cms_ND: 8
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8 | THE MEADOWS ON UNIVERSITY | 355024 | 1315 S UNIVERSITY DR | FARGO | ND | 58103 | 2017-05-10 | 441 | D | 1 | 1 | ZMNB11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, record review, review of the facility policies, review of professional literature, and staff interview, the facility failed to follow infection control practices for 2 of 9 sampled residents (Resident #4 and #7) observed during personal cares and/or foley catheter cares. Failure to follow infection control practices of hand hygiene following perineal cares (Resident #4 and #7) and foley catheter cares (Resident #7) has the potential to spread infection to other personnel, residents, and visitors. Findings include: Review of the facility policy titled, Hand Hygiene occurred on 05/10/17. This policy, dated 12/2009, stated, . When to wash hands or use an alcohol-based hand rub: * Before applying and after removing gloves . *After contact with body fluids and excretions . Review of facility policy titled, INCONTINENCE CARE occurred on 05/10/17. This policy, revised (MONTH) 2014, stated, . if feces present, remove with toilet paper or disposable wipe . Discard soiled materials and gloves. Perform hand hygiene . Dry peri-area and buttocks . Remove and discard gloves. Perform hand hygiene. Reposition for comfort . provide additional care needs . - During observation on 05/09/17 at 10:20 a.m., two certified nursing assistants (CNAs) (#2 and #3) provided perineal cares for Resident #4 after using the toilet. A CNA (#2) completed the cares, including the cleansing of a smear of bowel movement (BM). Following the incontinence care and assisting Resident #4 into the wheelchair, the CNA (#2) removed her gloves, failed to perform hand hygiene, and donned a new pair of gloves. The CNA then proceeded to complete other tasks of pushing Resident #4 out of the bathroom and applying leg rests to the wheelchair. During an interview on 05/10/17 at 10:10 am, an administrative nurse (#1) stated she would expect staff to perform hand hygiene after removing gloves, and before doing other tasks. Berman and Snyder, Kozier & Erb's Fundamentals of Nursing Concepts, Process, and Practice, Tenth Edition, Pearson Education, Inc., New Jersey, page 1192 and 1198, states, . MAINTAIN THE URINARY CATHETER . Maintain a sterile, closed drainage system. Empty the collection bag regularly with a separate, clean collecting container . prevent contact of the drainage spigot with the nonsterile collecting container. Nursing care of the client with an indwelling catheter and continuous drainage is largely directed toward preventing infection of the urinary tract . preventing contamination of the drainage system . Dugan, Successful Nursing Assistant Care, Second Edition, Hartman Publishing Inc., New Mexico, page 300-301, states, Emptying a catheter drainage bag . Open drain or clamp on the bag. Allow urine to flow out of the bag into the graduate. When urine has drained, closed clamp. Using alcohol wipe, clean the drain clamp. Replace the drain in its holder on the bag. - Review of Resident #7's medical record occurred all days of survey. [DIAGNOSES REDACTED]. The current quarterly Minimum Data Set (MDS), dated [DATE], identified an indwelling catheter (suprapubic), always incontinent of bowel, and extensive assistance of one to two required for all cares. During an observation on 05/09/17 at 1:45 p.m., two CNAs (#2 and #10) assisted Resident #7 with perineal cares. The CNA (#2) applied gloves and cleansed the front perineal area which showed visible stool on the wipe. The CNA (#2) picked up a piece of stool off the blanket on the bed with a wipe, placed it in the garbage can, and without removing her soiled gloves adjusted the clean brief, pulled up the resident's pants, adjusted her shirt, and repositioned the resident. The CNA (#2) removed her gloves and adjusted the level of the bed using the controls then washed her hands and left the room. The CNA (#2) failed to remove her gloves and perform hand hygiene after providing perineal cares and prior to completing other cares. During an observation on 05/09/17 at 2:00 p.m., a CNA (#10) entered Resident #7's room to empty the catheter drainage bag. She applied gloves, went into the bathroom, took two clean collection containers and placed approximately 75 milliliters (ml) of water from the bathroom faucet into one of the containers. The CNA placed the container with the water on the bedside table. She placed a paper towel on the floor and the empty container on the paper towel, opened the end of the drainage tube from the indwelling catheter collection bag, and drained the urine in to the container. The CNA (#10) took the end of the collection bag tube, turned it upwards, and poured water from the other container into the catheter bag, shook the bag and stated I'm rinsing out the catheter bag. The CNA (#10) drained the water back into the container, wiped off the port with an alcohol swab, and disposed of the contents in the toilet. The CNA removed her gloves and sanitized her hands. During an interview on 05/10/17 at 11:35 a.m., an administrative staff member (#1) confirmed the CNA (#10) did not follow facility practice when emptying the catheter drainage bag. | 2020-09-01 |