CMS issued new guidance in QSO-24-08-NH for State Survey Agencies and long-term care (LTC) facilities on the use of enhanced barrier precautions (EBP). The new guidance will align with nationally accepted standards.
The new guidelines now include use of EBP for any resident with an indwelling medical device and/or chronic wounds during high contact resident care activities regardless of their multidrug-resistant organism.
Enhanced barrier precautions are used with standard precautions and expand the use of personal protective equipment during high contact resident care activities inside and outside the residents’ room. It is with high-contact resident care that can result in transferring MDROs (Multidrug resistant organisms) to staff hands and clothing.
EBPs should be followed:
- When performing transfers
- Assisting during bathing
- When working with residents in a therapy gym while assisting with transfers and mobility.
- When infection or colonization with a CDC targeted MDRO when contact precautions do not otherwise apply.
- Resident with wounds and/or indwelling medical devices even if the resident is not known to be infected or colonized with a MDRO.
CMS notes that providers will have some discretion when implementing EBP and balancing the need to maintain a homelike environment.
It is important to know that residents are not restricted to their rooms or limited in participating in activities.
Recommended Action:
- Read the new guidance found in QSO-24-08-NH
- Be on the lookout for updates to F880 Infection Prevention and Control as well as the corresponding Critical Element Pathway.
- Train current and newly hired staff on EBP, proper use of Personal Protective Equipment (PPE), and the storage and availability of PPE with hand hygiene products.
- Attend the April 4, 2024, Regulatory Roundup at 12 noon: https://www.ihca.org/regulatory-roundup/
- Use the additional educational resources as follows:
- CDC provides several resources for providers including educational materials and signage.
- The CDC offers a short video regarding EBP in LTC centers on its YouTube channel.
- The CDC TRAIN environment provides additional resources.
A CDC Frequently Asked Questions site is also available.