Failure to Implement Enhanced Barrier Precautions During Catheter Care
Penalty
Summary
A deficiency was identified when a registered nurse performed suprapubic catheter care for a resident with a history of dementia, benign prostatic hypertrophy, obstructive and reflux uropathy, and a suprapubic catheter, who also had a documented history of ESBL in the urine and recurrent urinary tract infections treated with antibiotics. During the procedure, the nurse followed hand hygiene and glove protocols but failed to wear a gown as required under Enhanced Barrier Precautions (EBP), despite the presence of isolation signage, supplies, and containers for transmission-based precautions. The nurse later acknowledged that a gown should have been worn for EBP, and the Director of Nursing confirmed the resident was on EBP due to the suprapubic catheter and ESBL history.