CNAs Failed to Demonstrate Competency in Incontinent Care Techniques
Penalty
Summary
Certified Nursing Assistants (CNAs) at the facility failed to demonstrate competency in providing proper incontinent care for two residents. In the first instance, a CNA did not thoroughly clean the buttocks and hips of a resident with multiple chronic conditions, including diabetes, COPD, hypertension, and mild to moderate cognitive impairment, during incontinent care. The resident's care plan specifically required thorough cleaning to prevent skin breakdown, but observation revealed these areas were not cleaned. The CNA acknowledged the omission and stated she was nervous during the care, despite having received recent training and passing a competency check for infection control and incontinent care. In the second case, another CNA used an incorrect cleaning technique while providing incontinent care to a resident with diabetes, hypertension, dementia, and an indwelling catheter. The CNA cleaned the resident using a back-to-front motion from the buttocks to the scrotum, contrary to facility policy and standard infection control practices, which require a front-to-back motion to prevent cross-contamination. The CNA admitted to using the wrong technique and attributed the error to nervousness, despite having received recent training and passing a competency check. Both incidents were observed directly by surveyors and confirmed through interviews with the CNAs and the Assistant Director of Nursing (ADON). Facility policy and training materials reviewed by surveyors clearly outlined the correct procedures for perineal care, which were not followed in these instances. The failures were identified through a combination of observation, record review, and staff interviews.