cms_ID: 3
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3 | BOUNDARY COUNTY NURSING HOME | 135004 | 6640 KANIKSU STREET | BONNERS FERRY | ID | 83805 | 2019-01-31 | 880 | F | 0 | 1 | N5WL11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, record review, and policy review, it was determined the facility failed to ensure infection control measures were consistently implemented as they related to laundry service practices, hand hygiene practices, and urinary catheter care. Failure to ensure staff processed and transported linens in a sanitary manner, had the potential to impact 12 of 12 residents (#1, #3, #4, #6, #7, #8, #9, #12, #13, #16, #18, and #72) reviewed who resided in the facility and the other 10 residents residing at the facility. Lapses in hand hygiene directly impacted 4 of 15 residents (#1, #6, #7, and #10) whose care was observed. Lapse in urinary catheter care directly impacted 1 of 1 resident (#9) reviewed who had a catheter. These deficient practices created the potential for harm by exposing residents to the risk of infection and cross contamination. Findings include: 1. The facility's Handwashing and Hand Hygiene policy, dated 9/3/17, documented staff should perform hand hygiene when they changed gloves and when moving from a unclean body site to a clean-body site during resident care. This policy was not followed. Examples include: a. On 1/28/19 at 11:15 AM, CNA #1 was observed providing peri care for Resident #7. After assisting Resident #7 with peri care CNA #1 removed her gloves but did not perform hand hygiene. CNA #1 continued to provide care for Resident #7 applying an incontinence pad, readjusting clothing, and transferring Resident #7 back to her recliner. On 1/28/19 at 11:34 AM, CNA #1 stated she should have performed hand hygiene after removing her gloves, prior to touching other items. b. On 1/28/19 at 1:15 PM, CNA #6 was observed assisting Resident #6 with peri care. CNA #6 was observed washing her hands and placing clean gloves onto her hands. CNA #6 retrieved clean supplies to change Resident #6's adult brief and prepared the supplies. CNA #6 began removing Resident #6's soiled pants and placed them into the dirty hamper. CNA #6 then looked around and grabbed the trash can with her hand and placed it next to her. CNA #6 removed Resident #6's soiled brief and threw it into the trash can. CNA #6 provided Resident #6 with peri care, applied a clean brief, placed pillows under and between Resident #6's contracted legs, and then removed her gloves. CNA #6 adjusted Resident #6's blanket and washed her hands. On 1/28/19 at 1:27 PM, CNA #6 stated she forgot to perform hand hygiene after she assisted Resident #6 with peri care. c. On 1/29/19 at 9:43 AM, CNA #5 and CNA #7 were observed assisting Resident #6 with peri care. CNA #5 washed her hands and placed clean gloves onto her hands. CNA #5 retrieved the clean supplies needed to assist Resident #6 with peri care. CNA #5 removed Resident #6's pants and soiled adult brief and began providing peri care. CNA #7 was assisting CNA #5 by holding Resident #6's contracted legs in place for peri care to be completed. CNA #5 stated she needed more wipes, removed her gloves, and left the room. CNA #5 returned with new wipes, opened the wipes, removed a few wipes, washed her hands, and placed clean gloves onto her hands. CNA #5 continued to assist with peri care and completed the task. After CNA #5 completed the task she placed a clean brief onto Resident #6 and placed pillows under and between her legs, and then removed her gloves and washed her hands. On 1/29/19 at 9:53 AM, CNA #5 stated she forgot to complete hand hygiene after she assisted Resident #6 with peri care. d. On 1/30/19 at 7:46 AM, CNA #3 was observed assisting Resident #10 with morning cares. CNA #3 cleaned Resident #10's legs, arms, chest, and back with wipes and then assisted Resident #10 with sitting up. CNA #3 placed a clean shirt and clean pants up to Resident #10's knees and rested an opened clean adult brief on the top of her pants. CNA #3 then stood Resident #10 up with the sit to stand, removed her soiled brief, and provided peri care. CNA #3 pulled up and fastened the clean brief, pulled Resident #10's pants over the clean brief, and lowered her into her wheelchair. CNA #3 removed her gloves and washed her hands. On 1/29/19 at 8:00 AM, CNA #3 stated she realized she did not change her gloves and perform hand hygiene after peri care was completed. On 1/31/19 at 12:54 PM, the DNS stated staff should be washing their hands after removing gloves and the staff were educated constantly about this. 2. According the Centers for Disease Control and Prevention, Guidelines for Prevention of Catheter Associated Urinary tract infections, updated 2/15/17, states the urinary collection bag should not rest on the floor. This guideline was not followed. Examples include: a. On 1/29/19 at 9:04 AM, Resident #9 was observed in the dining room, and he was stepping on his catheter tubing. On 1/29/19 at 9:06 AM, CNA #4 was asked if Resident #9's catheter tubing should be on the floor and she stated no. CNA #4 was observed washing her hands, placing gloves on, and adjusting Resident #9's catheter tubing off the floor. b. On 1/29/19 at 2:50 PM, Resident #9 was observed in bed and his catheter collection bag was inside a privacy bag and the privacy bag was resting on the floor. On 1/29/19 at 3:01 PM, LPN #1 stated the catheter collection bag should be off the floor, and the privacy bag was permeable to germs. LPN #1 adjusted Resident #9's collection bag off the floor. 