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SELECT SPECIALTY HOSPITAL - CENTRAL PA HARRISBURG
INFECTION CONTROL PROFESSIONAL
Tag No.: A0748
Based on review of facility policies and procedures, medical records (MR), and interview with staff (EMP), it was determined that the facility failed to follow their policy for changing central and peripheral line dressings for five out of ten medical records reviewed (MR1, MR4, MR8, MR9, and MR10).
Findings include:
A review on February 8, 2013, of facility policy C06-N "Central Venous Access Device Maintenance" revised 4/1/11 revealed, "...Central line dressing should be changed ... Single or multi-lumen percutaneous catheters - once per week; Implanted port - once per week... PICC - Once per week..."
A review on February 8, 2013, of MR1 and MR4 revealed the peripherally inserted central catheter (PICC) line dressings were not changed according to policy.
A review on February 8, 2013, of facility policy "Intravenous Therapy: Peripheral IV Therapy Protocol" revised 01/01/11 revealed, "...Dressing should be changed every 72 hours and/or with site change."
A review on February 8, 2013, of MR8, MR9, and MR10 revealed the peripheral intravenous line dressing was not changed according to policy.
An interview conducted on February 8, 2013, at 2:30 PM with EMP2 confirmed the PICC and peripheral intravenous line dressing for MR1, MR4, MR8, MR9 and MR10 was not changed according to policy.