Failure to Provide Proper Perineal Care and Unauthorized Handling of Feeding Pump
Penalty
Summary
A deficiency was identified when a Certified Nursing Assistant (CNA) failed to provide perineal care according to the facility's policy and accepted standards for a resident with significant neurological impairments, including hemiplegia, hemiparesis, dysphasia, and aphasia. During the observed care, the CNA used wipes to clean the resident's groin area but did not separate the labia or clean each side and the center thoroughly, nor did he clean the rectal area. The CNA also placed the resident's feeding pump on hold, an action that facility policy reserves for nurses only. The CNA acknowledged not following proper procedure and attributed the lapse to nervousness. Interviews with facility staff, including the RN Unit Manager, Executive Director, and Director of Nursing, confirmed that the CNA did not perform perineal care correctly and was not authorized to operate the feeding pump. The facility's policy requires thorough cleaning of the entire perineal area and mandates that only nurses handle feeding pumps. The resident involved was unable to participate in a mental status interview, as indicated by a BIMS score of 00, and had been admitted with multiple neurological diagnoses.