Deficient Infection Control and Documentation for Respiratory Devices
Penalty
Summary
Surveyors identified deficiencies in the facility's provision of safe and appropriate respiratory care for residents requiring respiratory devices, specifically related to infection control practices and documentation. For one resident using a nebulizer, the device was observed stored on the floor and the mask was hung on a tack between uses. The resident reported not cleaning the mask after treatments, and there was no documentation in the electronic medical record (EMR) regarding cleaning frequency, responsibility, or method. The facility's policy required cleaning after each use, but this was not consistently followed or documented. Another resident using a CPAP machine did not have a current physician's order for its use, and neither the initial nor current care plan addressed the CPAP or the resident's respiratory diagnoses. The resident reported that while nurses refilled the CPAP reservoir, the mask and tubing had not been cleaned since admission. There was also no documentation in the EMR regarding cleaning of the CPAP equipment, despite facility policy requiring weekly cleaning and documentation in the medication administration record (MAR). Interviews with staff, including an LPN and the DON, revealed inconsistencies in knowledge and practice regarding cleaning and documentation of respiratory devices. The DON was unaware of the lack of physician order, care plan documentation, and cleaning records for the CPAP. Additionally, facility policies related to cleaning and storage of respiratory equipment were found to be inconsistent and not always reflective of actual practices, contributing to the deficiencies observed.