The Centers for Disease Control and Prevention (CDC) released updated guidance on enhanced barrier precautions designed to reduce the transmission of multi-drug resistant organisms (MDRO). MDROs are pathogens that cause infections and are resistant to antibiotics commonly used to treat infections.
Enhanced Barrier Precautions are a set of infection prevention strategies that go beyond standard precautions. They specifically aim to reduce the risk of transmission of certain multidrug-resistant organisms (MDROs) in nursing homes and other healthcare settings. EBP includes the use of personal protective equipment (PPE) based on the risk of transmission and the type of resident interaction.
Criteria for Implementing Enhanced Barrier Precautions
Residents who require EBPs meet the following criteria, irrespective of their location within the facility:
- Infection or colonization with a Centers for Disease Control and Prevention (CDC)-targeted multidrug-resistant organism (MDRO) when contact precautions are not otherwise indicated.
- Presence of wounds and/or indwelling medical devices, even if there is no known infection or colonization with an MDRO.
- Facilities may determine when to apply EBPs for residents lacking chronic wounds or indwelling medical devices but are infected or colonized with an MDRO not currently targeted by the CDC.
Examples of this type of care include:
- Dressing
- Bathing/showering
- Transferring
- Providing hygiene
- Changing linens
- Changing incontinent products/assistance with toileting
- Device use: central line, urinary catheter, feeding tube, tracheostomy/ventilator
- Wound care: any opening requiring a dressing
The CDC also released a FAQ on enhanced barrier precautions for further information and clearly states the recommendation to implement enhanced barrier precautions in situations where contact precautions are not recommended. For a complete list of pathogens and the appropriate type of precaution, look to the CDC’s Appendix A as a reference.
With a continued emphasis on infection prevention and control, it is an excellent time to review your broader policies, including transmission-based precautions, isolation cart status, and availability of reference materials for the use of transmission-based precautions for pathogens other than COVID-19.