Failure to Follow IV Catheter Dressing and Flushing Protocols
Penalty
Summary
The facility failed to ensure that midline and central venous access device dressings and flushing were completed according to professional standards of practice for two residents receiving intravenous therapy. For one resident with a midline catheter for IV antibiotics, the dressing was not changed 24 hours after insertion as ordered, and gauze was placed under the transparent dressing, preventing observation of the insertion site. The medical record lacked documentation of the required dressing change, and the resident reported the dressing had not been changed since insertion. During medication administration, an LPN failed to check for blood return to confirm catheter patency before administering saline and antibiotics, contrary to facility policy. For another resident with a peripherally inserted central catheter (PICC), the dressing was not changed as scheduled, with the dressing date indicating it was overdue. The medication administration record documented a dressing change that staff later admitted was not performed, and the staff member acknowledged the documentation was inaccurate. Facility policies required dressing changes at specific intervals and confirmation of catheter patency before medication administration, but these were not followed for the residents involved.