Failure to Implement Infection Control Practices for Wound and Catheter Care
Penalty
Summary
The facility failed to implement proper infection prevention and control practices for two residents with specific care needs. For one resident with a facility-acquired wound behind the left calf, staff did not follow enhanced barrier precautions (EBP) as required by facility policy and CDC guidelines. Despite the presence of a wound with fluid and drainage, staff did not don personal protective equipment (PPE) during high-contact activities such as bathing and wound care. Additionally, there were no signs posted outside the resident's room to indicate the need for EBP, and multiple staff members stated they did not use PPE because they believed the wound was not infected or the drainage was minimal. For another resident with an indwelling urinary catheter, the catheter tubing was repeatedly observed on the floor while the resident was in the activity room. Staff members acknowledged that the tubing should not touch the floor and confirmed the observation, but failed to ensure proper catheter care practices were followed. These lapses in infection control placed both residents at increased risk for infection.