Infection Control Deficiencies in Housekeeping and Glucometer Disinfection
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program on one of four units, as evidenced by multiple deficiencies in housekeeping and clinical practices. Housekeeping staff did not consistently follow proper cleaning techniques for resident rooms and high-touch surfaces. Observations revealed that a housekeeper neglected to disinfect high-touch areas such as bed remotes, call lights, light switches, over-bed tables, and nightstands. Additionally, the housekeeper did not perform hand hygiene after removing gloves and before donning new gloves, despite facility policy and CDC guidelines requiring hand hygiene at these points. The housekeeper also used a toilet brush outside of the toilet bowl, which is not in accordance with facility procedures, and failed to clean the base of the toilet. The housekeeper admitted to not always cleaning high-touch areas and not documenting which rooms required additional cleaning, relying instead on memory. Interviews with staff confirmed gaps in training and adherence to infection control protocols. The housekeeper stated she had received hand hygiene education but had developed poor habits from previous employment. She was unaware that the toilet brush should not be used outside the toilet bowl and did not consistently clean all required high-touch areas. The housekeeping and laundry manager and the director of nursing both confirmed that hand hygiene should be performed after glove changes and that high-touch areas must be cleaned daily, but these practices were not consistently followed by staff. In addition to housekeeping deficiencies, clinical staff failed to properly disinfect individual glucometers according to manufacturer guidelines. A registered nurse was observed cleaning a resident's glucometer with only one disinfectant wipe and not allowing the device to remain wet for the required four-minute contact time. The nurse believed a two-minute drying time was sufficient, which does not meet the manufacturer's instructions. The clinical nurse resource and infection preventionist both acknowledged that glucometers should be cleaned according to manufacturer recommendations, but the observed practice did not align with these standards.