Failure to Implement Enhanced Barrier Precautions for Residents with Chronic Wounds
Penalty
Summary
The facility failed to implement infection control policies, specifically Enhanced Barrier Precautions (EBPs), for two residents with chronic wounds. According to facility policy and federal guidance, EBPs, including the use of gowns and gloves during high-contact care activities, are required for residents with chronic wounds such as pressure ulcers and diabetic foot ulcers. For one resident with a stage 4 pressure ulcer and diabetes, there was a physician order for daily dressing changes, but no order or care plan for EBPs. During observation, an LPN performed a dressing change on this resident without wearing a gown, contrary to policy requirements. Another resident with a diabetic foot ulcer and additional wounds also had physician orders for dressing changes and a care plan for wound management, but there was no care plan or order for EBPs. The Director of Nursing confirmed that the facility did not interpret these wounds as chronic and therefore did not implement the required enhanced barrier precautions for either resident.