Could the failure to properly train and supervise nurses on the appropriate use of blood glucose monitors lead to a systemic failure to provide quality care, thereby resulting in the submission of false claims? [F600 Free from Abuse and Neglect, F684 Quality of Care, F689 Free of Accident Hazards/Supervision/Devices, and F880 Infection Prevention and Control]
Compliance Perspective – Citations
Policies/Procedures: The Compliance and Ethics Officer will review the glucometer policy and procedure for cleaning and training on properly using the device with multiple residents.
Training: Staff will be trained at hire and periodically on infection prevention and control practices and the protocol for disinfecting glucometers between each use, especially when used for multiple residents.
Audit: An audit will be conducted to determine if nurses are cleaning the glucometer between uses for multiple residents. The results of the audits will be summarized and submitted to the QAPI/QAA Committee and the Compliance and Ethics Committee.
Failure to disinfect a blood-testing device after using it on an HIV-positive resident, repeated elopements, and failure to provide “basic health and safety requirements” were cited against a skilled nursing facility by the Tennessee Board for Licensing Health Care Facilities.
Staff (including two nurses and a supervisor) reported that they did not know they were required to disinfect the blood glucose monitor (glucometer) between treatment of patients. The glucometer was used regularly on 20 residents and at least one of the residents was known to be HIV positive. The glucometer was designed to be used on multiple residents; however, it was supposed to be cleaned using specified disinfectant wipes and allowed to dry for 5-minutes between uses.
The 155-bed facility was shut down in May after losing its Medicare certification. Examples of the facility’s failures were detailed in the report that was just released when the Tennessee Board of Health made it public that the nursing home’s license was suspended.
The report showed that at least four “cognitively impaired” residents eloped (sometimes multiple times) from the nursing home in the last year, and frequently it took as long as seven hours for the staff to notice they were missing.
In another example, basic hygienic care was not being provided to a resident who was supposed to be showered three times a week and was actually only bathed once a month.
