Centerwell Home Health

“Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This Standard is not met as evidenced by: Based on document reviews, observations, and staff interviews, the facility failed to ensure that tablet sanitation, hand hygiene, and handling equipment were according to the agency’s policies/procedures. This failure has the potential to negatively impact all Patients receiving treatments from the agency. (Refer to 484.70(a)) Findings are as follow: An observation was conducted on 09/10/2024 at 9:43 a.m. with Staff #1. [He/She] took out the blood pressure cuff, thermometer, pulse oximeter, and stethoscope from [his/her] supply bag and start taking the Patient’s blood pressure. While [he/she] was wrapping the blood pressure cuff on the Patient’s upper arm, the blood pressure bulb (bulb) fell between the Patient and the chair. [He/She] pulled out the bulb and proceeded to take the Patient’s blood pressure without sanitizing the bulb. When [he/she] completed the Patient’s vitals, [he/she] laid the blood pressure cuff, thermometer, and the pulse oximeter on the patient’s furniture without a barrier. An observation was conducted on 09/10/2024 at 11:36 a.m. with Staff #2. [He/She] took out the stethoscope, blood pressure cuff, pulse oximeter, thermometer, and dynamometer from [his/her] supply bag and placed them on a clean barrier. After taking the Patient’s vitals, [he/she] placed the contaminated pulse oximeter on the clean barrier next to the dynamometer. [He/She] proceeded to take the Patient’s blood pressure and placed the contaminated blood pressure cuff on top of the pulse oximeter and the dynamometer on the clean barrier. When Patient’s vitals were completed, [he/she] sanitized the pulse oximeter, blood pressure cuff, stethoscope, and the thermometer with the contaminated gloves. The dynamometer was not sanitized. An observation was conducted on 09/10/2024 at 1:08 p.m. with Staff #3. While [he/she] was putting the blood pressure cuff to take the Patient’s blood pressure, the bulb fell between the Patient and the chair. [He/She] proceeded to take the Patient’s blood pressure without sanitizing the bulb and listen to the Patient with the stethoscope. Then, [he/she] changed gloved without performing hand sanitization and measured the Patient’s oxygen level with the pulse oximeter. [He/She] put the contaminated pulse oximeter into [his/her] supply bag without sanitizing it. An observation was conducted on 09/10/2024 at 3:00 p.m. with Staff #4. [He/She] took out the stethoscope, blood pressure cuff, thermometer, and the minimalist sling from [his/her] supply bag. [He/She] wore gloves to take the Patient’s temperature and blood pressure. Then, [he/she] reached into [his/her] supply bag, still wearing the contaminated gloves, and reached for the pulse oximeter. After taking the Patient’s vitals, [he/she] reached into [his/her] supply bag for the sanitizing wipes wearing the same pair of gloves. [He/She] start disinfecting the reusable equipment wearing the contaminated gloves. An observation was conducted on 09/10/2024 at 4:14 p.m. with Staff #5. While [he/she] wrapped the blood pressure cuff around the Patient’s upper arm, the blood pressure bulb touched the chair. [He/She] proceeded with taking the Patient’s blood pressure without disinfecting the blood pressure bulb. An interview was conducted on 09/09/2024 at 1:04 p.m. with Stagg #7. [He/She] explained the barrier requirement as, “We don’t have any policy stating about the barrier. But when Staffs pull out the equipment from their bag, they (Staffs) need a clean barrier if they (Staffs) are going to set the equipment down. The equipment cannot be placed on a surface without a barrier.” [He/She] further disclosed the disinfection of equipment and barrier as, “If the Staffs are going to lay the equipment down to sanitize them, they (Staffs) need a dirty barrier. They (Staffs) cannot use the clean barrier to put down used equipment. If the Staffs are going to disinfect the equipment immediately after use, they don’t need a barrier and they don’t need to dry the equipment before putting it back into the bag. When Staffs are sanitizing the equipment, they should not be wearing gloves.” An additional interview was conducted on 09/10/2024 at 9:02 a.m. with Staff #7l. [He/She] further explained the equipment disinfection process as, “We don’t have a specific policy stating how the equipment have to be sanitized. But I would expect while disinfecting the equipment, the equipment can touch the Staff’s scrub but not any other surface in the Patient’s home. If the equipment touches any surface in the Patient’s home, the Staff should sanitize the equipment.” An additional interview was conducted on 09/11/2024 at 8:42 a.m. with Staff #7. [He/She] explained the standard hand hygiene procedure as, “Before and after they (Staffs) touch the Patient, if their (Staffs’ hands are soiled), if they (Staffs) contacted blood, bodily fluid, etc. They (Staffs) have to sanitize their (Staffs’) hands if they are changing gloves as well.””