Failure to Clean and Disinfect Urine Collection Canister per Manufacturer Instructions
Penalty
Summary
The deficiency involves the facility’s failure to clean and disinfect a urine collection canister according to the manufacturer’s instructions and the facility’s own policies. A cognitively intact resident, admitted with chronic systolic heart failure, acute myocardial infarction, and type 2 diabetes mellitus, used a Purewick external female catheter urine collection system every shift for urinary incontinence management. During an observation and interview in the resident’s room, the resident reported that the urine canister had never been disinfected and had only been rinsed with soap and water. A CNA stated that the resident’s urine canister was cleaned with soap and water once or twice a day and that there was no documentation of canister cleaning. An undated procedure titled “Cleaning Procedure for Purewick Cannister, Tubing, and External Catheter” posted in the resident’s bathroom directed staff to empty urine into the toilet, scrub the canister with soap and water using a brush, and dry it with a paper towel, with no disinfection step or required contact time. The Infection Preventionist confirmed that staff were educated to clean and disinfect the canister with soap and water and to wipe off sediments with a brush, and also confirmed there was no documentation for canister cleaning. Review of the facility’s policy “External Catheter for Female Urinary Incontinence Management” stated that the urine collection system and accessories should be cleaned and disinfected at each use or at least daily per manufacturer’s instructions. The manufacturer’s instructions for “Cleaning the Collection Canister” required an initial rinse, then full submersion of the canister and lid in a dish soap solution for a minimum of ten minutes with brushing while submerged, followed by rinsing, visual inspection, and then full submersion in 70% isopropyl alcohol for a minimum of ten minutes, with a final rinse and drying. The Infection Preventionist acknowledged that following these instructions could prevent growth of bacteria and fungus and that the canister is a non‑critical care item. The facility’s policy on cleaning and disinfection of resident-care items identified alcohol as an appropriate disinfectant for non‑critical items, but the implemented procedure and staff practice did not follow the required cleaning and disinfection steps or contact times for the resident’s urine collection canister.
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