Delay in Initiating Droplet Precautions for Influenza A Positive Resident
Penalty
Summary
The facility failed to implement timely infection prevention and control measures for a resident who tested positive for Influenza A. After a respiratory panel plus COVID test was completed, the positive result for Influenza A was obtained, but droplet precautions were not initiated until two days later. There was no documented evidence that droplet precautions were started immediately after the positive result, as required by the facility's Influenza Protocol. The medical record also lacked documentation of the clinical rationale for ordering the test, and there was no record of timely physician notification regarding the positive result. Interviews with facility staff revealed that nurses are responsible for notifying physicians of abnormal test results and can initiate droplet precautions without a physician's order. However, in this case, there was a delay in both notifying the physician and implementing necessary precautions. The Director of Nursing and the Medical Director both confirmed that the delay represented a lapse in communication and infection control practices. The resident involved had significant medical conditions, including severe cognitive impairment, and was at increased risk due to the delay in implementing appropriate infection control measures.