Maybe I can help to answer the actual question. Mind you, this is not a good explanation, but it's an explanation. First, you said that the order was a clamping protocol, so that gets rid of the bag ideas. Maybe the buck stops at the DON of the facility. Maybe the DON doesn't know the protocol for a clamping procedure. Maybe she is the owner of the facility and doesn't want to spend the money on a clamp (I know, this is a dumb idea, but I have worked in some LTCs that still don't think it's a big deal to make sure there are gloves on hand cuz they are expensive.) Maybe the DON missed the whole infection control related to UTIs discussion in class. In going with this theory, one would think that the other nurses would correct the DON, right? Well, in some facilities, what the DON says, goes, because she is ultimately responsible over and above the other nurses, especially if she is the only RN and the rest are LPNs. Of course the LPNs would know proper procedure and infection control, but they are somewhat covered since they are under the RNs license, and if she said this is the way we are doing it, then what can they really do? Quit? That doesn't solve the problem. And considering the economy, many can't afford to quit. So the next choice for a nurse would be to call the dept of health and report this. An inspection by them could happen next week, next month, or 2 months away. So maybe an inspection regarding this resident was in the works but you happen to get them in your ER before they could step in and help.
By your post, it sounds like the DON didn't understand the clamping procedure or just didn't care? She is the leader. Maybe the other nurses just felt they had to follow her orders.
As for being reimbursed for nosocomial infections, it has been many years since I was an MDS nurse, but I don't remember this being a direct question. (MDSs are how SNFs are reimbursed.) Besides that, since it is a residential living facility, any and all infections that the residents get while being there can be considered nosicomial, right? That's a lot of nosocomial infections and if SNFs were not paid if this occurred, they wouldn't get paid at all for some residents who get infections often, or there would be months when there would be barely any reimbursement because the majority of the facility catches the flu or something.
Maybe this answers some of your questions, or at least provides another view to consider.