Deficient Perineal Care and Improper Technique During Incontinent Care
Penalty
Summary
Two residents with a history of incontinence and multiple comorbidities did not receive appropriate perineal care as required by facility policy. For one resident with moderate cognitive impairment and frequent bladder incontinence, a CNA failed to clean the buttocks and hips during incontinent care, as observed by surveyors. The CNA acknowledged the omission and stated she was nervous, despite having received recent training in infection control and incontinent care. The resident's care plan specifically identified the need to prevent skin breakdown due to incontinence. For another resident with mild cognitive impairment, an indwelling catheter, and bowel incontinence, a CNA used an improper back-to-front cleaning technique during perineal care, moving from the buttocks to the scrotum. The CNA admitted to using the incorrect technique and recognized that the correct method was front to back, as outlined in facility policy. Both incidents were confirmed by interviews with the ADON, who stated that staff are trained to clean the perineal area front to back to prevent cross-contamination and infection.