Failure to Use Enhanced Barrier Precautions During Catheter Care
Penalty
Summary
Surveyors identified a deficiency in the facility’s infection prevention and control program when two CNAs provided urinary catheter care to a resident without using required enhanced barrier precautions. Observation showed that the CNAs appropriately provided privacy, set up supplies, and donned gloves, but they did not wear gowns while performing catheter care, despite facility policy and the resident’s care plan requiring both gloves and gowns for such high-contact care. The facility’s undated Enhanced Barrier Precautions policy specified that residents with catheters require enhanced barrier precautions, including the use of gloves and gowns whenever touching the resident or their environment, to prevent the spread of infections, especially multidrug-resistant organisms. The resident’s care plan, initiated for an indwelling catheter and risk for infection and complications, directed staff to consistently use gowns, gloves, and hand hygiene during high-contact care. A recent quarterly assessment documented that the resident had severely impaired cognition, with a BIMS score of 03, and an indwelling urinary catheter, and a physician’s order required monthly catheter changes for urinary retention. During interviews, both CNAs and the ADON acknowledged that gowns should have been worn during the catheter care under enhanced barrier precautions.
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