Failure to Properly Handle and Store Clean Linens for Infection Control
Penalty
Summary
The facility failed to ensure that laundry was handled and transported in a manner that would prevent the spread of infection. Observations and interviews revealed that staff did not wear gowns when handling dirty laundry, only gloves and masks. Clean linens and personal laundry were transported to resident floors in large, uncovered bins and metal carts, and were not covered during transport. In one unoccupied room with an open door to the hallway, multiple open-top bins containing clean linens were found, with linens exposed and some scattered within the bins. Additional clean linens were stacked on top of an armoire alongside various medical equipment, and the room was cluttered with both clean and soiled items. Staff were observed entering this room to retrieve linens due to supply shortages and lack of assigned personnel to restock the linen closet, resulting in staff rummaging through the bins for needed items. Interviews with staff, including nursing assistants and LPNs, confirmed that the room intended for clean linen storage was often used inappropriately, with clean linens left uncovered and the door left open. The infection preventionist acknowledged that the expectation was for all clean linen to remain covered and for the room door to be closed, but confirmed that reeducation was needed. The facility's infection control policy required active efforts to control and prevent communicable diseases, but these practices were not consistently followed, potentially affecting all 70 residents in the facility.