Failure to Ensure Nurse Competency in Skin Scraping Procedures
Penalty
Summary
The facility failed to ensure that three licensed nursing staff members were competent to perform skin scraping procedures, a skill necessary for diagnosing certain skin conditions. Review of the employee file for Treatment Nurse 1, hired on 11/13/2024, showed a competency skills assessment dated 1/14/2025 that did not include skin scraping. Treatment Nurse 2, hired on 2/11/2025, had a competency skills assessment dated 2/12/2025, also without any documented assessment of skin scraping. The Infection Preventionist Nurse, hired on 6/12/2024, had a competency skills assessment dated 10/13/2025, which likewise did not include skin scraping procedures. There was no documentation that any of these staff had been assessed for competency in performing skin scraping upon hire or annually. During interviews and concurrent review of employee files, the Director of Staff Development acknowledged that the competency assessments for these nurses did not include skin scraping and stated that without such assessments, the facility would not know if the nurses were performing the procedure correctly. The Director of Nursing confirmed that there were no skin scraping competency assessments completed on the licensed nurses and stated that, without these assessments, the procedure had the potential not to be done properly and could negatively affect the accuracy of results. Review of the facility’s Scabies Prevention and Control Guidelines indicated expectations for evaluation of residents and staff for scabies and access to diagnostic skills of clinicians experienced in recognizing scabies. The facility’s Competency Assessment policy stated that each employee must demonstrate competency related to skills and techniques necessary to provide care and that competency must be completed prior to assignment, which was not met for the skin scraping procedure for the identified staff.
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