Deficiency in Tracheostomy Care Competency
Penalty
Summary
The facility failed to ensure that nursing staff were qualified and competent to perform tracheostomy care and suctioning for a resident with a tracheostomy. The facility's policy on orientation and competency evaluation was not effectively implemented, as evidenced by the lack of documented competencies for tracheostomy care and suctioning among licensed nursing staff. During an observation, it was noted that suctioning equipment was not available at the bedside of a resident who required tracheostomy care, leading to a situation where the resident experienced coughing and desaturation after the inner cannula was replaced. The LPN had to leave the resident's bedside to retrieve the necessary equipment, indicating a lapse in preparedness and competency. Interviews with the Director of Nursing and the LPN revealed that the staff did not receive training or in-service to confirm competency in tracheostomy care or suctioning. Further review of employee personnel files confirmed the absence of documented evidence of completed competencies for these procedures among the licensed nursing staff. This deficiency was identified through observations, policy reviews, and staff interviews, highlighting a significant gap in staff development and competency assurance in the facility.
Plan Of Correction
A - Resident R1 suction supplies obtained and placed at bedside. Employee E2 was competent after the event was reported. B - N/A C - All nursing staff completed competencies on suctioning of resident with tracheostomy prior to next shift worked. New Jersey Respiratory Association completed additional in-services with staff. D - Weekly x 4 then monthly x 2 audits by DON or designee of new staff to ensure trach care training and competency is completed. Results discussed during QAPI meetings.