Failure to Follow Enhanced Barrier Precautions for Residents Requiring Infection Control
Penalty
Summary
Surveyors found that the facility failed to implement and follow Enhanced Barrier Precautions (EBP) for two residents requiring infection control measures. One resident with a Stage III sacral pressure ulcer and an active order for daily and as-needed wound care to the coccyx did not have an EBP sign or PPE bin outside the room, and the wound care nurse entered the room and performed wound care without donning a gown. Another resident with an active order for EBP due to ESBL, a multidrug-resistant organism in the urine, had an EBP sign and PPE bin outside the room, but a CNA entered the room without a gown to provide incontinence care by changing the resident’s brief. The DON stated that any resident with wounds or a history of MDROs must be on EBP, with signage on the door and PPE, and that staff are required to perform hand hygiene and don a gown and gloves before entering the room for direct resident care such as incontinence care and wound care, and remove PPE before exiting the room. These observations, interviews, and record reviews demonstrate that staff did not consistently follow the facility’s stated EBP requirements for residents with wounds or MDROs, resulting in failures to use required PPE and to ensure appropriate EBP signage and supplies were in place for affected residents.
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