Unqualified Staff Performed Oral Suctioning Against Care Plan and Policy
Penalty
Summary
A Certified Nurse Assistant (CNA) provided oral suctioning to a resident who had chronic respiratory failure, a tracheostomy, and a gastrostomy, despite not being trained or authorized to perform this procedure. The resident's care plan specified that oral suctioning was to be performed only by licensed staff such as Licensed Vocational Nurses (LVN), Registered Nurses (RN), or Respiratory Therapists (RT). The CNA used a Yankauer suction tip to remove secretions from the resident's mouth, during which the resident bit down on the device, and the CNA had to instruct the resident to open her mouth several times to remove it. Interviews with the CNA, another CNA present, and the Director of Nursing (DON) confirmed that CNAs are not trained or permitted to perform oral suctioning, and that the facility's policy restricts this procedure to licensed clinical staff. The DON acknowledged that the CNA should have called for licensed staff assistance instead of performing the procedure. The resident's care plan and facility policy were not followed, resulting in care being provided by an unqualified person.