Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
A deficiency occurred when a registered nurse (RN) failed to follow proper infection prevention and control protocols during wound care for a resident with a diagnosis that included congestive heart failure and severe cognitive impairment. The resident was under Enhanced Barrier Precautions (EBP) due to being at high risk for acquiring or spreading multidrug-resistant organisms (MDROs), as indicated by the facility's policy. The physician's order required specific wound care procedures for the resident's right foot. During the observed wound care, the RN donned disposable gloves and removed the old dressing, but after removing the gloves in the bathroom, did not perform hand hygiene before applying a new pair of gloves. Additionally, the RN did not don a gown prior to beginning the wound treatment, despite gowns being available in the room and the facility's policy requiring both gloves and gowns for high-contact activities such as wound care under EBP. The RN acknowledged during an interview that she would normally wear a gown and perform hand hygiene after doffing gloves, but failed to do so during this instance. The facility's current EBP policy, provided by the Director of Nursing, clearly outlined the requirements for PPE use and hand hygiene during high-contact care activities for residents at high risk for MDROs.