Failure to Maintain Resident Privacy During Personal Care
Penalty
Summary
The facility failed to maintain personal privacy during personal care for one resident when a CNA opened the resident’s door while he was lying in bed wearing only a brief. The resident had been admitted with malnutrition, cerebral infarction due to small artery occlusion or stenosis, dysphagia following cerebral infarction, a gastrostomy for enteral feeding, and a cognitive communication deficit. His admission MDS showed he was severely cognitively impaired, totally dependent for all ADLs including toileting and personal hygiene, and had a feeding tube. His care plan documented impaired communication related to CVA with aphasia, cognitive communication deficit, impaired physical functioning, debility/weakness, hemiplegia/hemiparesis, neurological disease, prolonged hospitalization, lack of coordination, and abnormalities of gait and mobility, and that he required one to two persons for toileting and hygiene, as well as enteral tube feeding for oropharyngeal dysphagia and failure to thrive. During observation, the CNA exited the resident’s room and opened the door, exposing the resident in bed closest to the door. Although the privacy curtain was pulled, it did not extend around the foot of the bed, leaving the resident visible while wearing only a brief and connected to a G-tube. The CNA reported she opened the door to get help from another CNA because the resident, normally a one-person assist, was stiffer than usual and had paralysis on his left side, and she needed assistance to turn him to secure his brief. She stated she typically pulled the privacy curtain to the edge of the bed and never all the way around because it was not long enough, and in this instance did not draw it to cover the foot of the bed closest to the door to avoid exposing the resident to his roommate. The resident did not engage in conversation during an attempted interview and did not speak. The DON stated staff should ensure privacy during care and that exposing a resident during care would be a violation of privacy and could cause embarrassment. Facility policy on Quality of Life – Dignity required staff to promote, maintain, and protect resident privacy, including bodily privacy during personal care and treatment procedures.
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