cms_WV: 231
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 231 | ELKINS REGIONAL CONVALESCENT CENTER | 515025 | 1175 BEVERLY PIKE | ELKINS | WV | 26241 | 2019-04-03 | 880 | D | 0 | 1 | P29Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, policy review, medical record review, and staff interview the facility failed to the facility failed to ensure staff used appropriate infection control practices to prevent the development and transmission of infectious and communicable disease within the facility. Facility staff failed to use proper technique during perineal care to eliminate the spread of infectious diseases for Resident #16. Oxygen tubing was found to be maintained in an unsanitary manner for Resident #30. This was a random opportunity for discovery. This practice had the potential to affect more than an isolated number of Residents. Resident Identifiers: #16, #30. Facility Census: 97. Findings included: a) Resident #16 On 04/03/19 at 1:19 PM Nurse Aide (NA) #36 and NA #141 were observed as they provided perineal care (washing genitalia and surrounding area) for Resident #16. NA #36 presented to bedside with gloves donned (to put on gloves), with one wet soapy wash cloth, one wet wash cloth without soap, one dry wash cloth, and no wash basin. NA #36 draped all wash clothes across top of left upper bed rail and positioned Resident supine (on back), unfastened Resident's brief and folded the front of brief down and tucked it under the Residents buttock. Resident's brief was visibly soiled with a bowel movement and urine. NA #36 proceeded with perineal care by separating Resident's legs that were bent at the knees and very stiff (due to contractures) and made one wipe down the front of the perineum across the labia with the soapy wash cloth. NA #141 then assisted NA #36 to turn resident to her right side and NA #36 folded soiled soapy wash cloth over one time and wiped one pass up the Resident's buttocks. NA #36 then wiped the perineal area one time from front to back bewteen the buttocks with the wash cloth that was said to be a rinse wash cloth containing only water, then wiped one time between the buttocks with the dry wash cloth. NA #36 then pulled soiled brief out from under resident, rolled brief up and laid brief on top of trash bag on foot of bed with soiled washcloths on top. Without removing soiled gloves, NA #36 then walked over to resident's dresser, opened top drawer with soiled gloves on, shuffled through clothing and obtained heel protectors from drawer and placed them on resident. NA #36 then separated soiled brief from soiled washcloths, removed soiled glove from right hand only, and placed items in separate trash bags. While continuing to wear soiled glove on left hand, NA# 36 covered resident up with sheet with both hands, lowered bed with right ungloved hand, and placed call bell on resident's chest with left hand. NA#36 then removed soiled glove from her left hand and handed trash bags to NA# 141 for disposal, and went to bathroom and washed hands. Review of Perineal Care policy with revise date of 10/16/16 included the following instructions for perineal care for a female resident without an indwelling catheter: -Wet wash cloth and apply soap or skin cleansing agent. -Wash perineal area, wiping from to back. -Separate labia and wash area downward from front to back. -Continue to wash perineum moving from inside outward to and including thighs, alternating from side to side, and using downward [MEDICAL CONDITION]. Do not use same washcloth or water to clean the urethra or labia. -Rinse perineum thoroughly in same direction, using fresh water and a clean washcloth. -Gently dry perineum. - Instruct or assist the resident to turn on her side with her top leg slightly bent, if able. -Rinse wash cloth and apply skin cleansing agent. -Wash the rectal area thoroughly, wiping from the base of the labia towards and extending over the buttocks. Do not reuse the same wash cloth or water to clean the labia. -Rinse thoroughly. -Dry area thoroughly. -Discard disposable items into designated containers. -Remove gloves and discard into container. Wash and dry your hands thoroughly -Reposition the bed covers. Make resident comfortable. Review of employee record revealed NA #36 attended in-service training on 01/15/19 for education of perineal care and hand hygiene and successfully completed staff competencies for female incontinence care (perineal care) in bed and proper hand washing technique observed by Director of Staff Development Registered Nurse (RN) #20. During an Interview on 04/03/19 at 2:43 PM, Director of Staff Development Registered Nurse #20 verified NA# 36 was in attendance for in-service training on 01/15/19 for perineal care of residents, and NA #36 demonstrated competency in care area by successfully completing skills evaluation check off. b) Resident #30 During an observation on 04/01/19 at 11:06 AM, it was noticed the Nasal Cannula (NC) (oxygen tubing that goes in the residents nose) was on the floor. The oxygen machine running, Licensed Practical Nurse (LPN) #1 was asked to come to the room. She removed the tubing and said, that she was going to replace it with a new one. On 04/03/19 at 4:40 PM, Administrator was informed of findings. | 2020-09-01 |