Failure to Follow Infection Control Protocols During Resident Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by the actions of a registered nurse (RN) during the care of a resident with multiple medical conditions, including a history of stroke, hemiplegia, and muscle weakness. The RN did not disinfect the blood pressure cuff between uses on different residents and failed to perform hand hygiene after providing stoma care and before administering medications via a G-tube. The RN was observed using the same blood pressure machine on multiple residents without cleaning it and did not wash her hands or use hand sanitizer after removing gloves and gown following direct care contact. Additionally, the RN used tweezers to clean the resident's stoma and returned them to a cup on the bedside table after only cleaning them with normal saline, rather than disinfecting them as required. The facility's policies and the infection control preventionist confirmed that equipment should be disinfected between residents and that hand hygiene should be performed before and after resident contact and medication administration. Despite having received prior in-service training on these procedures, the RN did not follow established infection control protocols during the observed care.