Improper Catheter Care Technique Leading to Contamination Risk
Penalty
Summary
The deficiency involves failure to provide catheter care in a manner that prevented contamination for a resident with an indwelling urinary catheter and a history of urinary tract infections. The resident had diagnoses including dementia and neuromuscular dysfunction of the bladder, and physician orders and the active care plan required catheter care every shift and after each incontinent episode. Facility records showed the resident had UTIs requiring antibiotic treatment on two recent occasions. During observation, two CNAs provided care using a basin of soapy water and a basin of plain water, with one intended for washing and the other for rinsing. While providing care, one CNA cleaned stool from the resident’s buttocks using a washcloth, then, without washing her hands or changing gloves or water, obtained a new washcloth, dipped it into the same basin, and cleansed the urinary catheter tubing from the urethra downward. This sequence of actions occurred despite the resident’s chronic indwelling catheter and history of UTIs. The DON stated that when stool is present during catheter care, CNAs are expected to change gloves and water after cleaning the stool and before performing catheter care to prevent contamination of the catheter tubing. The facility’s catheter care policy also states that to prevent contamination when feces are present, staff should wash hands, change gloves, and use new equipment for catheter care.
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