Failure to Perform Hand Hygiene After Glove Removal During Resident Care
Penalty
Summary
The facility failed to ensure proper hand hygiene was performed after glove removal during care activities for two residents. In the first instance, a resident with a urinary catheter due to benign prostatic hyperplasia and neurogenic bladder received catheter care from an LPN. After completing the care, the LPN removed her gloves and gown while holding a bag of soiled linen but did not perform hand hygiene immediately after glove and gown removal. She proceeded to handle the door and soiled utility linen closet before performing hand hygiene. In the second instance, a resident with diabetes mellitus underwent blood sugar testing by another LPN. The LPN performed hand hygiene before donning gloves and conducting the finger stick, but after removing her gloves, she did not perform hand hygiene before exiting the room or before handling the glucometer and labeling supplies. The facility's policy required hand washing or use of alcohol-based hand rub immediately after glove removal, but this was not followed in both observed cases.