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Based on observation, staff interview, review of facility policy and procedures and review of manufacturer's instructions for use it was determined the Infection Control Officer failed to develop cleaning and disinfection of the multi-use blood glucose monitoring device, after every use, according to manufacter's instructions for use.

Findings include:

Review of the facility policy, "Glucose Monitoring with TRUEbalance Meter," #1204, dated 1/12/2018, stated the meter should be wiped clean with an alcohol pad before each use.

The TRUEbalance meter Quality Assurance/Quality Control Reference Guide for Multi-Patient Use Facilities, specific for Healthcare Providers, H9NPD21, Rev. 22. was reviewed. Review of Section 7 Care, Cleaning/Disinfection and Storage of System stated if dedicating blood glucose meters to a single patient is not possible, the meters must be properly cleaned and disinfected after every use following the guidelines found in Meter Care, Cleaning/Disinfection. Review of Meter Care, Cleaning/Disinfection stated to clean and disinfect Meter, use PDI Super Sani-Cloth Germicidal Disposable wipes (active ingredients - 55% Isopropyl alcohol/Isopropanol, 5,000 ppm (Parts Per Million) quarternary ammonium chlorides) Viraguard/Virahold wipes (active ingredient -70% Isopropyl alcohol/isopropanol) or disinfectants with identical active ingredients from www.epa.gov/oppad001/list_d_hepatitisbhiv.pdf. Please follow the prepared wipes product label manufacturer's instructions for cleaning and disinfecting the Meter.

On 10/24/2018 at 11:00 am, the Infection Control Manager was interviewed. The above findings were confirmed at the time of the interview.

Based on record review and staff interview, the facility failed to develop a treatment plan based on the client as an individual. The facility failed to identify the strengths and weaknesses for 5 (Clients #13, #17, #18, #21 and #27) out of 8 sampled clients.

The findings included:

On 10/25/18 at 9:45 a.m., a record review of Clients #13, #17, #18, #21 and #27's treatment plans were conducted with the Hospital Administrator / Director of Social Services. She acknowledged the section on the treatment plan identified "Strengths and Challenges" had the questions unanswered.

On 10/25/18 9:45 a.m., the Hospital Administrator and Social Services Director said if the client is not asked about their strengths and weakness, then the treatment plan is based on the condition and not the client. She said the treatment plans for Clients #13, #17, #18,
#21 and #27 did not include the information to develop appropriate treatment plans.