Inadequate Perineal Care Provided to Incontinent Resident
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) failed to provide appropriate perineal care to a female resident who was frequently incontinent of bowel and bladder. The resident, who had severe cognitive impairment due to dementia and other medical conditions, required thorough incontinence care as outlined in her care plan and the facility's policy. During an observed episode, the CNA did not separate the resident's labia or clean down the middle, and wiped the resident's buttocks from back to front, contrary to the required front-to-back technique. The resident's brief was also found to be soaked through, indicating a need for prompt and proper care. The facility's policy specifically required staff to separate the labia and wash downward in the center and on each side, using a different wipe for each stroke, and to clean the buttocks in an upward motion towards the back. The CNA acknowledged during an interview that she did not follow these procedures and recognized the importance of proper cleaning. The Director of Nursing confirmed that the observed care did not meet facility standards and that such lapses could place residents at risk for urinary tract infections, skin breakdown, and poor hygiene.