Failure to Follow Enhanced Barrier Precautions During G-Tube Care
Penalty
Summary
The deficiency involves the facility’s failure to implement its Enhanced Barrier Precautions (EBP) program for a resident requiring these precautions due to an indwelling gastrostomy tube (G-tube). The resident was admitted with multiple diagnoses including encounter for attention to gastrostomy, and had a Minimum Data Set (MDS) Brief Interview for Mental Status (BIMS) score of 02, indicating severe cognitive impairment. The resident’s physician orders included an enteral feeding regimen with water flushes via PEG tube every three hours and specified the use of Enhanced Barrier Precautions during high-contact care each shift due to the G-tube. The resident’s care plan also documented that Enhanced Barrier Precautions were required during high-contact care activities because of the G-tube indwelling device. During observation, a Licensed Vocational Nurse (LVN) entered the resident’s room to perform a water flush through the G-tube and, together with a family member, repositioned the resident in bed. The LVN did not don a gown while performing these high-contact care activities, despite a sign posted outside the room indicating Enhanced Barrier Precautions and the LVN’s own acknowledgment that the resident was on EBP for the presence of a G-tube. The facility’s written EBP policy states that EBPs are used to prevent the spread of multidrug-resistant organisms and require targeted gown and glove use during high-contact resident care activities, including device care or use such as feeding tubes. The LVN confirmed that she did not put on a gown when flushing the G-tube, demonstrating noncompliance with both the resident’s orders and the facility’s EBP policy.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.