Failure to Maintain Infection Control During Meal Service
Penalty
Summary
Dietary staff failed to maintain proper infection control practices during meal service, as observed during multiple instances of food plating and tray setup. Staff were seen touching various unclean surfaces, such as the food service cart, tape dispenser, trays, their aprons, and even the floor, with gloved hands and then proceeding to handle residents' food without changing gloves or performing hand hygiene in between tasks. One staff member was observed opening a bun and then opening the service cart door without changing gloves or sanitizing hands, while another touched her face and then handled a resident's silverware. Additionally, a meal ticket that had fallen to the floor was picked up and placed on a resident's tray without glove change or hand hygiene. Interviews with dietary staff indicated a belief that gloves and hand hygiene were only necessary between certain tasks, not consistently after every potential contamination. The Dietary Manager, Assistant Director of Nursing, and Administrator all stated expectations that staff should change gloves and perform hand hygiene after touching unclean surfaces, their clothing, or their face, and between serving each resident. However, these expectations were not consistently followed, as evidenced by the observed actions during meal service.