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F0690
D

Failure to Timely Drain Catheter Bag Increases Infection Risk

Effingham, Illinois Survey Completed on 07-15-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when staff failed to timely drain a full indwelling catheter bag for a resident with a history of cerebral infarction, urinary retention, neuromuscular bladder dysfunction, and previous urinary tract infections. The resident's care plan included an intervention to empty the drainage bag as needed, and there was an active order to replace the bedside drainage bag with a leg bag each morning. Despite these directives, observation revealed that the resident's leg catheter drainage bag was completely full, with urine backing up into the tubing. A Licensed Practical Nurse confirmed that the bag was so full that urine was backing up, acknowledging that this situation could lead to infection, especially since the resident was known to have frequent urinary tract infections. The CDC guidelines referenced in the report emphasize the importance of regularly emptying catheter bags to prevent infection, but staff failed to check and empty the resident's drainage bag in a timely manner, resulting in the observed deficiency.

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