Failure to Perform Hand Hygiene Between Resident Contacts During Meal Assistance
Penalty
Summary
During a survey, it was observed that a Licensed Practical Nurse (LPN) failed to perform hand hygiene between assisting multiple residents during breakfast in the dining room. The LPN assisted one resident who frequently eats with their hands, then proceeded to assist several other residents, including helping with clothing protectors and touching residents' shoulders, without using alcohol-based hand sanitizer (ABHS) or washing hands between contacts. The LPN only used ABHS after assisting several residents and then continued to assist more residents before using ABHS again. A review of the facility's Hand Hygiene policy indicated that hand hygiene is required in all situations, especially when handling food or assisting residents, and that supplies are to be readily accessible. Interviews with the Assistant Director of Nursing (ADON) and the LPN confirmed that hand hygiene was not performed between resident contacts, and the LPN stated they did not have their usual personal bottle of ABHS that day. The deficiency had the potential to affect all nine sampled residents who were assisted during the meal.