Failure to Obtain Permission and Inappropriate Touching During Incontinence Check
Penalty
Summary
A staff member failed to obtain permission from an alert and oriented resident before checking for incontinence and inappropriately touched the resident in the vaginal area. The resident, who had multiple medical diagnoses including a femur fracture, congestive heart failure, diabetes, atrial fibrillation, chronic kidney disease, COPD, anxiety disorder, major depression, obesity, and GERD, reported feeling angry, violated, and emotionally harmed by the incident. The resident described waking up to the staff member's hand between her legs under her brief, touching her vaginal area, and stated that she pushed the staff member's hand away and told him to leave. The resident subsequently reported the incident to her family, who contacted the police, and expressed a desire to pursue the matter criminally. The staff member involved stated that he announced himself and informed the resident he was there to check if she was dry, but omitted obtaining explicit permission before touching the resident. He reported patting the resident's brief to check for wetness and did not provide further incontinence care during that shift. The staff member acknowledged that the resident was alert and oriented and typically requested assistance when needed. Other staff interviews confirmed that facility practice requires staff to announce themselves, inform residents of intended care, and obtain permission before touching alert and oriented residents. It was also noted that patting or massaging a brief is not an accepted practice for checking incontinence. Facility policies reviewed indicated that residents are to be treated with respect and dignity, and that staff must explain procedures and obtain permission before providing care, especially for alert and oriented residents. The policies also prohibit abuse, neglect, and mistreatment, and require the prevention of such occurrences. The resident's care plan emphasized the need for person-centered care and maintaining a supportive environment, but the baseline care plan did not include a toileting assessment. The failure to follow these protocols resulted in the resident experiencing emotional distress and reporting the incident as abuse.