Failure to Provide Timely Incontinence Care for Dependent Resident
Penalty
Summary
A deficiency occurred when a resident who was unable to perform activities of daily living (ADLs) independently was not assessed or changed in a timely manner for a wet and soiled incontinence brief, as required by the resident's care plan. The resident, who had diagnoses including hemiplegia, hemiparesis following a stroke, metabolic encephalopathy, and dementia, was observed at 2 PM with a brief soaked in urine and feces. The certified nurse assistant (CNA) responsible stated the last incontinence check and change had occurred at 8 AM, and was unsure when the resident had last had a bowel movement. The CNA acknowledged that the resident should have been checked more frequently and that care was not provided as needed. Further observation and interviews revealed that the resident was dependent on staff for nearly all ADLs, including toileting hygiene. A registered nurse (RN) noted the presence of blanchable redness near the resident's left medial buttock and sacrococcyx, which could have resulted from prolonged exposure to urine and feces. The director of nursing (DON) confirmed the importance of timely incontinence and perineal care, stating that failure to maintain good hygiene could lead to skin breakdown and other complications. Review of facility policy indicated that residents unable to perform ADLs independently should receive necessary support and assistance with elimination in accordance with their care plan.