Improper Storage and Handling of Respiratory Equipment
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards, the resident’s care plan, and facility policy for one resident requiring respiratory support. Facility policy required that respiratory equipment be cleaned and disinfected by qualified staff on a scheduled basis, between patients, and upon discontinuation from service, with the purpose of removing microorganisms from equipment surfaces. The resident had diagnoses including COPD and muscle wasting/atrophy, and physician orders for scheduled nebulized Ipratropium-Albuterol every six hours for shortness of breath/wheezing and oxygen via nasal cannula titrated to maintain oxygen saturation above 90%. The comprehensive care plan identified the resident as at risk for respiratory complications related to COPD, shortness of breath, and wheezing, with interventions to administer aerosol treatments and oxygen as ordered. On multiple observations over two days, the resident’s respiratory equipment was found stored and maintained in a manner that did not prevent contamination. The resident, who reported feeling sick and wanting to see a doctor and exhibited a wet cough, had a nebulizer machine at the bedside with the nebulizer mask lying on a bedside table on top of a tissue box, nebulizer tubing on the floor dated the previous day, and oxygen tubing from the concentrator to the nasal cannula lying across the floor. Later observations showed the nebulizer mask and tubing bagged but with the same date, indicating the tubing had not been changed after being on the floor, and both the oxygen tubing and the storage bag were touching the floor. On the following day, the nebulizer tubing remained in a bag touching the floor with the same date, and the oxygen tubing continued to lie on the floor between the concentrator and the resident’s nose. The DON stated an expectation that respiratory equipment be stored and used in a way that prevents contamination with microorganisms.
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