Bma Blythe Desert Dialysis

“IC-CDC MMWR 2001 CFR(s): 494.30(a) The facility must demonstrate that it follows standard infection control precautions by implementing- (1)(i) The recommendations (with the exception of screening for hepatitis C), found in “Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients,” developed by the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, volume 50, number RR05, April 27, 2001, pages 18 to 28. The Director of the Federal Register approves this incorporation by reference in accordance with 5 U.S.C. 552(a) and 1 CFR Part 51. This publication is available for inspection at the CMS Information Resource Center, 7500 Security Boulevard, Central Building, Baltimore, MD or at the National Archives and Records Administration (NARA). Copies may be obtained at the CMS Information Resource Center. For information on the availability of this material at NARA, call 202-741-6030, or go to: http://www.archives.gov/federal_register/code_of_regulations/ibr_locations.html. The recommendation found under section header “HBV-Infected Patients”, found on pages 27 and 28 of RR05 (“Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients”), concerning isolation rooms, must be complied with by February 9, 2009. This Standard is not met as evidenced by: 36038 Based on observation, interview, and record review, the facility failed for one of three sampled patients (Patient 1), to ensure that Patient 1’s nose was covered with the mask while Registered Nurse (RN) was initiating hemodialysis (HD- process of removing waste from the blood with the use of a machine) treatment with the Central Venous Catheter (CVC- a type of access site used to facilitate hemodialysis). This failure had increased the potential for Patient 1 to have blood-borne infections. Findings: During an observation on March 13, 2024, at 11:40 a.m., with Registered Nurse (RN) in chair number 12 of the hemodialysis treatment area, the RN was observed initiating treatment in Patient 1’s right groin CVC. During the entire procedure of cleaning the CVC ports (part of CVC), disinfecting (process of eliminating the number of microorganisms such as bacteria and viruses by using chemical agents) CVC hubs (part of CVC), connecting sterile syringe aseptically (free from germs) to each port, and initiation of treatment, Patient 1 was observed not properly wearing his mask. Patient 1’s mask was not covering the patient’s nose. During an interview on March 13, 2024, at 12 p.m., with the RN, the RN stated the patient’s mask should have covered the patient’s nose. The RN further stated, if the mask was not covering the nose, there was a potential for Patient 1 to exhale microorganism and potentially spreading infection. During a concurrent interview and review of policy and procedure titled “Initiation of Treatment using CVC,” on March 13, 2024, at 2:15 p.m., with the Facility Administrator (FA), the FA stated, when doing a procedure like initiation of hemodialysis with CVC, the staff should follow the facility policy and procedure. The FA further stated, the mask should cover the nose and mouth of the patient when initiating treatment of hemodialysis with CVC. During a review of the facility policy and procedure, titled, “Initiation and Termination of Treatment Using a Central Venous Catheter (CVC), “ dated July 2, 2022, indicated “ ...When initiating and terminating the hemodialysis treatment the appropriate procedure must be followed ...Infection Control ...Staff, patients, and care partners must use personal protective equipment (PPE), per policy, A mask must be worn that covers the nose and mouth ...for all procedures that require accessing the catheter ...””