Deficient Incontinence Care Due to Use of Double Briefs
Penalty
Summary
Surveyors identified a deficiency in incontinence care during rounds on one of two nursing units, where two residents who were dependent on staff for activities of daily living were found to be wearing double incontinence briefs. In both cases, a staff member exposed the front of the resident's brief, which was wet, and upon further inspection, a second, also wet, incontinence brief was discovered layered underneath. The staff member present acknowledged that applying two briefs was not appropriate. Both residents had significant medical histories, including congestive heart failure, type 2 diabetes mellitus, and acute respiratory failure, and were assessed as always or frequently incontinent and dependent on staff for toileting hygiene. The medical records and individualized care plans for these residents documented their incontinence and dependence on staff, but one care plan did not include specific interventions for incontinence. The facility's policy on incontinence care required appropriate treatment to prevent infections and restore continence to the extent possible. The surveyor confirmed with facility staff and policy that the use of double briefs was not acceptable practice, and the deficiency was cited based on these observations and record reviews.