| 2774 |
LAKE MARION NURSING FACILITY |
425300 |
1527 URBANA ROAD |
SUMMERTON |
SC |
29148 |
2019-11-04 |
880 |
D |
0 |
1 |
09P711 |
Based on observations, interviews and policy reviews, the facility failed to utilize proper handwashing techniques during wound care for 1 of 2 nurses observed. The facility failed to maintain infection control practices during medication pass for 3 of 5 nurses observed. The findings included: 1. On 11/03/19 at 10:38 a.m., Nurse #74's handwashing technique was observed during wound care observation for Resident #3. Nurse #74 turned on the water faucet with his unwashed hands. He washed his hands with soap and water, then used his clean hands to turn off the water faucet. He then pressed the lever on the paper towel dispenser to dispense a towel to dry his hands. He repeated this technique each time he washed his hands during wound care. After the wound care observation, the nurse was asked about his handwashing technique. Nurse #74 responded by demonstrating his handwashing technique, and again used his clean hands to turn off the water faucet and press the lever to dispense a paper towel to dry his hands. When questioned about the last time he was checked off on handwashing, he stated it had been more than 1 year. During an interview on 11/04/19 at 9:19 a.m., the Director of Nursing (DON) stated the correct handwashing procedure would be to dispense a paper towel, perform handwashing, dry the hands, then use the elbow to dispense another towel to turn off the faucet. A review of the facility's policy for Handwashing/Hand Hygiene, revised 8/2015, indicated, Washing hands, 1. Vigorously lather hands with soap and rub them together .2. Rinse hands thoroughly 3. Dry hands thoroughly with paper towels and then turn off the faucet with a clean, dry paper towel. 2a. During an observation and interview on 11/03/19 at 8:43 a.m., Nurse #64 was observed administering an insulin injection to Resident #25. Nurse #64 placed the syringe in his own mouth, prepped the injection site with alcohol, then administered the injection. He did not wear gloves during the procedure. When questioned, he stated it was the facility's policy to wear gloves during injections. When asked about placing the syringe in his mouth, he stated old army habits. The facility's undated policy for Injectable Medication Administration, indicated, Bring supplies to bedside or beside resident and maintain a clean space. Put on gloves. Expose the area to be injected and clean with an alcohol wipe. After administering the medication, the policy indicated, Dispose of syringe in sharps container and supplies in appropriate waste container. Remove & discard gloves. 2b. During a medication pass observation and interview on 11/4/19 at 8:20 a.m., Nurse #73 entered Resident #7's room to administer her morning medications. The nurse began by washing his hands. He turned the faucet on with his unwashed hands, washed his hands with soap and water, turned the faucet off with his arm, then used his clean hands to press the lever on the paper towel dispenser to dispense a towel to dry his hands. While he was washing his hands, in reference to handwashing, he stated, It isn't a good system. As he touched the paper towel dispenser lever to dispense a paper towel, he stated, Even this is dirty. He was questioned about his handwashing technique. He proceeded to demonstrate his handwashing technique, and once again used his clean hands to dispense a paper towel. When asked what he could do to prevent contaminating his hands while dispensing a paper towel, he stated his previous employer had tissues available that he used to dispense a paper towel. During an interview on 11/04/19 at 10:19 a.m., the DON stated the correct handwashing procedure would be to first dispense a paper towel, wash and dry the hands, then use the elbow to dispense another towel to turn off the faucet. A review of the facility's policy for Handwashing/Hand Hygiene, revised 8/15, indicated, Washing hands, 1. Vigorously lather hands with soap and rub them together .2. Rinse hands thoroughly 3. Dry hands thoroughly with paper towels and then turn off the faucet with a clean, dry paper towel. 2c. On 11/4/19 at 8:20 a.m., Nurse #73 entered Resident #7's room to administer her morning medications. He had prepared the medications and placed them in a plastic tray. Nurse #73 took the tray into the resident's room and placed it directly on the resident's table. After administering the medications, he returned to the medication cart with the plastic tray. He did not clean the tray. During a follow up interview on 11/04/19 at 9:55 a.m., Nurse #73 stated he didn't usually use the plastic tray with medication pass. He stated he had never been instructed to clean the tray in between use with each resident. During an interview on 11/4/19 at 10:05 a.m., the Clinical Nurse Coordinator stated the staff don't usually use the plastic trays with medication pass. She indicated if the nurses use the trays with medication pass, it should be cleaned in between each resident use with bleach wipes that are available on the medication carts. |
2020-09-01 |