Failure to Provide Proper Perineal Care for Incontinent Resident
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to provide appropriate perineal care to a female resident who was incontinent of bladder. During an observation, the CNA did not separate and clean the resident's labia area while providing incontinence care, despite removing the soiled brief and cleaning other areas. The CNA later acknowledged forgetting to perform this step due to nervousness, even though she had received peri-care training and had recently passed a skill checkoff for female perineal care. The resident involved had severe cognitive impairment, as indicated by a BIMS score of 5 out of 15, and was always incontinent of both bowel and bladder. Her care plan required incontinence care at least every two hours and the application of a moisture barrier after each episode. Facility policy specified that perineal care for female residents should include separating and cleaning the labia majora from front to back. The Director of Nursing confirmed that the CNA should have separated and cleaned the labia area to prevent possible infection.