Failure to Properly Disinfect Shared Glucometer and Use PPE for Contact Precautions
Penalty
Summary
The deficiency involves failures in the facility’s infection prevention and control practices related to shared glucometer disinfection and use of personal protective equipment (PPE) for residents on isolation precautions. For one resident with multiple diagnoses including diabetes, hepatic encephalopathy, cirrhosis, and chronic viral hepatitis B and C, an LPN was observed checking the resident’s blood glucose using a shared facility glucometer and then cleaning the device only with an alcohol wipe. The LPN confirmed this was the method used to cleanse the glucometer. Review of the facility’s Shared Glucometer Cleaning Protocol showed that staff were required to use a fresh approved low-level disinfectant wipe each time the glucometer was used, and the Regional Nurse confirmed that cleaning a shared glucometer with an alcohol wipe would not prevent blood illnesses such as hepatitis. The deficiency also includes failure to follow required PPE use for a resident on contact isolation precautions for Clostridioides difficile (C. diff). This resident had diagnoses including atrial fibrillation, COPD, diabetes, dysphagia, and cognitive communication deficit, and was ordered contact isolation precautions. A sign on the resident’s door instructed staff to don gloves and a gown before room entry. A respiratory therapist was observed entering the room without any PPE, and a CNA was later observed performing incontinence care for the same resident without wearing a gown, with her scrub top visible. The CNA acknowledged that PPE should be worn in the room and had to read the sign after exiting to determine what PPE was required and for which resident. The unit manager confirmed the resident had been on contact isolation for C. diff and that contact precautions required the use of appropriate PPE, including gown and gloves upon entering the resident environment, as outlined in the facility’s Standard Precautions policy.
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