Failure to Use Required PPE During Wound Care Under Enhanced Barrier Precautions
Penalty
Summary
Staff failed to use appropriate personal protective equipment (PPE) while providing wound care to a resident who was on Enhanced Barrier Precautions (EBP). The resident had been admitted with an unspecified open wound on the right knee. During an observation, a Licensed Practical Nurse (LPN) was seen performing wound care for the resident while only wearing gloves, despite a sign indicating the need for EBP, which requires both gown and gloves for high-contact care activities such as wound care. Interviews with the LPN and the Director of Nursing confirmed that the facility's policy mandates the use of both gown and gloves for residents on EBP, particularly during direct care activities like wound care. Review of the facility's policies further supported that EBP is required for residents with wounds, and that staff should adhere to these infection control standards to prevent the transmission of multidrug-resistant organisms. The failure to follow these procedures was directly observed and acknowledged by staff.