Failure to Implement Enhanced Barrier Precautions and Staff Training
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program, specifically by not implementing enhanced barrier precautions (EBP) for a resident identified as requiring such measures. During an observation, a certified nursing assistant (CNA) entered the resident's room, which had EBP signage indicating the need for personal protective equipment (PPE), but did not sanitize her hands or don a gown and gloves before providing activities of daily living (ADL) care. The CNA admitted in an interview that she was unaware of what EBP entailed, had not received training on EBP, and could not articulate the potential negative outcomes of failing to follow EBP protocols. Further interviews revealed that the infection prevention (IP) nurse confirmed there was no documentation of staff training on EBP, and the business office manager, responsible for new hires, stated that no new employees were trained or checked off on EBP. A review of the new hire orientation checklist showed it did not address EBP, despite the facility having an EBP policy outlining when PPE should be used during high-contact resident care activities. These findings demonstrate a lack of staff awareness and training regarding EBP, resulting in non-compliance with infection control protocols.