Failure to Provide Timely and Appropriate Perineal Care for Incontinent Resident
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to provide timely and appropriate perineal care to a female resident who was always incontinent of urine and bowel. The resident, who had diagnoses including Down syndrome, dementia, and a severe cognitive communication deficit, required moderate assistance with toileting and personal hygiene. During an observation, the CNA did not separate the resident's labia while cleaning, missing a critical step in perineal care, and the resident was found to have soaked through her brief and bed sheet, with her skin noted to be wet and red but intact. The CNA admitted to missing this step and acknowledged its importance in preventing infection. Further review revealed that the CNA had not provided any incontinent care to the resident since the start of her shift, despite facility policy and the resident's care plan requiring incontinence care after each episode and at least every two hours. The CNA stated she was busy and had not yet checked on the resident. The Director of Nursing confirmed that proper perineal care, including cleaning the labia, is expected and that failure to do so places residents at risk. Facility policy and CDC guidelines emphasize the importance of good perineal hygiene to prevent urinary tract infections.