Inadequate Perineal Care Provided to Dependent Resident with UTI History
Penalty
Summary
A deficiency was identified when staff failed to provide adequate perineal care for a resident with a history of urinary tract infections (UTIs) and total dependence on staff for activities of daily living, including personal and toileting hygiene. The resident, who was frequently incontinent of urine and bowel, had documented episodes of E. coli and yeast present in urine cultures. During observation, a certified nursing assistant (CNA) cleaned the resident's perineal area from front to back using wipes, but reused the same wipe for multiple passes instead of using a new clean wipe for each stroke as required by facility policy. This practice was confirmed during interviews with both the CNA and a registered nurse (RN), who acknowledged that reusing wipes could lead to contamination of the perineal area. The facility's policy and procedure for perineal care specified that a new section of the washcloth or a new disposable wipe should be used for each stroke, particularly when cleaning the urethral meatus and vaginal orifice, to prevent infection. The observed deviation from this protocol was corroborated by staff interviews and was inconsistent with both facility policy and CDC guidance on UTI prevention. The resident's family member also expressed concern about the resident's recurrent UTIs, further highlighting the importance of proper perineal care in this case.