Failure to Follow Infection Control and Hand Hygiene Practices During Meal and Medication Service
Penalty
Summary
Multiple observations and interviews revealed that staff did not consistently follow infection prevention and control practices during meal service and medication administration. Staff members, including CNAs, the Activities Director, and dietary staff, were observed failing to perform hand hygiene between tasks such as passing meal trays, assisting residents, handling garbage, and touching their faces. In several instances, staff did not offer or assist residents with hand hygiene prior to meals, despite residents expressing a desire for such assistance. Additionally, hand sanitizer dispensers were found to be empty or inaccessible to residents who required help. Further deficiencies were noted in personal hygiene practices among staff. Several staff members, including CNAs and nurses, were observed with fingernails extending beyond the facility's policy limits and CDC recommendations, and with hair styles that could interfere with care. One CNA was seen repeatedly using a personal cloth to wipe perspiration from their face and then continuing to assist with meal service without performing hand hygiene. Staff interviews confirmed a lack of adherence to hand hygiene protocols, particularly after touching their faces or other potentially contaminated surfaces. The facility's own policies and CDC guidelines require hand hygiene before and after resident contact, after glove use, and after contact with potentially contaminated surfaces. However, staff interviews and direct observations indicated that these protocols were not consistently followed. Residents with moderate cognitive impairment were not offered hand hygiene before meals, and staff did not always perform hand hygiene as required by policy during medication administration and meal service. These lapses were confirmed by both staff and residents during interviews.