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Based on observation, facility policy review, and interview, the facility failed to ensure hand hygiene practices were followed for one patient (#9) of five patients reviewed.

The findings included:

Patient #9 was admitted to the facility on August 1, 2012, with diagnoses to include Internal Fixation of Left Femur Fracture.

Observation on August 6, 2012, at 10:30 a.m., revealed Registered Nurse (RN) #1 and the Orthopedic Medical Surgical Unit Charge Nurse, without washing or sanitizing the hands, entered the patient's room to answer a call light. Continued observation revealed the Charge Nurse adjusted the covers on the patient's bed, and without washing or sanitizing the hands, exited the patient's room, preceded to the nursing desk, and had contact with items on the desk.

Review of the facility policy Hand Hygiene, policy # PC.IP.022, dated as revised January 2011, revealed "...to decrease the risk of transmission of infection...Hand Hygiene shall be practiced before and after each patient contact...Before and upon patient room exit..."

Interview with the Charge Nurse at the Nursing station on August 6, 2012, at 10:40 a.m., confirmed the hands were to be washed or sanitized before entry and after exit of a patient's room. Continued interview confirmed the hands had not been washed or sanitized before entry or after exiting the patient's room and the patient's bed linens had been handled while in the patient's room.