Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program as evidenced by the Director of Nursing (DON) not wearing a gown while performing wound care on a resident with a stage 4 pressure ulcer and a colostomy. The resident's care plan and physician orders specified the need for enhanced barrier precautions (EBP), including the use of personal protective equipment (PPE) such as gowns, gloves, and goggles during high-contact care activities like wound care. Despite these documented requirements, the DON did not don a gown during the procedure, which was confirmed during an interview immediately following the observation. Interviews with other nursing staff, including an RN and a CNA, confirmed that EBP should be implemented for residents with wounds, catheters, or ostomies, and that appropriate PPE is expected to be used during high-contact care. The facility's policy on enhanced barrier precautions, implemented in June, also outlined the necessity of PPE during wound care. The DON acknowledged that not following EBP during the wound care was a violation of infection control protocols.