Fmc Florence Dialysis Center

“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: 41879 Based on observations, staff interviews and review of the facility policy, “Hand Hygiene”, the dialysis facility staff failed to perform hand hygiene after touching contaminated supplies to prevent cross contamination for one of three Registered Nurses (RN) observed. (RN #2) Findings are: On 06/26/2024 at 11:55 AM observations are conducted in the treatment area of the facility. RN #2 is observed taking a temperature dot strip out of the patient’s mouth at Station #20 with gloves on and puts the temperature dot strip in the gloved hand. RN #2 throws the temperature dot strip in the waste basket next to the dialysis chair and does not doff the gloves after possible contamination with bodily fluids. RN #2 proceeds to type on the computer screen with the same gloves on, touches the blood pressure cuff and the patient with the gloves. During an interview on 06/26/24 at 1:30 PM, RN #2 verified the findings. On 06/26/2024 at 12:02 PM observation are conducted in the treatment area of the facility. RN #2 is observed providing Central Venous Catheter (CVC) line care the patient at Station #20. RN #2 with gloves donned applies a new dressing to the catheter site touching the patient’s chest with gloved hands. RN #2 touches the patient’s dialysis machine including the dialyzer then returned to the CVC to flush the lines and connect for treatment. RN #2 did not change gloves after touching the patient’s chest during dressing change and/or change gloves or perform hand hygiene after touching dirty dialysis machine. During an interview on 06/26/24 at 1:30 PM, RN #2 verified the findings. Facility policy entitled, “Hand Hygiene,” reads, “Decontamination using alcohol-based hand rub or by washing hands with anatomic soap and water must be done before and after direct contact with patients, entering and leaving the treatment area, before performing invasive procedures such as vascular access cannulation or administration or parenteral medications immediately after removing gloves, after contact with body fluids or excretions, mucous membranes. non-intact skin, and wound dressings hands visibly soiled, and after contact with inanimate objects near the patient.””

“IC-IF TO STATION=DISP/DEDICATE OR DISINFECT CFR(s): 494.30(a)(1)(i) Items taken into the dialysis station should either be disposed of, dedicated for use only on a single patient, or cleaned and disinfected before being taken to a common clean area or used on another patient. -- Nondisposable items that cannot be cleaned and disinfected (e.g., adhesive tape, cloth covered blood pressure cuffs) should be dedicated for use only on a single patient. -- Unused medications (including multiple dose vials containing diluents) or supplies (syringes, alcohol swabs, etc.) taken to the patient’s station should be used only for that patient and should not be returned to a common clean area or used on other patients. This Standard is not met as evidenced by: 22313 Based on observation, interview and review of facility policy, the dialysis facility failed to ensure staff are cleaning non-disposable items (stethoscopes) between patient assessments. The findings include: Observation on 06/25/24 11:22 AM showed Registered Nurse (RN #1) assessing breath sounds on the patient in station A1 with a stethoscope. After removing the diaphragm from the patient’s chest and back, RN #1 placed the stethoscope around his/her neck without sanitizing the stethoscope and left the station. RN #1 then took the stethoscope from his/her neck and placed it on the fistula of the patient in Station A 2 and placed the stethoscope back around his/her neck with sanitizing it. At 12:02 PM, RN #1 used the the unsanitized stethoscope on the patient at station #7 and placed it back around his/her neck. During an interview on 06/25/24 at 11:45 AM, RN #1 was questioned on not sanitizing the stethoscope between patients and stated, “Sometimes I forget. We’re pretty busy”. Review of the facility’s policy titled, “Cleaning and Disinfecting the Disinfecting the Dialysis Station,” dated 09/05/23, show that any non-disposable equipment (ex. Stethoscopes) must be disinfected with 1:100 (one to one hundred) bleach or EPA (Environmental Protection Agency) registered disinfectant before being removed from the dialysis station.”