Failure to Maintain Sterile Technique and Documentation for IV Catheter Care
Penalty
Summary
The facility failed to provide safe and appropriate care for midline and PICC catheters in accordance with professional standards of practice for two residents. For one resident with a PICC line in the left upper extremity, an LPN performed a dressing change using a process that was not fully sterile. The LPN touched non-sterile surfaces, such as her own hair and the resident's arm, while wearing sterile gloves, and did not cleanse her hands between glove changes. The resident's care plan indicated weekly dressing changes, but the observed process did not maintain sterility as required. For another resident with a midline IV catheter, there was no documentation of required dressing changes within 24 hours of insertion, nor evidence of regular flushing or assessment of the catheter site for infection or placement. The care plan called for weekly dressing changes and regular site monitoring, but there were no physician's orders for these interventions, and no documentation that they were performed. The facility's own policy required physician orders for treatments and dressing changes, as well as sterile technique and timely dressing changes, but these standards were not met for the residents involved.