Failure to Keep Foley Catheter Drainage Bags Off the Floor
Penalty
Summary
Surveyors observed that the facility failed to ensure that indwelling Foley catheter drainage bags were kept off the floor for two of three residents reviewed with indwelling catheters. For one resident with a history of neurogenic bladder, cirrhosis, BPH, and other conditions, repeated observations showed the catheter bag lying on the floor without a dignity cover. The resident was noted to be non-compliant with keeping the catheter bag off the floor and not using the cover, as confirmed by an LPN who stated the resident drags the bag on the floor. The resident's care plan documented non-compliance with catheter care, including not hanging the bag and not keeping the cover on, with interventions focused on education and documentation of non-compliance. Another resident with a history of traumatic amputation, stage four pressure ulcer, diabetes, and cognitive impairment was also observed with a Foley catheter drainage bag lying uncovered on the floor. Staff confirmed the observation. The resident's care plan included instructions to position the catheter bag and tubing below the bladder and away from the entrance, but did not specifically address keeping the bag off the floor. Additionally, facility policies on infection control and catheter care did not address infection prevention measures related to Foley catheters.