Failure to Obtain Physician's Order for Isolation Precautions for Resident with ESBL UTI
Penalty
Summary
The facility failed to obtain a physician's order for isolation precautions for a resident who was being treated for a urinary tract infection (UTI) caused by an Extended-Spectrum Beta-Lactamase (ESBL) producing organism. According to the facility's infection control policy, an order from a physician is required to implement isolation precautions for multidrug-resistant organisms (MDROs). Medical record review showed that the resident was admitted with multiple psychiatric diagnoses and later developed a UTI with ESBL, confirmed by laboratory results. While a physician's order was present for the administration of intravenous ertapenem sodium to treat the infection, there was no corresponding physician's order for isolation precautions as required by facility policy. The resident's comprehensive care plan indicated that contact precautions should be implemented per facility policy due to the ongoing IV medication for the ESBL UTI. However, during an interview, the Assistant Director of Nursing/Infection Preventionist confirmed that, despite the resident being treated for an ESBL UTI, no physician's order for isolation precautions had been obtained. This omission was identified through facility policy review, medical record review, and staff interview.