Improper Perineal Care Technique During Incontinence Care
Penalty
Summary
A deficiency was identified when a certified nurse assistant (CNA) provided incontinence care to a resident with severe cognitive impairment and multiple diagnoses, including Alzheimer's disease, chronic obstructive pulmonary disease, and dysphagia. The resident was always incontinent of bowel and bladder and required substantial to maximal assistance for hygiene. During observed care, the CNA performed hand hygiene, donned gloves, and used a cloth washcloth to cleanse and rinse the resident after urinary incontinence. However, the CNA cleansed the perineal area from back to front, both during cleaning and rinsing, contrary to best practices for infection prevention. The CNA confirmed in an interview that she should have cleansed the resident from front to back, as specified in the facility's perineal care policy. The policy states that female residents should be cleansed from the pubic area toward the anus to promote cleanliness and prevent infection. This failure to follow proper perineal care technique constituted non-compliance and was identified during the investigation of two complaints.