cms_WV: 538
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 538 | MERCER NURSING AND REHABILITATION CENTER | 515052 | 1275 SOUTHVIEW DRIVE | BLUEFIELD | WV | 24701 | 2018-11-29 | 690 | D | 0 | 1 | J9FW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview and policy review the facility failed to ensure residents, with an indwelling catheter, received the appropriate care based upon current professional standards of practice and services to prevent urinary tract infections to the extent possible. Also failed to ensure the indwelling Foley catheter was secured to the leg was used to prevent injury, accidental removal. This was true for two (2) of two (2) reviewed for catheter care. Identified Residents were Resident #70 and #6. Facility Census 97. Findings included: a) Resident #70 During an interview on 11/26/18 at 11:39 AM, Resident's husband said that she has ESBL in urine she has a catheter. On 11/28/18 at 9:23 AM, Indwelling Foley Catheter care observation with Nursing Assistant (NA) #40, it was noted the catheter anchor was not on the resident's leg. NA#40 wiped once down the sides of the inner legs (groin area), one down stroke over the outside of the vagina. She then emptied the water basin and left room. When she returned with clean wash cloth and water she wiped the catheter tubing but not at the insertion site, only a section of the tubing about 3 inches from the vagina. Licensed Practical Nurse (LPN) #27 brought in a thigh strip to secure the Foley catheter to the leg. NA #85 wiped the buttock crevices toward the vagina, not away from the vagina to prevent Infections. After the two (2) NAs had finished and put the supplies away they were asked the following; - How often are they in-serviced on catheter care? They both said the last time was in (MONTH) this year. - How do they believe they did? NA # 85 said that, she knew that she should not have wiped towards the vagina and NA #40 said she normally does a better job. Both NAs agreed they did not use proper technic for catheter care. During an interview on 11/28/18 at 10:04 AM, DoN was notified of findings that were observed. She stated that she was disappointed. The Facility Policy, Catheter Care, Urinary Dated; 8/2002. reads: -Ensure that the catheter remains secured with a leg strap to reduce friction and movement at the insertion site. (Note; Catheter tubing should be strapped to the resident's inner thigh.) - report unsecured catheters to the Charge Nurse. The Facility Policy, Perineal Care Dated, 1,2002, reads: -Wash perineal area wiping from front to back. -Separate labia and wash area downward from front to back - gently wash the juncture of the tubing from the urethra down. -Continue to wash the perineum moving from inside outward to and including the thighs alternating from side to side and using downward [MEDICAL CONDITION]. Do not use the same washcloth or water to clean the urethra or labia. -Wash the rectal area thoroughly, wiping the base of the labia towards and extending over the buttocks, do not use the same washcloth or water to clean the labia. Care Plan from electronic chart: Resident #70 has an Indwelling Catheter for [MEDICAL CONDITION] bladder, 16 FR with 10cc balloon. Patient will be/remain free from catheter-related trauma through review date. Change catheter every 4 weeks and as needed. Document pain/discomfort/intolerance due to catheter and report to physician as necessary. Document/report to physician s/sx UTI: pain, burning, blood tinged urine, cloudiness, no output, deepening of urine color, increased pulse, increased temp, Urinary frequency, foul smelling urine, fever, chills, altered mental status, change in behavior, change in eating patterns. Provide patient-specific catheter care as ordered URINARY CATHETER: Patient has a Foley. Position drainage bag and tubing below the level of the bladder to allow free flow of urine into the bag. Secure tubing. Cover drainage bag with appropriate privacy bag. Report any concerns to the Unit Charge Nurse. Provide catheter care and record volume of urine every shift. b) Resident #6 On 11/26/18 at 1:35 pm, an observation with Employee #52, Clinical Care Supervisor (CCS) found Resident #6 had an indwelling Foley Catheter. The catheter was not anchored to the resident's leg. Care Plan from electronic chart reviewed: Focus: Resident #6 has an Indwelling Catheter due to a pressure ulcer on coccyx, 20 FR with 10 cc balloon. Goal: Patient will be/remain free from catheter-related trauma through review date. Intervention: 1. Change catheter every 4 weeks and as needed. 2. Document pain/discomfort/intolerance due to catheter and report to physician as necessary. 3. Document/report to physician s/sx UTI: pain, burning, blood tinged urine, cloudiness, no output, deepening of urine color, increased pulse,increased temp, Urinary frequency, foul smelling urine, fever, chills, altered mental status, change in behavior, change in eating patterns. Provide patient-specific catheter care as ordered 4. URINARY CATHETER: Patient has a Foley. Position drainage bag and tubing below the level of the bladder to allow free flow of urine into the bag. Secure tubing. Cover drainage bag with appropriate privacy bag. Report any concerns to the Unit Charge Nurse. Provide catheter care and record volume of urine every shift. An interview on 11/27/18 at 10:00 am with the DON, the DON was informed of findings. No further information provided. | 2020-09-01 |