Infection Control Failures in Laundry Handling and Glucose Monitoring
Penalty
Summary
Surveyors identified deficiencies in the facility’s infection prevention and control practices related to handling soiled laundry and performing blood glucose testing. On the 200 hall, a laundry aide was observed removing laundry from multiple soiled bins and adjusting soiled laundry bags on her cart without wearing gloves. The aide stated that staff were told not to wear gloves when collecting laundry in the hallway. The facility’s Infection Preventionist later stated that gloves should be worn when handling soiled items, including laundry, and specifically when removing laundry from bins because the items are soiled and in case the bag tears. The aide’s orientation checklist indicated she had been trained on linen handling, infection control procedures, and use of personal protective equipment. The facility’s Infection Prevention and Control Program policy required all personnel to routinely wash hands and use appropriate barrier precautions to prevent transmission of infections, and CDC guidance cited by the surveyors stated that reusable rubber gloves should always be worn before handling soiled linen. Surveyors also found that nursing staff failed to follow the facility’s glucose testing policy and hand hygiene requirements during blood glucose monitoring for two residents with type 2 diabetes mellitus. During a medication pass, a nurse donned gloves, obtained a blood glucose level for one resident, then placed the used glucometer directly on the medication cart without a barrier, without cleaning the device, and without performing hand hygiene after removing gloves. Shortly afterward, the same nurse donned new gloves and used the same uncleaned glucometer to obtain a blood glucose level of 147 mg/dL for another resident, again without cleaning the glucometer or performing hand hygiene after glove removal. The nurse later acknowledged he was supposed to wash or sanitize his hands before and after donning and doffing gloves and between each resident, and to clean the glucometer between residents with bleach wipes. The DON stated she expected nursing staff to follow the glucometer policy, including placing a barrier on the surface, performing hand hygiene before and after glove use, and cleaning the glucometer. Facility policies on glucose testing and hand hygiene required use of a clean barrier on surfaces, removal of gloves and hand hygiene, and hand hygiene at room entry, before aseptic tasks, after contact with blood or body fluids, and after glove removal.
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