Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
A deficiency occurred when a treatment nurse provided wound care to a resident with chronic osteomyelitis and peripheral vascular disease without wearing a gown, despite the resident being on enhanced barrier precautions (EBP) due to an open wound. The nurse was observed wearing gloves only while performing wound care on the resident's left plantar foot, even though an EBP sign was posted outside the resident's room and the physician's order specified the use of EBP for this resident. The nurse later stated she was unaware that a gown was required for wound care under EBP. Interviews with the infection control nurse and the director of nursing confirmed that staff are expected to wear gowns and gloves during high-contact care activities, such as wound care, for residents on EBP. The facility's policy also indicated that personal protective equipment, including gowns, is necessary during high-contact activities involving skin openings requiring dressings. The failure to follow these protocols was directly observed and confirmed through staff interviews and record review.