HospitalInspections.org

The Critical Access Hospital (CAH) reported two acute and 14 swing bed patients. Based on observation, document review and staff interview, the CAH failed to develop a system to identify and control infections or staff practices which could contribute to healthcare acquired infections of patients and personnel for 5 of 5 patients observed receiving medications, 3 of 3 patients observed receiving treatments and 1 of 1 patients observed receiving blood sugar checks. The CAH ' s failure to identify infection control practices, failure to follow policy, and acceptable professional standards of practice created the potential for healthcare acquired infections.

Findings include:

- The CAH's policy titled "Infection Control Exposure Control Plan, Policy #IC1.4", reviewed on 7/31/13 at 12:30pm revealed at 2.A.,"Employees are required to wash their hands before and after caring for a patient/resident ...After removing gloves, employees are required to wash their hands as soon as possible. "

- Nursing staff B observed on 7/29/13 at 2:25pm dispensed patient #16's medication from the medication cart and went to the water fountain to fill a cup of water. Staff B administered patient #16 ' s medications at the dining table and encouraged the patient to drink the cup of water. Staff B returned to the medication cart and disposed of the empty water cup. Staff B failed to perform hand hygiene prior to dispensing patient #16 ' s medications and failed to perform hand hygiene after administering the medication and disposing of the empty water cup.

- Nursing staff B observed on 7/29/13 at 2:45pm dispensed patient #18 ' s medication from the medication cart, filled a cup of water at the water fountain and walked into the activity room where patient #18 was. Staff B gave patient #18 the medication, the cup of water, took the empty cup and returned to the medication cart where they disposed of the cup. Staff B failed to use hand hygiene after dispensing and administering the medications.

- Nursing staff C observed on 7/30/13 between 8:00am and 8:15am dispensed patient #19 ' s, #20 ' s, and #21 ' s daily medications. Staff C failed to use hand hygiene prior to the medication set-ups and after administering the medications for patient #19, 20 and #21.

- Nursing staff C observed on 7/30/13 at 9:10am removed treatments from the medication cart, took a pair of gloves, entered the shared room of patient #26 and #27, applied the gloves, administered #26 ' s eye drops to each eye and moved over to patient #27 and administered nasal spray, removed the gloves and disposed of them in the trash. Staff C gathered the treatments and returned to the medication cart. Staff C failed to use hand hygiene between dispensing the medications and after administering the medications.

- Nursing staff C observed on 7/30/13 at 11:10am went to the dining room to patient #20 and obtained a glucometer (a machine used to test a patient's blood sugar level) test. Staff C placed a white basket (tote) with equipment and supplies on the dining table without a protective barrier. After performing the blood sugar test staff C returned the white basket to the medication room without cleaning the glucometer or the white basket. Staff C failed to use hand hygiene after removing the gloves and returning the white basket and glucometer to the medication room.

- Nursing staff D observed on 7/30/13 at 10:00am to provide wound care to patient #30. Nursing staff D washed hands, gloved, removed old dressing, removed gloves, placed a clean barrier under the patient ' s feet, gathered supplies, gloved, completed dressing, and removed gloves. Nursing staff D failed to use hand hygiene during the treatment and failed to follow the facility policy for hand hygiene.

- Nursing staff C interviewed on 7/31/13 at 11:15am acknowledged the CAH ' s policy is to perform hand hygiene after all patient care.

- Administrative nursing staff A interviewed on 7/31/13 at 3:30pm verified the CAH ' s policy is to follow CDC Standards of Care for hand hygiene and infection control practices.