Failure to Provide Adequate Fingernail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate fingernail care for two residents who were dependent on staff for activities of daily living. Both residents were observed to have long fingernails with an accumulation of unknown substances underneath. One resident, with diagnoses including diabetes mellitus and hypertension, was seen feeding herself with her hands and expressed concern about the length of her nails and the risk of scratching her scalp. The other resident, who was legally blind and had a history of intracerebral hemorrhage, also had long fingernails and stated a preference for them to be shorter. Both residents were assessed as having intact cognition but required assistance with personal hygiene tasks. Staff interviews revealed that CNAs acknowledged the importance of keeping resident nails clean and trimmed for infection prevention and to avoid skin injury, but admitted that nail care was sometimes neglected due to time constraints. The Infection Prevention Nurse and the Director of Nursing both confirmed the significance of proper nail care for infection control and resident dignity. Review of the facility's policy indicated that daily cleaning and regular trimming of nails are required to prevent infections and skin problems, but these procedures were not consistently followed for the two residents involved.