Failure to Follow Enhanced Barrier Precautions During Resident Care
Penalty
Summary
A certified nursing assistant (CNA) failed to follow the facility's infection prevention and control program by not wearing a gown while providing care to a resident on enhanced barrier precautions. The resident had multiple diagnoses, including diabetes, stroke, non-Alzheimer's dementia, hemiplegia, muscle wasting, cognitive communication deficit, and a feeding tube, as well as a stage 4 pressure wound. The resident's care plan required enhanced barrier precautions, including the use of gloves and gowns for high-contact care activities such as dressing, bathing, transferring, and wound care. During an observation, the CNA entered the resident's room, donned gloves but not a gown, and proceeded to remove the resident's boots to check skin integrity and reposition the resident in bed, both of which are considered high-contact activities under the facility's policy. Interviews with the CNA, Assistant Director of Nursing (ADON), and Director of Nursing (DON) confirmed that staff are required to wear both gloves and gowns when providing care to residents on enhanced barrier precautions. The CNA admitted to not wearing a gown and stated she was told by another aide that it was not necessary if only checking on the resident. Facility policy, revised in May 2023, clearly states that enhanced barrier precautions require the use of gloves and gowns for residents with wounds or indwelling medical devices during high-contact care activities. The failure to adhere to these precautions was observed and confirmed through staff interviews and policy review.