Incomplete Peri-Care Provided to Cognitively Impaired Resident
Penalty
Summary
A deficiency was identified when a resident with diagnoses including hemiplegia, dementia, and schizophrenia, who was severely cognitively impaired and dependent on staff for activities of daily living, did not receive complete incontinent care. The resident was observed after a bowel movement to have her rectal area wiped by a CNA, but the front perineal region was not cleaned before a new brief was applied and her clothing was replaced. This incomplete peri-care was inconsistent with the facility's policy, which requires thorough cleaning of both the perineal and rectal areas for female residents, wiping from front to back. Interviews with other CNAs confirmed that standard practice is to clean both the front and back perineal areas after incontinence or toileting. The administrator also stated that the expectation is for peri-care to be performed completely. The failure to provide complete peri-care was documented for one resident who had a recent physician's order for antibiotics to treat a urinary tract infection, highlighting the importance of proper care in this context.