Failure to Retract Foreskin During Incontinent Care for Uncircumcised Resident
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to retract the foreskin of an uncircumcised male resident while providing incontinent care. Observation revealed that the CNA did not properly clean underneath the foreskin, which is necessary for adequate hygiene. The CNA acknowledged during an interview that he did not retract the foreskin and was unclear about the reason, despite being aware that this step was required. The Director of Nursing (DON) confirmed that staff are trained to retract the foreskin for proper hygiene and infection prevention, and that skills are checked annually and as needed. The resident involved had a history of vascular dementia, schizoaffective disorder, hypertension, type 2 diabetes mellitus, and irritable bowel syndrome, and was always incontinent of bowel and bladder. The care plan for the resident included interventions to maintain proper incontinence care due to a history of excoriation on the scrotum related to moisture, friction, or incontinence. Facility policy on perineal care specified that the foreskin should be gently retracted if applicable, but this was not followed during the observed care.