Deficient Perineal and Incontinence Care Due to Improper Technique and Infection Control
Penalty
Summary
A deficiency was identified when a resident with chronic obstructive pulmonary disease, right hip pain, and a history of repeated falls, who was always incontinent of bowel and bladder, did not receive appropriate perineal care. During an observed care episode, a CNA gathered supplies and prepared to provide perineal care but placed clean washcloths in the bottom of the resident's sink with running water, then applied shampoo and body wash directly to the washcloths in the sink. The CNA then transferred the washcloths to a basin and used them for cleansing and rinsing the perineal and buttocks areas, without patting the areas dry before applying a new incontinence brief. The CNA also failed to use separate washcloths for soaping and rinsing, and did not follow infection control protocols as outlined in facility policy. Interviews with the CNA and the RN Unit Manager confirmed that the perineal care was not performed according to facility policy, specifically regarding infection control and the use of basins and washcloths. The facility policy required equipment to be placed on the bedside stand, the use of a wash basin filled with warm water, and proper rinsing and drying of the area. The observed actions did not align with these procedures, resulting in a failure to provide appropriate incontinence and perineal care for the resident.