Failure to Ensure Staff Knowledge and Adherence to Enhanced Barrier Precautions
Penalty
Summary
Staff failed to adhere to and demonstrate knowledge of Enhanced Barrier Precautions (EBP) for a resident with an indwelling medical device. Multiple staff members, including one in orientation and others working independently, were observed either not knowing what EBP stood for or not following the required use of personal protective equipment (PPE) such as gowns and gloves during high-contact care activities. Staff interviews revealed confusion about when and how to use PPE, with some staff incorrectly associating EBP only with certain infections and expressing uncertainty about the full scope of required precautions. Observations included staff exiting a resident's room on EBP without PPE, and two staff assisting a resident under EBP without wearing gowns or gloves, despite signage and PPE being available. The resident's care plan specified the need for gown and glove use during high-contact activities, and facility policy outlined specific situations requiring PPE. However, staff training and understanding of these requirements were inconsistent, leading to non-compliance with established infection prevention protocols.