Failure to Maintain Safe and Sanitary Respiratory Care Practices
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for multiple residents requiring oxygen therapy and related respiratory equipment. For one resident with pulmonary fibrosis and diabetes, observations revealed that both the oxygen tubing and nebulizer tubing were found on the floor, and a CNA confirmed that the tubing had become contaminated due to contact with the floor. The Director of Nursing (DON) acknowledged that such contamination poses an infection control risk, as equipment on the floor is considered contaminated and could be a source of infection for the resident. Another resident with a history of lung cancer, pneumonia, and chronic kidney disease was observed with oxygen nasal prongs not properly placed in the nostrils, and the nebulizer face mask was left on the bedside table instead of being stored in a clean bag. The DON and a nurse both stated that the nasal prongs should be in the nostrils to ensure the resident receives the prescribed oxygen, and the nebulizer mask should be stored in a clean bag to prevent contamination. Additionally, a resident with asthma and hypertension was found to be receiving oxygen therapy without the required "Oxygen No Smoking, No Open Flames" sign posted outside the room, contrary to facility policy and staff statements regarding fire safety. A further observation involved a resident with diabetes and chronic kidney disease, where the nasal cannula was found on the floor with the prongs directly touching the surface. Nursing staff confirmed that the cannula should be stored in a plastic bag when not in use to prevent cross-contamination. The facility's policy and procedure on oxygen administration and respiratory supply require that all supplies not in use be placed in a bag for infection control, and that appropriate signage be posted when oxygen is in use. These deficiencies were identified through direct observation, staff interviews, and review of facility records and policies.