HospitalInspections.org

Based on medical record reviews, American Association of Critical Care Nurses standards of practice and interviews, nursing staff failed to document baths for Patient Identifier (PI) # 1 and Patient Identifier # 2, two of 11 sampled patients and had the potential to affect all patients served. As a result of this deficient practice, there is no way to determine if the patients received baths for the purpose of hygiene and comfort.

Findings include:

A review of the medical record revealed PI # 1 was admitted to the hospital on 3/10/15 with diagnoses to include Symptomatic Anemia and Hypertension. PI # 1 was discharged on 3/12/15. There was no documentation regarding baths for PI # 1 by nursing staff during the patient's entire hospitalization.

A review of PI # 2's medical record revealed the patient was admitted to the hospital on 3/3/15 with a diagnosis of Compression Fractures. The nursing notes revealed PI # 2 required assistance with bathing. However, there was no documentation to indicate PI # 2 was assisted with a bath on nine of 12 inpatient days (3/3, 3/4, 3/5, 3/6, 3/9, 3/11, 3/12, 3/13, 3/14).

The American Association of Critical-Care Nurses continues to advocate for daily bathing to improve hygiene and promote patient comfort. (www.NURSE.com)

During an interview on 4/8/15 at 10:06 AM the RN (Registered Nurse) Clinical Analyst - Information Technology, Employee Identifier (EI) # 1, verified there was no documentation in the medical record to indicate PI # 1 was bathed, assisted with a bath or the patient bathed independently on 3/10/15, 3/11/15 or 3/12/15.

During an interview on 4/8/15 at 10:30 AM, EI # 1 verified there was no documentation in the nursing notes to indicate PI # 2 was bathed on the following days: 3/3, 3/4, 3/5, 3/6, 3/9, 3/11, 3/12, 3/13, 3/14.

During an interview on 4/8/15 at 1:46 PM the Chief Nursing Officer (CNO) / Vice President (EI # 2) stated there is no policy regarding the frequency of patient baths. According to the CNO, baths should be given by nursing staff daily if a patient needs assistance with bathing. If a patient can bathe independently, the frequency is determined by the patient. Nursing staff should document patient baths.

Based on review of policy and procedure, United States (US) Food Code, observation and interview, dietary staff failed to have their hair restrained and/or completely covered when plating patient meals. This deficient practice had the potential to affect all patients receiving meals from the hospital dietary department.

Findings Include:

Policy and Procedure # E004:
Subject: Uniform Dress Code
Date Revised: 1/2015

Policy: Personal cleanliness and a neat appearance are essential for the food service worker.

Procedures:
...Wear the approved hair restraint when on duty...


US Food Code 2013

Food Food Contamination Prevention

Hair Restraints 2-402.11 Effectiveness.

(A) Except as provided in ? (B) of this section, FOOD EMPLOYEES shall wear hair restraints such as hats, hair coverings or nets, beard restraints, and clothing that covers body hair, that are designed and worn to effectively keep their hair from contacting exposed FOOD; clean EQUIPMENT, UTENSILS, and LINENS; and unwrapped SINGLE-SERVICE and SINGLE-USE ARTICLES.

During a tour of the kitchen on 4/8/15 at 12:40 PM two female dietary employees who where plating food for patient meals failed to have their hair restrained appropriately. Employee Identifier (EI) # 3's bangs were exposed and EI # 4 was not wearing any type of hair covering.


During an interview on 4/8/15 at 12:45 PM, the Dietary Director (EI # 5)confirmed both employees did not have their hair covered as required.