Failure to Secure Indwelling Catheter and Prevent Leakage
Penalty
Summary
A deficiency occurred when staff failed to maintain a urinary indwelling catheter in a secure manner for a resident with a diagnosis of obstructive and reflux uropathy. The resident's care plan indicated the presence of an indwelling catheter and a risk for urinary tract infection, with a goal to remain free from catheter-related trauma. During observation, it was noted that the resident did not have a security leg strap or any adhesive tape to secure the catheter, as required by facility policy. The catheter tubing and drainage bag were also not dated, and the resident's linen and bed were found to be wet due to urine leakage from the catheter. The resident reported ongoing pain at the catheter insertion site, describing sensations of the catheter pulling and requests for the catheter to be secured, which had not been addressed. The resident also stated that the catheter had not been changed monthly as ordered, and that frequent leakage resulted in daily pad changes by CNAs. The CNA confirmed the absence of a leg strap and the need to notify the nurse about the resident's pain. Facility policy required the use of adhesive tape or a leg band to secure the catheter, but this was not implemented, leading to the resident's discomfort and repeated episodes of urine leakage.