Multiple Infection Control Failures in Staff Screening, Hand Hygiene, and Equipment Storage
Penalty
Summary
The facility failed to ensure that pre-employment health screenings were completed for a newly re-hired nurse aide. Although the facility's policy required all new hires to complete a health screening and tuberculosis test during general orientation, the personnel and medical files for the nurse aide did not contain documentation of a health screening for the current hire date. The business office and infection preventionist confirmed that the health screen was not repeated upon re-hire, despite a gap in employment. Dietary staff were observed not adhering to hand hygiene and personal grooming standards during meal service. A dietary aide with long artificial nails, which is prohibited by facility policy, was seen serving food and drinks to residents without performing hand hygiene between tasks or wearing gloves. The dietary manager was aware of the artificial nails but did not consider them a concern, and the infection preventionist confirmed that artificial nails should not be worn in the dietary department. The aide's competency review indicated requirements for short, unpolished, and clean nails, as well as proper handwashing, which were not followed during the observed meal service. The facility also failed to maintain sanitary storage and documentation for oxygen delivery devices and nebulizer equipment for two residents. Observations revealed that oxygen tubing was stored on the floor or in bags with outdated or missing labels, and there were no clear directions in the administration records for changing the equipment as required by policy. Additionally, enhanced barrier precautions (EBP) were not properly implemented for residents with wounds or at risk for multidrug-resistant organisms. PPE was not available near or outside resident rooms as required, and staff were not consistently aware of EBP protocols. These failures affected multiple residents, including those with chronic wounds, respiratory conditions, and those requiring supplemental oxygen.