Failure to Perform Hand Hygiene and Sanitize Equipment Between Residents
Penalty
Summary
The facility failed to ensure proper hand hygiene and sanitation of medical equipment before and after resident use, as observed with two residents. A registered nurse was seen preparing medications while wearing a glove on one hand, touching the medication cart, medications, and computer with the same glove, and then removing the glove without sanitizing her hands. She entered the residents' rooms, took their blood pressure and pulse oximetry readings with the same machine, administered medications, and left the rooms without performing hand hygiene or cleaning the equipment. These actions were repeated for both residents observed. During an interview, the nurse confirmed she did not change gloves after touching surfaces other than the residents' medications, did not sanitize her hands before and after entering the residents' rooms, and did not clean the blood pressure and pulse oximetry equipment before or after use. Facility policies reviewed indicated that proper hand hygiene and equipment cleaning are required to prevent and control infection, but these procedures were not followed during the observed medication administration process.