Incomplete Incontinence Care Provided to Resident with Quadriplegia
Penalty
Summary
A deficiency occurred when a Certified Nursing Assistant (CNA) failed to provide complete and appropriate incontinence care to a resident with quadriplegia, severe cognitive impairment, and bowel incontinence. During observed care, the CNA performed hand hygiene, donned gloves, and used wipes to clean the resident's buttock and front perineal area, wiping from front to back. However, the CNA did not cleanse the resident's right and left hips, which was required by the facility's perineal care policy. The resident's care plan specifically directed staff to assist with perineal cleansing and to observe the skin daily for irritation and redness. Staff interviews confirmed that thigh areas should be cleansed during incontinence care, and policy review indicated that care should extend outward to the thighs.