Resident Exposed During Transfer to Shower Room
Penalty
Summary
A deficiency occurred when a certified nurse assistant (CNA) transported a male resident, who had been admitted with unsteadiness on his feet, from his bedroom to the shower room in a shower chair with a toilet seat opening. The resident was unclothed, with only a blanket covering the front of his legs, leaving the sides exposed. During this transfer, the resident's penis and scrotum were visible from the side of the chair, as they hung below the seat opening. This exposure was observed by staff, including the Infection Preventionist, who confirmed that the resident was not adequately covered to maintain privacy and dignity. Interviews with facility staff revealed that the CNA had received training on maintaining resident privacy and dignity but was unaware that the resident was exposed during the transfer. The Director of Staff Development also confirmed that staff were educated on the importance of privacy and that the resident's privacy was not maintained in this instance. A review of the facility's policy on dignity emphasized the need to promote and protect resident privacy, including bodily privacy during personal care, which was not upheld in this situation.