Failure to Follow CPAP Cleaning and Storage Protocols
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for one resident who required the use of a continuous positive airway pressure (CPAP) machine. The facility's policy required daily cleaning of the CPAP mask, nasal pillow, and tubing with mild soap and water, as well as proper storage in a bag to prevent contamination. However, observations revealed that the resident's CPAP mask, tubing, and headgear were repeatedly stored loosely in a nightstand drawer alongside personal items and visible debris, rather than in a clean bag as required. The care plan and electronic medical record did not specify instructions for cleaning or storing the CPAP equipment. Interviews with staff indicated inconsistent knowledge and practices regarding the cleaning and storage of the CPAP equipment. A CNA was observed cleaning the CPAP components with Super Sani-wipes, which is not in accordance with the manufacturer's recommendations or the physician's order, and then placing the items in a trash bag. Staff interviews revealed conflicting information about the appropriate cleaning agents and storage methods, with some staff incorrectly stating that Super Sani-wipes could be used on the CPAP mask and tubing, while others correctly identified that only mild soap and water should be used. The resident involved had multiple medical conditions, including obstructive sleep apnea, dementia, Parkinson's disease, and hemiplegia, and was dependent on staff for most activities of daily living. The resident reported that staff cleaned the CPAP mask and machine with a white wipe but was unsure of the frequency, and had never seen the equipment stored in a bag. The lack of adherence to cleaning and storage protocols, as well as the absence of clear documentation and staff training, led to the deficiency in providing safe and appropriate respiratory care.