Failure to Follow Hand Hygiene and Glove-Change Practices During ADL Care
Penalty
Summary
The deficiency involves failure to follow the facility’s infection prevention and control policy regarding hand hygiene and glove use during ADL care. A CNA assisted one resident with toileting and peri care after voiding, then applied a new incontinence brief and pulled up the resident’s pants while continuing to wear the same soiled gloves. Another CNA provided incontinence care to a resident who had a bowel movement, removed the soiled brief, cleansed the perineal area, applied barrier cream, and placed a new incontinence brief without changing gloves during the entire process. In a separate incident, a CNA assisted a resident with dressing while the resident had an indwelling catheter and wore shoes used for wheelchair propulsion. During this care, the CNA touched the catheter bag, the resident’s clothing, the resident’s shoes with dirty soles, and other surrounding surfaces, moving repeatedly between dirty and clean tasks without changing gloves. The DON later stated that staff are required to perform hand hygiene and change gloves when moving from dirty to clean tasks during ADL care. The facility’s written Standard Precautions policy requires hand hygiene after contact with blood, body fluids, excretions, intact skin, and inanimate objects in the resident’s vicinity, and requires changing gloves when moving from a contaminated body site to a clean body site.
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