Improper Reuse of Disposable Wipes During Incontinent Care
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to follow proper infection control practices during incontinent care for a male resident with significant medical needs, including type 2 diabetes, muscle weakness, dementia, bowel incontinence, and an indwelling catheter. During the observed care, the CNA used the same disposable cleansing wipe multiple times on different areas, crumpling and reusing the wipe instead of discarding it after a single use. This practice was observed repeatedly throughout the procedure, including care of the genital and buttock areas. Interviews with staff revealed inconsistent understanding and application of infection control protocols. The CNA involved stated that facility training allowed for folding and reusing wipes as long as a clean area was used, while another CNA and an LPN both indicated that wipes should be used once and then discarded to prevent cross-contamination. The Assistant Director of Nursing (ADON) acknowledged that best practice was to use one wipe per swipe and dispose of it, but also described some ambiguity in staff training regarding the reuse of wipes if a clean area remained. Review of the facility's policies and competency assessments confirmed that disposable items should be discarded after use, and FDA guidance also supports immediate disposal of used wipes to prevent cross-contamination. Despite regular in-service training and competency checks, the observed practice did not align with facility policy or best practice, resulting in a failure to maintain an effective infection prevention and control program for residents requiring incontinent care.