Incomplete Incontinent Care and Perineal Hygiene
Penalty
Summary
Staff failed to provide complete incontinent care for two residents who were always incontinent of bowel and bladder. For one resident with severe cognitive impairment and total dependence on staff for toileting, a CNA missed cleansing the left buttock during perineal care after removing a soiled brief containing urine and feces. The CNA acknowledged missing this area due to nervousness. For another resident, who was cognitively intact but required supervision and assistance with toileting, a CNA used the same portion of a washcloth to cleanse multiple areas, did not cleanse the right buttock, and did not dry the resident before applying a new brief after removing a urine-soiled brief. The facility's policy requires complete cleansing of the perineal area with appropriate cleansers, use of multiple towels for cleaning, rinsing, and drying, and cleansing from front to back. The Director of Nurses confirmed that staff should be performing complete incontinent care, including using new towels for each area and ensuring residents are dried before a new brief is applied. These requirements were not followed during the observed care for both residents.