Deficiencies in Infection Control: Pre-Employment Screening, Enhanced Barrier Precautions, and Hand Hygiene
Penalty
Summary
The facility failed to ensure completion of pre-employment health history screening for one of five sampled staff members. Specifically, the employee file for a hospitality aide did not contain a fully completed Health Questionnaire, as required by facility policy. The section for test information, including vital signs and provider follow-up, was left blank, and the employee did not sign or date the form. Despite this, the Director of Nursing signed off on the document as complete, and the aide began working and providing direct assistance to residents. Additionally, the facility did not follow its Enhanced Barrier Precautions (EBP) policy for residents with chronic wounds. During high-contact care activities, such as transferring a resident with a wound using a full body lift, two nurse aides failed to wear the required personal protective equipment (PPE), including gloves and gowns, despite signage and their own acknowledgment of the policy. Another instance involved the Assistant Director of Nursing in Training providing personal hygiene care to a resident on EBP without wearing a gown, contrary to facility policy and their own admission of the requirement. The facility also failed to ensure proper hand hygiene during wound care for a resident on EBP. The Assistant Director of Nursing in Training applied two different substances to the resident's wound area without changing gloves or performing hand hygiene between applications, as required by the facility's hand hygiene policy. This lapse was confirmed by both the staff member involved and the Assistant Director of Nursing.