Lack of Staff Competency for CPAP and BIPAP Care
Penalty
Summary
The facility failed to ensure that three sampled Licensed Vocational Nurses (LVNs) possessed the necessary competencies to provide care for residents requiring continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) therapy. During interviews and record reviews, it was found that there was no documented skills training for CPAP or BIPAP for these LVNs. A resident reported that the effectiveness of her BIPAP mask application varied depending on which LVN applied it, indicating inconsistency in staff competency. The Staffing Coordinator confirmed the absence of skills training records for the involved LVNs. The Director of Nursing acknowledged that there were seven residents with physician orders for CPAP and BIPAP and stated that training should be provided for these therapies to ensure proper application and resident comfort. Review of the facility's policy indicated that nursing staff are required to demonstrate skills and competencies based on the needs of the resident population, but this requirement was not met for CPAP and BIPAP care. The lack of appropriate training and competency assessment for these devices led to the deficiency.