Infection Control Lapses in Medication Administration and Equipment Cleaning
Penalty
Summary
The facility failed to maintain proper infection prevention and control practices, as evidenced by multiple observed incidents involving staff and residents. In one instance, a registered nurse placed insulin syringes directly on a resident's bed while preparing to administer medication, rather than using a protective barrier on the bedside table as required. Both the nurse and the infection preventionist acknowledged that this was not in accordance with facility protocol. The resident involved had a history of coronary artery disease and diabetes and was receiving insulin therapy at the time of the incident. Additional deficiencies were observed in the cleaning and disinfection of shared medical equipment. A nurse was seen using a blood pressure cuff on two different residents without cleaning it between uses, contrary to the facility's policy. Furthermore, a certified nursing assistant cleaned a sit-to-stand device after a resident transfer but failed to clean the straps, instead draping the uncleaned straps over the sanitized device. The director of nursing confirmed that the straps should have been cleaned. These lapses in infection control practices were confirmed through staff interviews and record review.