Delay in Incontinence Care Due to Staffing and Resident Preference
Penalty
Summary
A deficiency occurred when a resident with chronic obstructive pulmonary disease and heart disease, who was cognitively intact and required partial to moderate assistance for toileting hygiene, did not receive prompt incontinence care. The resident, who was frequently incontinent of the bladder and had a documented preference for female caregivers, reported having to wait approximately two hours for incontinence care after an episode. Staff interviews confirmed that on a specific evening, the resident requested assistance from a male aide but declined care, expressing a preference for a female aide. The male aide informed the resident that they would need to wait for the female aide to become available, and the resident ultimately waited about one hour to one hour and fifteen minutes before receiving care from a female aide. Further interviews with nursing staff revealed that the unit was staffed with two male aides and one female aide at the time, and the challenge of accommodating multiple female residents' preferences for female caregivers was noted. The LPN on duty was unable to assist due to other responsibilities, and the nursing supervisor was notified of the staffing issue. The care plan for the resident had been updated to reflect the preference for female caregivers, but the resident still experienced a significant delay in receiving incontinence care.