Failure to Use Enhanced Barrier Precautions During High-Contact Care
Penalty
Summary
Staff failed to utilize enhanced barrier precautions (EBP), specifically the use of gowns and gloves, during high-contact care activities for a resident with multiple open wounds. According to the facility's EBP policy, staff are required to use targeted personal protective equipment during activities such as dressing, bathing, hygiene, and transfers for residents at risk of multidrug-resistant organism (MDRO) transmission. Record review showed that the resident was dependent on staff for all activities of daily living, had multiple pressure ulcers, and required total assistance with hygiene and toileting. During an observed episode of incontinent care and repositioning, staff did not wear a gown and gloves as required by policy. Interviews with staff revealed inconsistent compliance with EBP. An LPN acknowledged that staff often only wore gloves, unless the wound was heavily draining, and did not always use gowns and gloves unless the resident was on isolation precautions. The Director of Nursing confirmed that staff were expected to follow the EBP policy but admitted that compliance was not always consistent, especially when residents became agitated or resisted care. The failure to follow EBP was directly observed and confirmed through staff interviews.