Here are the facts. A resident requested hot tea at 3 am. A Certified Nursing Assistant (CAN) obtained hot water from a hot water dispenser connected to a coffee maker. The hot water dispensed at around 190°F. The hot tea was delivered to resident and the resident requested that the light be turned off and that the door be closed. The resident then spilled hot water onto her leg that resulted in a 3rd degree burn. There was no evidence that hot water temperatures were being checked regularly.
What should have happened?
The cup should only be filled ¾ of the way to help avoid spillage. Hot water needs to cool to 140-155°F before serving to a resident to avoid burns. The CNA should have questioned the residents request to turn off the light and close the door. The CNA could have taken off the lid for the resident and make it easier for the resident to enjoy their beverage. Hot water temperatures need to be documented at least 3 times per day at meal times. All CNAs and food and nutrition staff should be inserviced on the steps required to safely serve hot beverages to residents.
As you can see from the Time and Temperature Relationship to Serious Burn grid below, it only takes seconds of exposure for a resident to be burned.