Failure to Ensure Nursing Staff Competency and Infection Control Practices
Penalty
Summary
The facility failed to ensure that nursing staff, specifically a registered nurse (RN), had the appropriate competencies and skills to provide safe and effective care for residents, as evidenced by the lack of completion of an annual competency and skills evaluation for the RN. This deficiency was observed in the context of infection control practices and the management of residents with complex medical needs. For example, one resident was admitted with enterocolitis due to a Clostridium difficile (C. diff) infection, requiring contact precautions. Observations revealed that the contact precaution signage was not properly displayed, and the RN used Clorox wipes with a white top, which were bleach-free, to disinfect medical devices, despite the need for sporicidal agents effective against C. diff. The Director of Nursing (DON) was unsure about the disinfectant's contents, and the Infection Preventionist (IP) clarified that only certain wipes were effective against C. diff spores. Additionally, another resident with a history of urinary tract infections experienced multiple episodes of diarrhea, which were not appropriately communicated or acted upon by the RN, despite being informed by a certified nursing assistant (CNA). The RN minimized the significance of the diarrhea, and there was no evidence of appropriate diagnostic testing or escalation. Review of facility policies indicated that staff should receive ongoing training in infection control and antibiotic stewardship, but the RN in question had not completed the required annual skills check. The DON acknowledged that failure to evaluate licensed nurses' skills could lead to significant errors.