F0880

D

Failure to Use Required PPE for Resident on Contact/Droplet Precautions for Influenza A

San Diego, California Survey Completed on 03-05-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to ensure staff consistently used required personal protective equipment (PPE) for a resident on contact/droplet precautions for Influenza A. Resident 10, admitted with hemiplegia, tested positive for Influenza A following persistent cough and flu-like symptoms and was placed on contact/droplet precautions with isolation in their room. Facility signage at the room indicated droplet/contact precautions and displayed required PPE, including a surgical mask, gown, and gloves. The Infection Preventionist (IP) reported that multiple Influenza A cases had occurred among residents and a staff member, that positive residents were isolated in their rooms, and that mandatory masking and specific PPE requirements for contact/droplet isolation rooms were in place.

During an observation of Resident 10’s room, a CNA was seen entering and interacting with the resident without wearing a gown or gloves, despite the posted droplet/contact precaution signage and PPE requirements. The CNA handled the resident’s lunch tray and spoke with the resident, then exited the room without donning or doffing the required gown and gloves. In an interview, the CNA stated she did not realize the room was under contact/droplet precautions but acknowledged that the expectation was to sanitize hands, don full PPE (mask, gown, gloves) before entering, and remove PPE and perform hand hygiene upon exit, and that failure to wear PPE could result in catching or spreading the virus. The IP and DON both confirmed that staff were expected to follow the signage and wear the required PPE for the assigned isolation type, consistent with the facility’s PPE policy, which states that PPE is based on the type of transmission-based precaution and that employees who fail to use PPE when indicated may be disciplined.