Failure to Perform Hand Hygiene Prior to Medication Administration
Penalty
Summary
A deficiency was identified when a medication aide (MA) failed to properly sanitize or wash hands prior to preparing and administering medications to a resident during a morning medication pass. The observation took place while the MA prepared and handled multiple medications, including Bumetanide, Famotidine, Tamsulosin, Entresto, Amiodarone, Eliquis, Docusate sodium, Vitamin C, a multivitamin, MiraLAX, Mucinex, and Zyrtec, without performing hand hygiene as required by facility policy. The MA acknowledged having received training on handwashing and recognized the risk of spreading germs and infection due to this lapse. Further interviews with the Interim DON confirmed that all staff are expected to wash hands or use hand sanitizer before and after medication administration, and that in-services and check-offs are conducted to reinforce this practice. However, the Interim DON was uncertain about the frequency of medication pass check-offs. Review of the facility's hand hygiene policy indicated that handwashing or use of alcohol-based hand rub is required before preparing or handling medications, which was not followed in this instance.