Improper Perineal Care Technique During Incontinence Care
Penalty
Summary
The facility failed to provide incontinence care in a manner that prevented potential urinary tract infections for one resident. The resident was admitted with diagnoses including functional quadriplegia, ventilator dependence, and heart failure. During observed incontinence care, a CNA began by cleaning the resident’s vaginal area while the resident was on her back, then, after the resident was rolled onto her side, the CNA wiped stool from the top of the buttocks toward the vagina twice, despite the presence of a moderate, tar-like bowel movement. As a result, the resident’s vaginal area required a second cleaning after she was rolled back onto her back. The shift coordinator/CNA later stated he had quietly instructed the CNA to wipe away from the vagina, acknowledging that wiping stool toward the vagina could lead to a urinary tract infection, and the DON confirmed that stool should be wiped away from the vagina to prevent contamination or infection. The facility’s incontinence and perineal care policy required maintaining clean technique to ensure cleanliness, comfort, and prevention of infection and skin irritation. These observations, interviews, and record review showed that staff did not consistently follow the facility’s incontinence and perineal care policy or accepted clean technique during perineal care for this resident.
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