Infection Control Lapses in Nail Hygiene, Barrier Precautions, and Equipment Storage
Penalty
Summary
The facility failed to uphold infection prevention and control practices in several instances involving both staff and residents. One licensed nurse was observed wearing long, red acrylic nails while providing direct patient care, including checking blood sugars and administering insulin. The nurse admitted to not knowing the facility's specific policy on artificial nails but acknowledged that long nails could increase the risk of infection transmission. The Infection Preventionist and Director of Nursing both confirmed that long or artificial nails were not permitted for direct care staff due to infection risks and potential for causing skin tears. The facility's employee handbook required nails to be kept clean but did not specifically address artificial or long nails in relation to infection control. Another deficiency was observed when a licensed nurse failed to follow enhanced barrier precautions (EBP) while providing direct care to a resident with a gastrostomy tube. The nurse donned gloves but did not wear a gown or mask while suctioning the resident's airway, despite signage and facility policy indicating that gown and gloves were required for high-contact activities under EBP. The nurse acknowledged not following the EBP procedure, and the resident's care plan and physician's order both indicated the need for EBP due to the presence of a gastrostomy tube. Additionally, infection control practices were not followed regarding the storage and maintenance of respiratory equipment for another resident. Nebulizer tubing and mask, as well as suction tubing and a Yankauer suction tip, were found placed directly on a bedside dresser and not stored in appropriate container bags when not in use. The nebulizer tubing was overdue for replacement, and the suction canister was undated and not discarded after use as required by facility practice. The Infection Preventionist confirmed that these items should have been stored properly and replaced or discarded according to protocol.