Failure to Implement Enhanced Barrier Precautions During Wound Care
Penalty
Summary
The deficiency involves the facility’s failure to implement its own Enhanced Barrier Precautions (EBP) policy during care of a resident with multiple wounds, an indwelling device, and an active MDRO infection. The facility’s EBP policy dated 01-2024 states that residents with wounds or indwelling medical devices, regardless of MDRO status, and residents known to be infected or colonized with an MDRO, are to be placed on EBP with signage on the door and targeted gown and glove use during high-contact activities, including wound care. EBP is required for activities such as dressing, bathing, hygiene, changing linens and briefs, toileting assistance, device care, and any wound care requiring a dressing. Record review showed that the resident was cognitively intact, required extensive assistance with multiple activities of daily living, was at risk for pressure ulcers, and had multiple wounds including venous ulcers, open wounds on both buttocks, a left BKA incision, several unstageable pressure ulcers on the right lower extremity, a PICC line in the right upper arm, and an active MRSA infection. Observations on separate days revealed there was no EBP signage on the resident’s door and no gowns available inside or outside the room. During observed wound care, an LPN used gloves but did not wear a gown, and later confirmed that EBP had not been utilized and should have been during the wound care encounter.
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