Incomplete Perineal and Catheter Care for Resident with Incontinence
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) failed to provide complete perineal and catheter care to a male resident who was incontinent of bowel and had an indwelling urinary catheter. During observed care, the CNA cleaned only the resident's penis, indwelling catheter, and buttock areas, omitting the suprapubic area, left and right groin areas, and scrotum. The CNA acknowledged forgetting to clean these areas due to nervousness, and both the CNA and the Director of Nursing (DON) confirmed that facility policy required cleaning all specified areas to prevent possible infection. The resident involved had a history of major depressive disorder, urinary tract infection, dysuria, neuromuscular dysfunction of the bladder, and paraplegia, and required substantial assistance for transfers and toileting. The resident's care plan addressed bladder and catheter care but did not include a plan for bowel incontinence. Facility policy specified thorough cleaning of the perineal area, including the penis, scrotum, inner thighs, and under the scrotum, anus, and buttocks, which was not followed during the observed care.