Failure to Implement Enhanced Barrier Precautions for Residents With Devices and Wounds
Penalty
Summary
Surveyors identified a failure to implement the facility’s Enhanced Barrier Precautions (EBP) policy for multiple residents who met criteria for these precautions. For one resident with a gastrostomy tube receiving enteral nutrition, there was a current physician order for EBP, but no EBP signage was posted on or near the room entrance and no PPE was available outside the room. Another resident with an indwelling urinary catheter in place for at least three months had current orders for EBP and for monthly catheter changes, yet the room lacked EBP signage and PPE outside the door. A third resident with a stage 4 pressure wound on the left lateral knee, receiving wound treatment and with a current EBP order, also had no EBP sign posted and no PPE located outside the room. Additional residents with qualifying conditions similarly did not have EBP implemented as required. One resident with an indwelling urinary catheter, whose drainage bag was changed to a leg bag during the day and who had current orders for EBP and monthly catheter changes, had no EBP signage or PPE outside the room. Two other residents sharing a room, one with orders for G-tube maintenance and bolus tube feeding and the other with orders for sacral wound treatments and dressings, had no EBP signs posted on or around their shared room. The facility’s own EBP policy stated that residents with medical devices such as catheters and feeding tubes, and residents with chronic wounds, must be on EBP precautions and that residents on EBP isolation must be identifiable as being on that status. The Infection Prevention Nurse confirmed that residents with chronic wounds, G-tubes, or indwelling urinary catheters should be on EBP.
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