Waters Of Chesterfield Skilled Nursing Facility

(Resident 2)Findings include:Resident 2's clinical record was reviewed on 3/25/26 at 2:17 p.m.

gastro-esophageal reflux disease (GERD).Current orders include the following: EBP related to PEG (gastrostomy) tube for infection prevention (1/14/26).A 2/24/26, quarterly, Minimum Data Set (MDS) assessment indicated the resident was moderately cognitively impaired and utilized a feeding tube.A 2/12/26, EBP care plan indicated for staff to follow the EBP guidelines when providing care and coming into direct contact with potentially infected materials or devices.

Direct care activities include device use such as feeding tubes.

Interventions included reinforcing proper handwashing and following personal equipment protocols (2/12/26) and set up isolation per facility protocol, following EBP guidelines (2/12/26).During a medication administration observation, on 3/26/26 at 9:27 a.m., LPN 5 completed hand hygiene and gathered the following supplies: some paper towels, two plastic cups with 30 milliliters (mL) of warm water in each, and the resident's liquid potassium medication.

LPN 5 entered the resident's room and placed the supplies on the bedside table.

She paused the resident's tube feed pump and entered the resident bathroom where she donned a pair of gloves. LPN 5 leaned her hips and thighs against the resident's bed and bedsheets and spoke with her. LPN 5 checked the g-tube for residual purposes and examined the g-tube site. LPN 5 flushed the tube with 30 mL of warm water, then administered the potassium medication, and flushed the tube again, with another 30 mL of warm water.

She restarted the tube feeding, gathered up the trash, and removed her gloves. LPN 5 remained leaning against the resident's bed and bedsheets through the whole medication administration process.

During an interview, at the time of the observation, LPN 5 indicated the EBP sign to the resident's door indicated that staff needed to wear personal protective equipment (PPE) to help prevent the spread of infection. Resident 2 had a g-tube and staff needed to wear a gown and gloves when providing direct patient care. LPN 5 indicated she had simply forgotten to put on the gown prior to the medication administration.

During an interview, on 3/20/26 at 11:28 a.m., the DON indicated that EBP was utilized when a resident has any lines, wounds, or catheters.

EBP helps to protect the residents from the spread of infection. Resident 2 had and g-tube and all staff members need to wear the appropriate PPE when proving direct contact care. LPN 5 should have worn a gown during the medication administration observation.A current facility policy, last revised 12/22, titled, Guidelines for Enhanced Barrier Precautions -(EBP) An extension of Personal Protective Equipment (PPE), provided by the DON on 3/30/26 at 10:20 a.m., indicated the following: .

Enhanced Barrier Precautions are defined as the use of PPE (gowns and gloves) during high- contact resident care activities that generate opportunities for transfer of MDRO's in the form of blood or body fluids, onto the hands and/or clothing of the rendering caregiver.

Who is at ?high risk' for acquiring or spreading a MDRO.c.) Feeding Tubes (any type) .Examples of ?high contact' resident care activities at which time EBP is to be practiced are. g.) Device care of Use of to include.

Feeding tubes (any type) .410 IAC (Indiana Administrative Code) 16.2-3.1-18(a)