Failure to Honor Continent Resident’s Dignity During Incontinence Check
Penalty
Summary
The deficiency involves staff failing to honor a resident’s right to be treated with respect and dignity and to make choices about incontinence care. The resident, admitted with multiple medical diagnoses including COPD, autoimmune hepatitis, asthma, hypoxemia, type 2 diabetes, Parkinsonism, and joint replacements, was documented on the admission assessment as always continent of bowel and bladder and as alert and oriented to person, place, time, and situation, with verbally appropriate responses. Facility policies and the bowel and bladder program state that continent residents should not be placed on incontinence programs or subjected to incontinence checks, and that residents have autonomy and choice in how they receive care, as long as facility rules and regulations are followed. Despite this, staff conducted an incontinence urine bed check at approximately 4:00 a.m. after the resident had stated to staff that they were continent of urine and did not need the bed checked. The resident’s family member reported that the resident felt embarrassed, degraded, and experienced low self-esteem as a result of staff continuing the incontinence check after the resident’s statement. A CNA and the admission LPN both stated that staff should follow the care plan, recognize when a resident is continent, and ask if assistance to the restroom is needed rather than insisting on checking the bed for incontinence when an alert resident reports being dry. The administrator and corporate nurse acknowledged that residents have the right to be treated with dignity and to choose whether they are checked and changed or assisted to the restroom, consistent with the facility’s resident rights policy.
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