Failure to Follow Enhanced Barrier Precautions During Incontinent Care
Penalty
Summary
A Certified Nurse Aide (CNA) failed to follow Enhanced Barrier Precautions (EBP) by not wearing a gown while providing incontinent care to a resident who was always incontinent of bowel and bladder and had a history of ESBL (Extended Spectrum Beta-Lactamase) resistant infection. The facility's policy required the use of gowns and gloves during high-contact care activities, such as changing briefs or providing hygiene, for residents under EBP. The CNA acknowledged during an interview that she did not wear the required personal protective equipment (PPE) despite being aware of the EBP indicator and the need for PPE to prevent infection. Interviews with other staff, including an LPN and the Director of Nursing (DON), confirmed that EBP was in place for the resident due to their infection history and that staff had been educated on these requirements. Record reviews showed an active physician's order for EBP and documentation of the resident's ongoing incontinence. The deficiency was identified through direct observation, staff interviews, and review of facility policy and resident records.