Failure to Follow PPE Protocols for COVID-Positive Resident
Penalty
Summary
A Certified Nurses Assistant (CNA) entered the room of a resident who was confirmed to be COVID positive without wearing the required personal protective equipment (PPE). The CNA was observed wearing only a face shield and gloves, but was not wearing a mask or a gown, as mandated by both facility policy and state guidance. The facility's infection prevention protocol, as well as the California Department of Public Health's guidance, specifically require staff to wear an N95 respirator, gown, gloves, and eye protection when entering the room of a COVID positive resident. During interviews, the CNA stated that full PPE was only necessary if physically touching the COVID positive resident, which contradicted the established protocols. Other staff members, including another CNA, an LVN, and the Unit Manager, all confirmed that the correct protocol is to wear complete PPE, including a gown, gloves, N95 respirator, and eye protection, until the resident is no longer in isolation. The failure to follow these protocols was identified through observation, interviews, and record review.