Failure to Follow Contact Precautions for Resident with Shingles
Penalty
Summary
The facility failed to maintain proper infection prevention and control practices for a resident with shingles. According to the facility's policy, contact precautions, including the use of gloves and gowns upon room entry, were required for certain cases of shingles. During observation, a nurse aide was seen entering the resident's room, which was marked with a contact precautions sign, wearing only gloves and not a gown. The nurse aide later stated she did not see any personal protective equipment (PPE) and assumed only gloves were necessary. The PPE was available in a caddy on the wall between rooms, but was not utilized as required. The Director of Nursing confirmed that contact precautions should have been followed as indicated by the signage and the resident's care plan. The resident in question had a history of shingles, with lesions localized to the right side and trunk, and was being treated with Valtrex. The care plan specified contact precautions, and signage was posted at the room entrance. However, there was no physician's order for contact precautions at the time of the observation, only an order for Enhanced Barrier Precautions due to a history of MRSA. The lack of adherence to posted contact precautions and the absence of a corresponding physician's order contributed to the deficiency identified during the survey.