Infection Control Failures in Dietary Services and Insulin Administration
Penalty
Summary
The deficiency involves failures in the facility’s infection prevention and control practices in both the dietary department and during insulin administration. Facility policies required dietary employees to perform hand hygiene before food preparation, when changing tasks, after contact with unsanitary items or body parts, and as often as necessary to prevent cross contamination, as well as to wear hairnets when cooking, preparing, or assembling food. During a meal service observation, the Kitchen Supervisor left the tray line to enter the walk-in refrigerator and dry storage areas and then returned to continue prepping plates without performing hand hygiene. A dietary aide pureed resident food items without performing hand hygiene, and another dietary aide prepped plates, left the kitchen to deliver trays, and returned to prep more plates without washing hands. The Food Service Manager and a dietary aide had their hair pulled back in ponytails under baseball-type hats, with the ponytails hanging out and not restrained by hairnets. The Kitchen Supervisor later stated he was probably not seen washing his hands as much as he should have because one of the handwashing sinks was out of order, and the Food Service Manager stated she believed hairnets were not required if staff wore hats and that handwashing was only needed when hands were visibly dirty and when changing tasks. The deficiency also includes improper infection control practices during insulin administration to a resident with diabetes and anxiety. The resident had physician orders for subcutaneous insulin glargine and insulin lispro per sliding scale. During an observation, an LPN placed a syringe containing insulin glargine on the resident’s bed next to the resident while cleaning the injection site, then picked up the syringe from the bed and administered the insulin. The LPN later acknowledged she should not have placed the insulin syringe on the resident’s bed. The Infection Preventionist stated that the LPN should have placed resident medications on a protective cover on top of the bedside table rather than in the bed.
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