Failure to Sanitize Glucose Meters and Maintain Hand Hygiene During Medication Administration
Penalty
Summary
The deficiency involves failures in the facility’s infection prevention and control practices related to blood glucose monitoring and medication administration. One resident with diabetes and peripheral vascular disease required blood glucose monitoring; after this resident’s blood glucose level was checked, the LPN carried the blood glucose meter in her hand and then placed it in the top drawer of the medication cart without sanitizing it. The LPN stated she did not clean the meters between residents, was unsure how to clean them, and reported that she had worked at the facility for three weeks without ever cleaning the meters. Manufacturer guidelines for the meter indicated it should be cleaned and disinfected with an EPA-registered disinfectant detergent or germicide wipe, and the facility’s policy required glucose meters to be disinfected with a high-level antimicrobial wipe. The facility also failed to follow infection control standards during medication administration for three residents with various diagnoses including Alzheimer’s disease, heart failure, diabetes mellitus, schizoaffective disorder, depressive type, and chronic obstructive pulmonary disease. During observations, one LPN placed multiple medications directly into her bare hand without sanitizing or wearing gloves before administering them to a resident with impaired cognition, and another LPN placed medications into her bare hand without sanitizing or wearing gloves when administering to two residents with intact cognition. Both LPNs confirmed these practices during interviews, with one acknowledging she should have worn gloves before touching medications. The Regional Director of Clinical Operations confirmed that staff should not be popping medications into their hands and that blood glucose meters should be sanitized between each resident. Facility policy on medication administration stated that staff are not to touch medications when opening liquid or dose packs. The census at the time was 170 residents, and the deficiency was identified incidentally during a complaint investigation.
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