Failure to Follow Enhanced Barrier Precautions During Resident Bathing
Penalty
Summary
A Certified Nursing Assistant (CNA) failed to follow the facility's Enhanced Barrier Precautions (EBP) policy while providing direct care to a resident with a feeding tube. During an observed bathing and dressing activity, the CNA wore a surgical mask and gloves but did not don a gown, despite the resident being on EBP due to the presence of a percutaneous endoscopic gastrostomy (PEG) feeding tube. The facility's policy, consistent with CDC and CMS guidelines, requires staff to wear both gloves and a gown during high-contact care activities, such as bathing, for residents with indwelling medical devices, regardless of their multi-drug resistant organism status. The resident involved had a medical history of cerebral palsy, contractures in all limbs, and was dependent on staff for all activities of daily living, including bathing. The care plan specifically directed staff to follow enhanced barrier precautions related to the resident's PEG tube. Both the Director of Nursing and the Administrator confirmed that the expectation was for staff to don appropriate PPE, including a gown, during such care activities, and acknowledged that the CNA did not comply with these protocols during the observed incident.