Improper Perineal Care Technique During Incontinent Care
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to provide appropriate incontinent care to a female resident with a history of urinary tract infection and severe cognitive impairment. During an observed episode of care, the CNA cleaned the resident's perineal area and then proceeded to clean the resident's bottom by wiping from back to front multiple times, contrary to established infection control procedures. The CNA later acknowledged that the correct technique is to wipe from front to back to prevent urinary tract infections, but was unaware of her error during the care episode. The resident involved was always incontinent of bowel and bladder, as documented in her comprehensive assessment and care plan, which specified cleaning the perineal area with each episode of incontinence. Facility policy also outlined the correct procedure for perineal care, emphasizing the importance of wiping from the base of the labia towards and over the buttocks to prevent infection. Interviews with facility leadership confirmed that the expectation was for staff to follow these procedures to avoid cross-contamination and infection.