Failure to Follow Enhanced Barrier Precautions During PEG Tube Medication Administration
Penalty
Summary
The deficiency involves the facility’s failure to implement its Enhanced Barrier Precautions (EBP) policy during PEG tube medication administration for one resident. The facility’s EBP policy, last reviewed on 6/30/25, defined EBP as an infection control intervention requiring targeted gown and glove use during high-contact resident care activities, and specified that EBP are indicated for residents with indwelling medical devices, including feeding tubes. Signage posted outside the resident’s room indicated that EBP were in effect and instructed providers and staff to wear gloves and a gown during high-contact resident care activities, including device care and use involving a feeding tube. On the survey date at 9:00 AM, an LPN was observed administering medications via the resident’s Percutaneous Endoscopic Gastrostomy (PEG) tube without donning a gown, contrary to the posted EBP instructions and facility policy. The resident had been admitted on 11/17/25 with diagnoses including an encounter for attention to gastrostomy, indicating the presence of a feeding tube. In a subsequent interview at 9:25 AM, the LPN stated that EBP were used to prevent the spread of infection, acknowledged that she did not wear a gown while administering the PEG tube medications, and agreed that she should have worn one. At 10:00 AM, the DON confirmed that her expectation was that the LPN would have worn a gown when administering medications through a PEG tube in accordance with EBP.
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