Failure to Change Midline Catheter Dressing as Ordered
Penalty
Summary
A deficiency occurred when a resident with a left upper arm single lumen midline catheter did not receive dressing changes as ordered and in accordance with professional standards of practice. Observations over several days revealed that the transparent dressing on the catheter was lifting at the edges and had gauze underneath, which occluded the view of the insertion site. The dressing was dated six days prior to the initial observation and had not been changed since insertion, despite physician orders specifying weekly dressing changes and as needed. The resident confirmed that the dressing had not been changed since it was put in, and staff interviews corroborated that the dressing should have been changed, especially given the presence of gauze under the transparent dressing. Facility policy required midline catheter dressings to be changed every 5-7 days, or every 48 hours if gauze was used under the transparent dressing. Both the RN and the DON acknowledged that the dressing was overdue for a change, particularly because the use of gauze necessitated more frequent changes. The failure to change the dressing as ordered and per policy resulted in the deficiency identified during the survey.