Failure to Follow Enhanced Barrier Precautions During Resident Care
Penalty
Summary
Staff failed to follow appropriate infection control practices for a resident with significant risk factors, including a suprapubic catheter and a diabetic ulcer, both requiring enhanced barrier precautions. During an observation, an LPN exited the resident's room wearing gloves and holding a device, which was then placed back into the medication cart, despite the presence of an Enhanced Barrier Precaution sign on the door. The LPN acknowledged the expectation to dispose of personal protective equipment (PPE) within the resident's room and to perform hand hygiene before and after resident care, but did not follow these protocols during the observed event. Interviews with facility staff revealed inconsistent understanding and application of enhanced barrier precautions. The LPN stated that only gloves were necessary when obtaining blood sugar levels, even when enhanced barrier precautions signage was present. In contrast, a CNA indicated that both gloves and gowns should be worn for care under enhanced barrier precautions, and that all PPE should be removed and disposed of in the resident's room, with hand hygiene performed before and after care. The Infection Preventionist and Wound Care Nurse further clarified that a gown is required when checking blood sugars for residents under enhanced barrier precautions, due to potential exposure to blood. The Director of Nursing confirmed that staff are expected to follow signage and use appropriate PPE, such as gloves and gowns, when performing tasks that may expose them to blood or bodily fluids. Facility policy also requires proper PPE use when care exposes staff to blood and bodily fluids. The observed failure to remove gloves before exiting the room and the inconsistent application of enhanced barrier precautions among staff contributed to the deficiency in infection prevention and control practices.