HospitalInspections.org

Based on observations, interviews and policy and procedure review, it was determined that the facility failed to provide care in a safe setting by not following the facility policy and current standards of practice for infection control for two (2) of three (3) staff members (Staff Members # 6 and # 7).

The findings include:

On December 11, 2019 at 2:45 p.m. an interview with Staff Member # 1 revealed "Yes, staff do have long fingernails."
At 3:00 p.m. an interview with Staff Member # 3 revealed "staff are informed of the facility policy regarding fingernails during orientation."

On December 12, 2019 at 9:30 a.m. a review of the facility policy provided by Staff Member # 2 at 9:25 a.m., titled "Infection Control Procedure on Hand Hygiene Guidelines" read in part "All staff, regardless of work area will keep natural nail and/or artificial nail tips no more than 1/4 inch past fingertips. Direct care staff should not wear artificial nails longer than 1/4 inch at [Facility Name] as they are more likely to harbor pathogens on their fingertips as well as develop yeast infection on fingertips. Artificial nails are difficult to clean underneath and many artificial nail wearers may be more reluctant to follow vigorous hand washing guidelines due to the risk of loosening the adhesives used with artificial nails. Chipped nail polish should be removed, as this also increases the number of organisms on fingernails and clear or transparent nail polish is preferred. This will allow for visual inspection of the nails to assure that proper cleaning under the nails has occurred."

At 9:55 a.m., an interview with Staff Member # 6 revealed Staff Member # 6 provides direct care to patients. Staff Member # 6 reported being responsible for patient showers/baths as assigned. Staff Member # 6 stated head to toe assessments of the patient's skin are completed during showers/baths and any findings of bruises, scratches, redness, etc are reported to the nurse. Staff Member # 6 stated if the previous shift is still on the unit, will ask if that staff member was aware of the findings and how it occurred. Staff Member # 6 was observed with colored fingernails at least a 1/2 inch past their fingertips. Staff Member # 6 stated "these are my nails, I just got them done."

At 10:10 a.m., an interview with Staff Member # 7 revealed Staff Member # 7 provides direct care to patients. Staff Member # 7 reported being responsible for patient showers/baths as assigned. Staff Member # 7 stated if any new bruises, cuts or scratches are seen during the shower/bath, the lead behavior tech, charge nurse and unit coordinator are notified. Staff Member # 7 was observed with colored fingernails at least a 1/2 inch past their fingertips. Staff Member # 7 stated "these are my nails with acrylic polish." Staff Member # 7 stated "I wear two to three pair of gloves when doing the showers/baths. I have never scratched a patient."