Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
A deficiency occurred when a Licensed Practical Nurse (LPN) failed to follow Enhanced Barrier Precautions (EBP) during wound care for a resident with diabetes mellitus type 2 and bilateral toe wounds. The LPN gathered supplies, performed hand hygiene, and donned gloves before entering the resident's room. During the wound care process, the LPN changed gloves but did not don a gown as required by the facility's EBP policy for residents with chronic wounds, such as diabetic foot ulcers. Additionally, the LPN did not perform hand hygiene between glove changes, which is also required by facility policy. The resident involved had a diagnosis of diabetes mellitus type 2, which can lead to poor blood flow and slow-healing wounds, and was under an order for daily wound care with Medi Honey and Band-Aids. The facility's policy specifies that EBP, including gown and glove use, must be followed for residents with chronic wounds. Interviews revealed that the LPN was unaware that EBP applied to wound care and believed it was only necessary for catheter and tube feeding care. The Director of Nursing confirmed that the resident was on EBP and that staff are expected to use gowns and perform hand hygiene as outlined in the policy.