Uncovered Foley Bags Compromise Resident Dignity
Penalty
Summary
The deficiency involves the facility’s failure to ensure resident dignity by not keeping urinary catheter drainage bags covered with privacy bags as required by physician orders, care plans, and facility practice. For one resident, an older female with diagnoses including urinary system disorder, chronic Hepatitis C, hypokalemia, acute kidney disease, and cirrhosis, record review showed an indwelling suprapubic catheter and an order specifying that the Foley bag must be in a privacy bag while the resident is in bed or in a wheelchair. Her care plan also directed that the catheter bag and tubing be positioned below the level of the bladder and in a privacy bag. During an observation while the resident was in bed with a family member present, the catheter drainage bag was noted to be uncovered and without a privacy bag. A second resident, an older female with dysphagia, muscle wasting and atrophy, anemia, hyperlipidemia, dementia, hypertension, GERD, and neuromuscular dysfunction of the bladder, also had an indwelling catheter. Her orders required Foley catheter care every shift, including ensuring the Foley was secured on the thigh and the drainage bag was inside a privacy bag attached to the bed rail every shift. Her care plan similarly directed that the catheter bag and tubing be positioned below the level of the bladder and in a privacy bag. During observation, this resident was asleep in bed, non‑responsive to the investigator, and her catheter bag was clipped to the right side of the bed, visible from the hallway, with no privacy bag covering it. Multiple staff interviews confirmed that facility staff were trained that catheter bags should always be in privacy bags to maintain resident dignity and privacy. A CNA with 13 years of employment, another CNA, an LVN, the RN, the DON, and the Administrator each stated that catheter bags were expected to be covered with privacy bags and that failure to do so was a dignity or privacy issue. The facility’s Resident Rights policy stated that each resident must be treated with respect and dignity, including privacy and confidentiality, and that the facility must protect and promote residents’ rights. Despite these expectations, the observed uncovered catheter bags for the two residents demonstrated that the facility did not ensure residents’ right to a dignified existence and privacy as outlined in their orders, care plans, and facility policy.
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