Fmc- Ocean Sound Dialysis

“IC-WEAR GLOVES/HAND HYGIENE CFR(s): 494.30(a)(1) Wear disposable gloves when caring for the patient or touching the patient’s equipment at the dialysis station. Staff must remove gloves and wash hands between each patient or station. This Standard is not met as evidenced by: 47207 Based on observations and interview, the facility failed to ensure that a Registered Nurse (RN) followed proper hand hygiene practices during the administration of a parenteral medication to 1 out of 20 sampled patients. Patient #16 Findings include: On 6/10/2025 at approximately 10:30 AM, the RN / Staff G was at the medication area drawing up a dose of Heparin for Patient #16. RN /Staff G followed the appropriate procedure for drawing up the dose of heparin for the patient. RN /Staff G applied the patient identifier to the syringe; then with his gloved hand, he reached into his pocket to remove a pen from under his lab coat. RN/ Staff G proceeded to write on the label with the pen, placed it back into his pocket and went to administer the Heparin to Patient #16. RN/ Staff G failed to remove the gloves before administering the Heparin to Patient #16. During an interview on 06/10/2025 at approximately 10:45 am, RN/ Staff G acknowledged the findings and stated that he was nervous while being watched during the procedure.”

“IC-CLEAN/DIRTY;MED PREP AREA;NO COMMON CARTS CFR(s): 494.30(a)(1)(i) Clean areas should be clearly designated for the preparation, handling and storage of medications and unused supplies and equipment. Clean areas should be clearly separated from contaminated areas where used supplies and equipment are handled. Do not handle and store medications or clean supplies in the same or an adjacent area to that where used equipment or blood samples are handled. When multiple dose medication vials are used (including vials containing diluents), prepare individual patient doses in a clean (centralized) area away from dialysis stations and deliver separately to each patient. Do not carry multiple dose medication vials from station to station. Do not use common medication carts to deliver medications to patients. If trays are used to deliver medications to individual patients, they must be cleaned between patients. This Standard is not met as evidenced by: 47207 Based on observations and interviews, the facility failed to ensure that a Registered Nurse (RN) kept medications in a secure place prior to the disconnection of a Central Venous Catheter (CVC) for 1 out of 20 sampled patients. Patient #10 Findings include: On 06/09/2025 at approximately 9:40 AM, the surveyor was observing the dialysis unit. The Clinical Manager (CM) stated “we have two 98-year-old patients.” The surveyor looked at the table aside Patient #10’s dialysis chair and saw two unattended unwrapped saline syringes there. When the surveyor asked, “Who put these here, and how long have they been here?” The CM asked the RN / Staff D how this had happened, in Spanish. The RN/ Staff D came over stating “I did that.” RN/ Staff D proceeded to remove the two syringes from the table. During an interview on 06/11/2025 at approximately 10:30 AM, the RN / Staff D acknowledged the findings and stated he had forgotten he had placed the two syringes on the chair side table.”

“IC-STAFF EDUCATION-CATHETERS/CATHETER CARE CFR(s): 494.30(a)(2) Recommendations for Placement of Intravascular Catheters in Adults and Children I. Health care worker education and training A. Educate health-care workers regarding the ... appropriate infection control measures to prevent intravascular catheter-related infections. B. Assess knowledge of and adherence to guidelines periodically for all persons who manage intravascular catheters. II. Surveillance A. Monitor the catheter sites visually of individual patients. If patients have tenderness at the insertion site, fever without obvious source, or other manifestations suggesting local or BSI [blood stream infection], the dressing should be removed to allow thorough examination of the site. Central Venous Catheters, Including PICCs, Hemodialysis, and Pulmonary Artery Catheters in Adult and Pediatric Patients. VI. Catheter and catheter-site care B. Antibiotic lock solutions: Do not routinely use antibiotic lock solutions to prevent CRBSI [catheter related blood stream infections]. This Standard is not met as evidenced by: 47207 Based on observations and Interview, the facility failed to ensure that a Patient Care Technician (PCT) followed appropriate infection control measures during the initiation of dialysis via a Central Venous (CVC) catheter for 1 of 20 sampled patients. Patient #14 Findings include: PCT / Staff P was observed on 06/10/2025 at approximately 10:00 AM initiating the process of dialysis for Patient #9. Patient #9 was observed seating in the chair, his shirt was unbuttoned to expose the CVC dressing. PCT / Staff P did not provide ample support to Patient #9’s shirt to keep it from falling back onto the exposed skin and CVC site. The Clinical Manager (CM) observed this with the surveyor, she went over to speak to PCT / Staff P. Further observation revealed that the PCT/ Staff P failed to provide appropriate support to the shirt, it again fell onto the exposed CVC site. During an interview conducted on 06/10/2025 between 10:00 AM-10:20 AM, the CM stated that PCT / Staff P had been nervous knowing that he was being watched.”