Failure to Follow Enhanced Barrier Precautions During Resident Care
Penalty
Summary
Certified Nursing Assistants (CNAs) failed to adhere to the facility's infection prevention and control program by not wearing the required personal protective equipment (PPE) while providing care to a resident on Enhanced Barrier Precautions. The resident, a male with a history of stroke, impaired swallowing and speech, and a feeding tube, was completely dependent on staff for activities of daily living and had wounds, necessitating Enhanced Barrier Precautions. Facility policy and posted signage required staff to wear gowns and gloves during high-contact care activities for residents with wounds or indwelling medical devices. However, video evidence and direct observation confirmed that two CNAs provided incontinence care to the resident without wearing gowns, despite the presence of PPE supplies and clear signage outside the resident's room. Interviews revealed that one CNA was unaware of the meaning of Enhanced Barrier Precautions, although she knew she was supposed to wear a gown and gloves when caring for the resident. She admitted to sometimes forgetting to wear a gown due to being busy and not always paying attention to posted signage. The Assistant Director of Nursing confirmed that staff were required to wear gowns and gloves for residents with artificial openings and that multiple in-services on infection control had been conducted. The facility's policy, dated 05/15/23, specified the use of Enhanced Barrier Precautions for residents with wounds or indwelling devices during high-contact care activities, such as changing briefs or assisting with toileting.