Improper Hand Hygiene During Incontinent Care
Penalty
Summary
A deficiency occurred when CNA A failed to follow proper hand hygiene practices during incontinent care for a resident. During an observation, CNA A performed hand hygiene and then assisted the resident to roll onto her side. While wearing gloves, CNA A used wipes to clean the resident’s left buttocks, right buttocks, and rectal area. Without performing hand hygiene between dirty and clean tasks, CNA A then placed a clean draw sheet and a new brief under the resident. After this, CNA A removed her gloves, washed her hands, donned new gloves, rolled the resident onto her back, and secured the new brief. In a subsequent interview, CNA A acknowledged that when moving from the dirty portion of care to the clean portion, she should have washed her hands and that she was “dirty” after wiping the resident, stating she probably cross-contaminated. CNA A reported she had been trained in hand hygiene by the former DON. In a group interview, the Corp RN stated she expected staff to perform hand hygiene before beginning incontinent care, when moving from any dirty to clean portion of care, and upon completion of care, to prevent cross contamination. The DON agreed and added that he expected staff to use ABHR before entering a resident’s room. Training records showed CNA A had received hand hygiene education, and facility policy on perineal care required hand hygiene before and after glove use.
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