Failure to Enforce Fingernail Length Standards for Direct Care Staff
Penalty
Summary
The facility failed to implement its infection prevention and control program and employee handbook requirements regarding fingernail length for direct care staff. During an observation with the Assistant Director of Nursing (ADON), a certified nursing assistant (CNA) was noted to have long, uneven fingernails that extended past the fingertips. The ADON stated that staff who provide direct resident care should keep their fingernails short and trimmed for infection control and resident safety. In a separate observation and interview, a licensed vocational nurse (LVN) who provided direct resident care acknowledged that her fingernails were long and extended past her fingertips. The LVN stated she was aware that staff fingernails were required to be kept short for infection control purposes but explained that she had just had her nails done. In an interview, the Infection Preventionist (IP) confirmed that nursing staff who provide direct resident care should not have long fingernails and that fingernails should not extend past the fingertips, stating that short, trimmed fingernails help decrease the risk of infection and promote resident safety by protecting skin integrity. Review of the facility’s Infection Control policy indicated the infection prevention and control program is a facility-wide effort addressing detection, prevention, and control of infections among residents and personnel. Review of the Skilled Nursing Facility Employee Handbook showed that, for safety and infection control, dietary employees and those providing direct resident care must keep fingernails clean and trimmed, and that fingernails must not extend beyond the end of each finger.
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