Failure to Follow Aseptic Technique and Timely Dressing Changes for IV Therapy
Penalty
Summary
The facility failed to ensure the safe and appropriate administration of intravenous (IV) fluids for a resident requiring parenteral antibiotics. Specifically, a registered nurse did not follow proper aseptic technique when administering IV medications. The nurse was observed flushing the resident's midline catheter infusion port and attaching a new antibiotic IV line without scrubbing the hub/infusion port with an antiseptic solution, as required by both facility policy and physician orders. The nurse also allowed the infusion port to rest on the resident's bare skin during the procedure. Additionally, the facility did not comply with physician orders regarding the frequency of dressing changes for the resident's midline catheter. The dressing, which was supposed to be changed every 48 hours, was found to be overdue for replacement. Staff interviews confirmed that the dressing should have been changed on specific dates but was not, and that this lapse could predispose the resident to infection. The resident involved had a history of local skin infection, type 2 diabetes mellitus with skin ulcers, and was receiving IV antibiotics for osteomyelitis. The resident was alert, oriented, and able to communicate effectively at the time of the incident. Facility policies reviewed indicated that strict aseptic technique and timely dressing changes were required for all IV therapy procedures, but these standards were not met in this case.