Failure to Implement Timely and Adequate Infection Control Precautions
Penalty
Summary
The facility failed to implement adequate infection prevention and control practices for a resident who was admitted with a wound infection positive for Staphylococcus aureus. Upon admission, the resident's hospital discharge paperwork included laboratory results indicating the presence of S. aureus, and the resident was receiving antibiotic treatment for the infection. Despite this, there were no physician orders for isolation precautions until two days after admission, and the resident was not placed into appropriate isolation precautions until that time. Facility leadership confirmed that it is the responsibility of the admitting nurse to review laboratory results and ensure proper isolation measures are implemented as needed. Further observations revealed additional lapses in infection control practices. There was no waste receptacle available for discarding used PPE outside the resident's room, as verified by the DON and a registered nurse. Additionally, an LPN entered the resident's room without donning PPE and stated she was unaware that the resident was on isolation precautions. The facility's infection prevention and control policy requires the implementation of appropriate isolation precautions when necessary, but these procedures were not followed in this instance.