Failure to Implement Resident Hand Hygiene Before Meals
Penalty
Summary
The facility failed to implement proper hygiene protocols for residents before meals, which is a critical component of their infection prevention and control program. Observations revealed that 23 residents dining in the main dining room were not offered any means to clean their hands before eating. Staff members, including CNAs, confirmed that the practice of providing wipes or other hygiene measures had ceased over time, despite acknowledging the importance of hand hygiene in preventing the spread of germs. The facility's policy on handwashing and hygiene, dated 2019, emphasized the importance of hand hygiene as a primary means to prevent the spread of infections, yet it did not specify that staff should offer hygiene to residents before meals. Interviews with several CNAs indicated a lack of consistent practice and awareness regarding the importance of offering hand hygiene to residents before meals. CNA D mentioned that the practice of handing out wipes had stopped, while CNA C and CNA B acknowledged that they had not been reminded or instructed to offer hygiene measures to residents. The facility's Infection Preventionist expressed disappointment that staff were not aware of the need to offer hand hygiene, despite previous education efforts. The Preventionist noted that resources such as washcloths, wipes, and gel were available for use, but staff had not been utilizing them to ensure residents' hands were clean before meals.
Plan Of Correction
This plan of correction is submitted as required under Federal and State regulations and statutes applicable to long term care providers. This plan of correction does not constitute an admission of liability on the part of the facility, and such liability is hereby specifically denied. The submission of this plan does not constitute agreement by the facility that the surveyors findings or conclusions are accurate, that the findings constitute a deficiency, or that the scope or severity regarding any of these deficiencies cited are correctly applied. 1. On preventionist immediately educated staff on the importance of hygiene for residents before and after meals. On NHA immediately obtained sanitizing wipes and sanitizer, provided them to staff and residents to use at that time and prior to upcoming meals. 2. On NHA observed both units and corrected any issues at that time. Both units were observed, and the deficient practice was corrected immediately. 3. The Director of Nursing/ Preventionist will educate all current nursing and activity staff on proper control practices related to hygiene before and after meals for residents. The Director of Nursing/ Preventionist/ or designee will administer an eating support competency to measure understanding. The Director of Nursing/ Preventionist will educate alert and oriented residents on proper hygiene before and after meals for increased awareness. The Administrator or designee will conduct 5 random quality reviews including weekends by weekend supervisor or designee. The audit will include control practices regarding hygiene for residents before and after meals to ensure compliance. 4. The Administrator or designee will conduct a quality review on proper hygiene prior to meals. This will be conducted 5 times weekly for 4 weeks, then weekly for 2 months. The findings of these quality reviews will be reported to the Quality Assurance/Performance improvement Committee monthly until committee determines substantial compliance has been met.