Failure to Perform Hand Hygiene During Dependent Resident Feeding
Penalty
Summary
Staff failed to perform proper hand hygiene while assisting with feeding dependent residents, as observed during a 40-minute meal service. The Activity Director/CNA assisted four dependent residents with their meals, touching dirty napkins, wiping residents' faces, and touching a resident's leg to prompt eating, without performing hand hygiene between each resident. This practice was inconsistent with the facility's hand hygiene policies and procedures, which require hand hygiene after contact with residents' mucous membranes, body fluids, or excretions, and between direct contact with different residents. Interviews with staff revealed a lack of consistent in-service training on hand hygiene specific to feeding residents. The CNA involved stated she believed hand hygiene was only necessary at the start and end of feeding, and admitted to cross-contaminating by not using hand sanitizer between residents. Other staff, including another CNA, the Infection Preventionist (LPN), the Medical Director, and the DON, all confirmed that hand hygiene should be performed between residents and after contact with potentially contaminated surfaces or body parts. However, both CNAs interviewed indicated they had not received in-service training on this topic at the facility.