Failure to Provide Complete Incontinence and Catheter Care
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) failed to provide appropriate incontinence care to a female resident with multiple complex medical conditions, including type 2 diabetes mellitus, necrotizing fasciitis, chronic kidney disease, hypertension, and heart failure. The resident was cognitively intact, had an indwelling urinary catheter, and was dependent on staff for transfers and toileting due to her medical status. Facility records indicated that the resident required catheter care every shift and incontinence care every two hours or as needed. During an observed care episode, the CNA cleaned the resident's catheter, genital area, and groin, but neglected to clean the suprapubic area, which was folded with skin and required attention to prevent infection. The CNA admitted during an interview that she forgot to clean the suprapubic area due to nervousness, despite having received peri-care training two months prior. The Director of Nursing (DON) confirmed that the suprapubic area should have been cleaned during peri-care, especially given the skin folds present. Facility policy on perineal care emphasized the importance of cleanliness to prevent infections and skin irritation, specifically instructing staff to wash the perineal area. The failure to clean the suprapubic area as required constituted a lapse in proper incontinence and catheter care for the resident.