Failure to Implement Enhanced Barrier Precautions During Wound Care
Penalty
Summary
The facility failed to implement Enhanced Barrier Precautions (EBP) during wound care for two residents, as required by its own infection prevention and control policy. According to the policy, EBP, which includes the use of gown and gloves, must be used for all residents with wounds, regardless of the presence or amount of drainage. However, during wound care observations for two residents—one with a history of atherosclerosis, chronic kidney disease, and hypertension, and another with systemic scleroderma and open areas on her foot—the registered nurse only wore gloves and did not use a gown. The nurse stated that EBP was not used because the wound drainage had never soaked through the dressing and there was no diagnosis of a multidrug-resistant organism (MDRO). Further confirmation from the Director of Nursing indicated that EBP should be used for every resident with a wound, regardless of whether the drainage is contained. The failure to follow the facility's EBP policy was identified through observation, interview, and record review, and involved two out of three residents reviewed for wound care.