Deficient Catheter Care and Improper Catheter Bag Placement
Penalty
Summary
The facility failed to provide proper catheter care for two residents, resulting in deficiencies related to sanitary technique, use of securing devices, and catheter bag placement. For one resident with diagnoses including bipolar disorder, type 2 diabetes, tremor, and neuromuscular dysfunction of the bladder, catheter care was observed to be performed using the same washcloth multiple times for different areas, and the washcloth was re-wetted in the same basin of water. The CNA did not clean between the labia, and no catheter securing device was in place during the procedure. The Director of Nursing confirmed that proper technique requires a fresh washcloth for each wipe, opening the labia for cleaning, and using more than two washcloths for the procedure. In another instance, a male resident with severe cognitive impairment was observed with his indwelling catheter bag placed directly on the floor. A CNA later picked up the bag and acknowledged it should not have been left on the floor, stating it should be hung on the bed frame. The Director of Nursing confirmed that catheter care is provided every shift and as needed, and that catheter bags should not be on the floor. The facility's policy also specifies that indwelling catheters should be secured to prevent trauma and that drainage bags and tubing should not touch the floor.