3. The facility's Environmental Services Department Laundry policy, reviewed 9/12/18, documented staff were to wear a gown and gloves when working in the sorting room and whenever handling soiled linen. The policy documented the clean linens should be covered. This policy was not followed. Examples include: a. On 1/28/19 at 2:47 PM, CNA #2 was observed passing out clean clothes to different residents. The items were on two carts, one was a metal cart with shelves, and had the residents' names on the shelves, and one had hangers hanging from it. The cover for the metal cart was set on top of the cart and residents' undergarments were seen as the cart moved down the hall. The hanging cart's cover was thrown to the side and residents' clothes were seen as the cart moved down the hall. On 1/28/19 at 3:00 PM, CNA #2 stated the laundry came from the laundry department covered and the staff uncovered it when it reached the floor, so residents' names could be seen. b. On 1/31/19 at 2:25 PM, CNA #8 and CNA #9 were observed passing laundry with the covers off the carts. The DNS was present when the laundry was passed, and asked CNA #8 to please cover the undergarments with the covering. The covering on the metal cart was placed over the cart and the covering did not reach to the bottom of the cart, and half of the cart was still exposed. The DNS stated the cart needed a longer covering. On 1/31/19 at 2:25 PM, the DNS stated the laundry should be covered for infection control reasons. c. On 1/31/19 at 7:00 AM, Laundry Staff #1 stated when the staff sorted laundry in the dirty laundry room, they donned a protective [NAME]et. The [NAME]et used was a light weight porous material, not a moisture barrier type of material. Laundry Staff #1 stated the staff changed to a new [NAME]et throughout the day, depending on the task, but always used the same type of [NAME]et. She stated for example, the [NAME]et was changed if residents' bowel movements were on linens. Laundry Staff #1 stated the [NAME]ets sometimes got wet. When they changed the [NAME]ets, they removed them and put them in with the laundry load and got a new [NAME]et. Laundry Staff #1 stated she was responsible for sorting, washing, drying, and folding clothes. She stated she delivered the laundry to the floors. Laundry Staff #1 stated the staff did not normally wear goggles when sorting laundry, but they were available for use if they were needed. On 1/30/19 at 7:30 AM, the Environmental Services Manager, stated the training she received was that the current [NAME]ets were the proper PPE (personal protective equipment) for laundry. She stated the laundry staff were to change [NAME]ets after every sort and the goggles were for when they worked with [MEDICAL CONDITION]. ([MEDICAL CONDITION], is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.) On 1/31/19 at 11:31 AM, the Infection Control Preventionist stated the facility followed the Association for Professionals in Infection Control and Epidemiology (APIC) guidelines. She stated the guideline recommended wearing barrier gowns and safety glasses. The 10/11/18 APIC Hygienically Clean Healthcare- Laundry Tour Planner for Healthcare Professionals guideline, posted on the APIC website on 10/11/18, documents employees should know what PPE was required in each function to guard against contamination and should be wearing barrier gowns, puncture resistant gloves, safety glasses/goggles, and face masks. A document 1910.1030 Bloodborne pathogens, provided by the Infection Control Preventionist, which she said she had printed from the Centers for Medicaid and Medicare Website documented, PPE would be considered appropriate only if it did not permit blood or other potentially infectious material to pass through to or reach the employee's work clothes, skin, eyes, mouth, or other mucous membranes under normal conditions of use, and for the duration of time which the PPE would be used. The document was researched on the internet and found to be from the Occupation Safety and Health Association's Bloodborne Pathogens Standard (29 CFR 1910.1030), which prescribes safeguards to protect workers against health hazards related to bloodborne pathogens | 2020-09-01 |