Failure to Follow Infection Control Protocols During Incontinent Care
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) failed to follow proper infection prevention and control procedures while providing incontinent care to a male resident with dementia, type 2 diabetes, and a psychotic disorder. The resident required varying levels of assistance with activities of daily living and was occasionally incontinent of bladder. During the observed care, the CNA did not wash or sanitize her hands before beginning care, donned gloves, and cleaned the resident from the rectal (dirty) area to the urethral (clean) area, contrary to facility policy which requires cleaning from clean to dirty. The CNA also assisted the resident with dressing without changing gloves or performing hand hygiene during the process. Interviews with the CNA and other staff confirmed that the CNA had received training on infection control and incontinent care, and that facility policy required hand hygiene and changing gloves when soiled. The facility's perineal care policy specifically instructs staff to perform hand hygiene and to clean from the urethral area to the rectal area to avoid contamination. Documentation showed the CNA had attended recent in-services and coaching, but the observed care did not comply with established infection control protocols.