Improper Perineal Care Technique During Incontinent Care
Penalty
Summary
A certified nursing assistant (CNA) provided incontinent care to a resident with a history of traumatic brain injury, dysphagia, hypertension, and congenital hydrocephalus, who was frequently incontinent of bowel and bladder and had moderate cognitive impairment. During care, the CNA was observed wiping the resident's buttocks in a back to front motion, contrary to the facility's policy and standard infection control practices, which require cleaning from front to back to prevent contamination of the urethra. The CNA confirmed using the incorrect technique and stated she believed it was correct, despite having received training and passing a competency check on perineal care earlier in the year. The Director of Nursing (DON) verified that staff are trained and their skills are checked annually, and that the correct technique is front to back. The facility's policy also specifies this method for perineal care. This improper care practice was identified through observation, interview, and record review.