Failure to Enforce Enhanced Barrier Precautions for Residents with Indwelling Devices
Penalty
Summary
The facility failed to follow infection control precautions for two residents who were under enhanced barrier precautions (EBP) due to their medical conditions. One resident, admitted with hypertension and urinary retention and with a urinary catheter in place, had an active order for EBP. Despite this, observations on multiple occasions revealed that the resident’s family members were present at the bedside assisting with care without wearing the required personal protective equipment (PPE). Both the LVN and the Infection Prevention Nurse confirmed that family members should have been wearing PPE to prevent the spread of infection, as outlined in the facility’s infection prevention and control policy. Another resident, admitted with multiple diagnoses including dysphagia, a gastrostomy tube, myocardial infarction, depression, heart failure, and respiratory failure, also had an order for EBP. During care, a CNA was observed changing the resident’s gown and providing a bed bath without wearing an isolation gown, which is required under EBP protocols. The CNA acknowledged the omission and stated that gloves and an isolation gown should have been used. The Infection Prevention Nurse and the DON both confirmed that staff providing direct care to residents with indwelling devices or wounds must adhere to EBP, including the use of gowns and gloves. The facility’s policies and procedures for infection prevention and EBP were reviewed and both require the use of appropriate PPE by staff and visitors when providing care or having direct contact with residents under EBP. The observed failures to ensure compliance with these precautions for both staff and visitors constituted a deficiency in the facility’s infection prevention and control program.