Deficiency in Nursing Staff Competency for Specialized Care
Penalty
Summary
The facility failed to ensure that nursing staff possessed the necessary competencies and skill sets related to medication administration, care, and assessment of residents with indwelling urinary catheters and gastrostomy tubes. This deficiency was identified through a review of facility documentation, clinical records, employee personnel records, and staff interviews. Specifically, Employee 2, a registered nurse, did not have documented competencies in these areas, which are critical for the care of residents with specific medical needs. The facility's assessment, last updated in March 2025, indicated that RN competency and training should include catheter insertion and flushing, as well as medication administration, but did not explicitly cover RN care for artificial feeding systems. Resident 101 had active physician orders for urinary catheter irrigation and changes, while Resident 57 required specific care for both an indwelling urinary catheter and a PEG tube. Despite these needs, the facility could not provide evidence of Employee 2's competencies in these areas, as confirmed by the Nursing Home Administrator. The RN orientation checklist lacked verification of competencies in medication administration, indwelling catheter care, or PEG tube care, highlighting a gap in ensuring that nursing staff were adequately trained to meet the residents' care requirements.
Plan Of Correction
Employee number 2 competency related to medication administration, the care and assessment of residents with indwelling urinary catheters and gastrostomy tubes will be completed. A baseline audit of nurses will be reviewed and ensure competencies are completed. Skills competency will be added to orientation checklist to be completed during orientation period. Registered Nurses will be educated on completion of the competency. An audit of newly hired nurses will be completed to ensure completion of competency monthly for 3 months. Results of this audit will be reviewed by the Quality Assurance Committee to evaluate the need for ongoing auditing or further education.