Failure to Implement Enhanced Barrier Precautions During Wound Care
Penalty
Summary
The facility failed to follow infection control guidelines related to Enhanced Barrier Precautions (EBP) during wound care for two residents. In one instance, the Assistant Director of Nursing (ADON) and a Certified Nurse Aide (CNA) provided wound care to a resident with chronic wounds without donning gowns, as required by EBP protocols. The resident's room did not have signage indicating EBP status, and there was no physician's order for EBP in the clinical record. The ADON applied treatments to wounds on two separate occasions without the appropriate use of personal protective equipment (PPE). In another case, a resident with a chronic pressure wound on the right heel received wound care from an LPN who only wore gloves and did not use a gown. The resident's room lacked EBP signage, and there was no PPE available other than gloves. The clinical record also did not contain a physician's order for EBP. The Director of Nursing confirmed that residents with chronic wounds should have been on EBP, but the required precautions were not implemented for these residents.