Failure to Follow Infection Control Practices During Glucose Monitoring and Urine Spill Cleanup
Penalty
Summary
The deficiency involves failure to implement proper infection prevention and control practices during medication administration. A resident with multiple diagnoses including diabetes and asthma was observed during a blood glucose check and insulin administration. An RN entered the resident's room with a glucometer (with test strip inserted), two insulin pens, a lancet, and alcohol wipes, and placed the glucometer and insulin pens directly on the foot of the resident's bed. After performing hand hygiene and donning gloves, the RN then moved the glucometer to a position above the pillow where the resident's arm was resting to check the blood glucose level, again without using any barrier. The RN did not place a clean, dry paper towel or other barrier under the glucometer or insulin pens on either surface, despite guidance from the American Health Care Association that such equipment should be placed on a paper towel before being set on a resident's table or medication cart. The DON later stated that insulin pens and glucometers should be placed on top of a paper towel before placing them on any surface in residents' rooms. The deficiency also includes improper cleaning of a urine spill in a common area. A CNA was observed assisting another CNA with a urine spill from a leaking urinary catheter collection bag in a wing common area. The CNA placed a dry white towel over a small puddle of urine, donned gloves, wiped up the urine with the towel, and then left the area without further cleaning or disinfection. CDC environmental cleaning procedures for spills of blood or body fluids specify wearing appropriate PPE, confining and wiping up the spill with absorbent material to be disposed of as infectious waste, then thoroughly cleaning with neutral detergent and warm water, disinfecting with a facility-approved intermediate-level disinfectant, and sending reusable supplies for reprocessing. When later asked about the process for cleaning soiled areas, the CNA stated the process was to wear gloves, wipe up the soiled area, and use alcohol or disinfectant wipes, and acknowledged that no disinfectant was used on the urine spill and that the area should have been sanitized and housekeeping notified.
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