Failure to Provide Proper Incontinence Care and Perineal Hygiene
Penalty
Summary
A deficiency was identified when a certified nursing aide (CNA) failed to provide proper incontinence care to a male resident with severe cognitive impairment and multiple medical diagnoses, including arteriosclerotic heart disease, schizophrenia, Alzheimer's disease, diabetes, chronic kidney disease, and convulsions. The resident was always incontinent of bladder and had a colostomy, requiring substantial assistance for toileting and personal hygiene. During an observed incontinence care episode, the CNA had the resident stand at the bedside, removed a moderately wet incontinence product, and proceeded to clean the resident using only wet washcloths without soap, despite soap being available at the bedside. The CNA wiped from back to front on both sides and did not thoroughly clean the penis before applying a new incontinence product. The CNA confirmed in an interview that soap was not used and that the cleaning of the penis was not thorough. Review of the facility's perineal care policy indicated that soap or a skin cleansing agent should be used, and specific steps should be followed to ensure proper cleaning and hygiene, including washing from the urethra outward and using a circular motion. The observed care did not align with these policy requirements, resulting in a failure to provide appropriate incontinence care for the resident.