Failure to Follow Enhanced Barrier Precautions and Proper Glove Use
Penalty
Summary
Staff failed to follow enhanced barrier precautions (EBP) for a resident with significant medical needs, including quadriplegia, a gastrostomy tube, and wounds. The resident was identified as requiring EBP due to infection risks, with clear signage and personal protective equipment (PPE) available at the room entrance. Despite these measures, nursing assistants provided personal care, including a sponge bath and pericare, without wearing gowns as required. One nursing assistant acknowledged awareness of the EBP requirements but stated she forgot to don a gown due to being rushed by a nurse. Additionally, during personal care, staff did not adhere to proper glove use and hand hygiene protocols. While one nursing assistant changed gloves between different care tasks, neither she nor her colleague washed their hands after removing dirty gloves and before putting on clean ones, as required by facility policy. Both staff members admitted forgetting to perform hand hygiene. Interviews with nursing and administrative staff confirmed the expectation for PPE use and hand hygiene, and facility policies directed staff to follow these infection control measures.