| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852550 | (X3) Date Survey Completed 10/29/2019 |
| Name of Provider or Supplier Dublin Kidney Institute | Street Address, City, State 207 Industrial Blvd Ste 2, Dublin, GA | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| V0115 | IC-GOWNS, SHIELDS/MASKS-NO STAFF EAT/DRINK CFR(s): 494.30(a)(1)(i) Staff members should wear gowns, face shields, eye wear, or masks to protect themselves and prevent soiling of clothing when performing procedures during which spurting or spattering of blood might occur (e.g., during initiation and termination of dialysis, cleaning of dialyzers, and centrifugation of blood). Staff members should not eat, drink, or smoke in the dialysis treatment area or in the laboratory. This STANDARD is not met as evidenced by: Based on observation, a review of the facility's policies and procedures (P & P), and staff interview, it was determined that the facility failed to ensure that one of three Patient Care Staff (LPN AA), wore personal protective equipment (PPE) while disconnecting dialysis bloodlines, and cleaning/disinfecting patient's (P#2's) hemodialysis chair and station. This breach in infection control techniques could negatively affect the health and safety of two of two patients (P#2 and P#3), who dialyzed at the Skilled Nursing Facility (SNF) and three Patient Care Staff (RN AA, RN BB, and LPN AA), who administered home hemodialyis (HHD) treatments at the SNF, and who were under the supervision and oversight of this facility. Findings were: During observation in the patient's dialysis treatment room at the SNF on 10/29/19 between 11:10 a.m. and 12:45 p.m., the following was observed: - LPN AA was observed taking down (or removing) used bloodlines and dialyzer from P#2's hemodialysis station, without wearing a gown, a faceshield, or goggles with mask. The Facility Administrator, who was also observing, reminded LPN AA to wear a gown. LPN AA stopped doing her task, and proceeded to put on a gown, but did not wear a mask with goggles or a faceshield. - During an interview with LPN AA on 10/29/19 at 12:40 p.m., she stated that she forgot to wear her PPE. A review of the facility's P & P titled, "Infection Control Manual" with an effective date of 09/2017 stated: - Safety glasses and a disposable paper mask or face shield must be worn when performing invasive procedures, e.g., initiating or terminating dialysis, tubing changing, or anytime there is a possibility of a blood/body fluid splash... - Staff must wear scrub suits while working in the dialysis unit. A review of facility records showed that the facility conducted an in-service and re-training of staff regarding PPE on 9/13/19. However, the records did not show that the staff had been observed and audited to verify if the in-service was effective and the procedure was followed since 9/13/19 up to present time. |