On March 20, 2024, the Centers for Medicare & Medicaid Services (CMS) issued new guidance for nursing homes on the use of enhanced barrier precautions (EBP) to prevent the spread of multidrug-resistant organisms (MDROs). EBP recommendations now include use of EBP for residents with chronic wounds or indwelling medical devices during high-contact resident care activities regardless of their MDRO status.
In 2019, the Centers for Disease Control and Prevention (CDC) introduced EBP as a new approach to the use of personal protective equipment (PPE) to reduce the transmission of MDROs when standard contact precautions were not applicable. The approach recommended gown and glove use for certain residents during specific high-contact resident care activities associated with MDRO transmission and did not involve resident room restriction.
In July 2022, the CDC released updated EBP recommendations for the implementation of PPE use in nursing homes to prevent spread of MDROs, and CMS is now updating its infection prevention and control guidance accordingly. The updated recommendations include the use of EBP during high-contact care activities for residents with chronic wounds or indwelling medical devices, regardless of their MDRO status, in addition to residents who have an infection or colonization with a CDC-targeted or other epidemiologically important MDRO when contact precautions do not apply.
The new guidance related to EBP is being incorporated into F880 Infection Prevention and Control. Access the guidance here.
Compliance Perspective
Issue
MDRO transmission is common in nursing homes, and can contribute to substantial resident morbidity and mortality and increased healthcare costs. Many residents in nursing homes are at increased risk of becoming colonized and developing infections with MDROs. Focusing only on residents with active infection fails to address the continued risk of transmission from residents with MDRO colonization, who by definition have no symptoms of illness. MDRO colonization may persist for long periods of time (e.g., months) which contributes to the silent spread of MDROs.
Discussion Points
- Review your infection prevention and control plan and PPE policies and procedures to ensure they include the most up-to-date information from CMS including new EBP protocols.
- Train staff on the most current infection prevention and control protocols, including EBP guidance. Document that the training occurred and keep a signed copy in each employee’s education file.
- Periodically audit to ensure that the new EBP guidance is being followed, and that all staff are following your infection prevention and control plan. Provide additional training where needs are identified.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
