Failure to Provide Proper Indwelling Catheter Care and Securement
Penalty
Summary
A deficiency occurred when a resident with an indwelling urinary catheter did not receive appropriate catheter care as required by facility policy and physician orders. During an observation, a CNA provided incontinent and catheter care but failed to clean the catheter tubing itself, only cleaning the perineum, thigh folds, shaft and head of the penis, and around the catheter insertion site. The CNA later acknowledged she was supposed to clean the catheter by holding it and wiping from the tip away from the body, but did not do so due to distractions and feeling nervous during the care. Additionally, the resident's catheter was not secured with a leg strap as ordered by the physician and facility policy, and the CNA confirmed the resident did not have a leg strap on before or after a shower. Record review showed active orders for securing the catheter with a leg strap or anchor to minimize injury and accidental removal, and for changing the leg strap weekly and as needed. The facility's policy also required cleaning the catheter in a downward motion from the urinary meatus at least four inches down. Interviews with the DON and CNA confirmed expectations for catheter care and monitoring, and the CNA admitted to not following proper procedure during the observed care. The resident, who was cognitively intact and had a history of catheter displacement, UTI, and diabetes, did not express concerns about his care.