Failure to Follow Infection Control Protocols During Resident Care and Medication Administration
Penalty
Summary
Staff failed to adhere to infection prevention and control protocols during resident care activities. On one occasion, a Certified Nursing Assistant (CNA) emptied a resident's indwelling urinary catheter bag without wearing a gown, despite the resident being on Enhanced Barrier Precautions (EBP) as indicated by signage on the room door. The facility's EBP policy requires staff to wear gloves and gowns when providing care to residents with urinary catheters due to the risk of exposure to bodily fluids. Additionally, the facility's policy states that gowns and gloves should be readily available near or outside the resident's room for such activities. Further observations revealed that another CNA did not change gloves or perform hand hygiene after providing incontinence care, and subsequently handled the resident's clothing and wheelchair controls. During medication administration, an LPN dispensed medications directly into her bare hands and did not perform hand hygiene before, after, or between administering medications to two residents. The facility's policies require hand hygiene before and after glove use, and prohibit handling medications with bare hands to prevent contamination. These failures were observed in three residents reviewed for infection prevention and control.