Failure to Maintain Infection Control for Enteral Feeding Tubes and IV Catheters
Penalty
Summary
The facility failed to implement and maintain infection control measures for two residents, resulting in deficiencies related to the handling of a gastric tube (GT) and the removal of an intravenous (IV) catheter. For one resident with a history of urinary tract infection and gastrostomy, observations revealed that the GT feeding machine was disconnected, and the GT bottle containing Jevity was left uncapped and lying on the floor, with a moderate amount of the nutritional supplement leaking onto the floor. Interviews with nursing staff and the Director of Nursing confirmed that the GT tubing should have been capped when disconnected to prevent contamination, and that failure to do so constitutes an infection control issue. Additionally, the facility did not remove a peripheral IV catheter from another resident after the completion of IV therapy. The resident, who had diagnoses including hypertension, chronic kidney disease, and diabetes, was observed with a peripheral IV line still in place two days after the physician's order for hydration had ended. Nursing staff and the Director of Nursing confirmed that IV access should be discontinued promptly after therapy is completed unless there is a physician's order to maintain it, which was not present in this case. Record reviews of facility policies indicated that staff are trained on infection control procedures, including the proper handling of enteral feeding tubes and the removal of peripheral IV catheters. However, the observed practices did not align with these policies, as the GT tubing was not capped and was left on the floor, and the IV catheter was not removed in a timely manner after therapy completion.