Improper PPE Use and Droplet Precautions During Influenza A Outbreak
Penalty
Summary
Surveyors identified a deficiency in the facility’s infection prevention and control program related to improper use of PPE and droplet precautions during an Influenza A outbreak. A CNA entered a room with residents on droplet precautions wearing only goggles and one glove, handled a resident’s urinal, then returned it to the nightstand without gloves. She then went to the roommate’s bedside, applied gloves without performing hand hygiene, handled and emptied a second urinal, and returned it to the bedside. After exiting, she removed her gown and gloves and performed hand hygiene, but removed her goggles and placed them back into a shared storage bin without sanitizing them. The CNA acknowledged she should have performed hand hygiene before donning gloves and should not have returned the goggles to the bin without cleaning them, and she reported that sanitation wipes for the multi‑use goggles were not sufficiently available. Surveyors also observed the Staff Development Coordinator (SDC) cleaning multi‑use goggles with an alcohol wipe and immediately returning them to the storage bin without allowing the required contact time for disinfection, despite stating that goggles should remain out on a clean barrier until dry or for 2 minutes. During the same Influenza A outbreak, multiple rooms were identified as positive for Influenza A and placed on droplet precautions requiring staff to wear face masks and perform hand hygiene before entry. An Activities Assistant was observed repeatedly entering both Influenza A–positive and negative rooms in succession to offer coffee and coloring sheets, performing hand hygiene between rooms but not changing her mask, and stating she did not need a gown and did not need to change her mask because she was not performing cares. The Infection Preventionist later confirmed that precautions for these residents should have included hand hygiene, face mask, gown, eye protection, and gloves, and the DON confirmed new positive Influenza A cases among additional residents and roommates during this period.
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