Failure to Maintain Proper Catheter Care
Penalty
Summary
Facility staff failed to provide appropriate care and services for an indwelling catheter for one resident. Specifically, the staff did not keep the resident's catheter collection bag off the floor, as observed during the survey. The collection bag was found lying flat on the floor next to the resident's bed, contrary to the care plan intervention that required the catheter to be kept off the floor. The resident had a diagnosis of urinary retention and was alert with some forgetfulness at the time of admission. The physician's order specified the use of a 16FR indwelling catheter with a 10cc balloon to bedside straight drainage for urinary retention. The comprehensive care plan, initiated upon admission, included an intervention to keep the catheter off the floor. Despite these documented requirements, the deficiency was observed and brought to the attention of administrative staff, with no additional information provided prior to the survey team's exit.