Failure to Discard Unlabeled IV Equipment and Maintain Infection Control
Penalty
Summary
Facility staff failed to follow proper infection control practices by not discarding an unlabeled intravenous (IV) hydration bag and uncapped IV tubing that was left hanging in a resident's room. Over several days, observations confirmed that the IV bag, which was undated and unlabeled, remained attached to an IV pole at the resident's bedside, despite the resident not having an active IV line. The IV tubing was also uncapped and unlabeled. The resident, who had a history of HIV and moderate cognitive deficits, shared the room with two other residents. Multiple observations and interviews with the resident, staff, and the Infection Control Prevention Nurse (ICPN) confirmed the presence of the IV equipment and the lack of labeling or proper disposal. The ICPN and Director of Nursing (DON) acknowledged that the IV hydration and tubing should have been labeled and discarded immediately, and that the IV pole should have been cleaned and stored properly. The facility's infection control policy did not provide guidance on the proper storage and disposal of IV devices and equipment. The failure to remove and properly dispose of the IV equipment was identified through direct observation, interviews, and record review, and was recognized by facility staff as an infection control issue.