on of the treatment being disconnected. No concerns noted. Measures Taken: 3) License Nurses were reeducated on by DON/Designee on the components of this regulation with an emphasis on appropriate and frequent hygiene during medication administration, handling medications in a sanitary manner, and proper hygiene protocol during treatments. Staff were reeducated on disconnecting the treatment in a sanitary manner by Karen Castelloni. Newly hired licensed nurses and staff will receive this education during general orientation. Ongoing Monitoring: 4) The Director of Nursing/Designee will conduct audits to verify appropriate hygiene during medication administration, handling medications in a sanitary manner, and proper hygiene protocol during treatments and staff disconnecting the treatment in a sanitary manner 3x weekly times x 4 weeks, and then weekly x 4 weeks and then every 2 weeks x 1 month. Audit results will be reviewed in Center QAPI meeting until substantial compliance has been met. F 880