Failure to Provide Timely Incontinence Care for Dependent Resident
Penalty
Summary
A resident who required maximum to dependent care for activities of daily living did not receive timely incontinence care. Observations showed that the resident was left in bed with a saturated incontinence brief and wet sheets, with the last incontinence care documented at 7:30 a.m. Staff acknowledged the resident was incontinent of a large amount of urine, and the resident had been waiting for assistance to get out of bed after breakfast. The resident's care plan indicated she should be offered toileting assistance upon rising, before and after meals, and before bedtime, and that she was always incontinent of bowel and bladder and unable to recognize the need to void. Record review revealed the resident had a history of metabolic encephalopathy, multiple urinary tract infections, and sepsis, with recurrent UTIs noted in a recent physician's note. The facility did not have a specific policy for how often residents should be checked for incontinence, but the DON stated residents were usually checked before and after meals and before bedtime. The Indiana State Department of Health Nurse Aide Curriculum recommends frequent monitoring and perineal care for residents with incontinence. The failure to provide timely incontinence care was observed and confirmed by staff.