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Enhanced Barrier Precautions

Updated: Jun 27, 2023

As we emerge from the Public Health Emergency, it is important not to let down our guard relevant to infection control practices and the judicious use of personal protective equipment (PPE). Recalling the initial guidance from the Centers for Disease Control and Prevention (CDC) in July, 2019, nursing homes need to focus energy on preventing the silent spread of multi-drug resistant organisms (MDROs) through the implementation of Enhanced Barrier Precautions. Specifically, CDC is intending Enhanced Barrier Precautions to prevent the transmission of Candida auris, carbapenemase-producing bacteria, MRSA, VRE, extended spectrum beta lactamase-producing Enterobacterales, multidrug-resistant Pseudomonas aeruginosa, drug-resistant Streptococcus pneumoniae, and other pan-resistant organisms. Enhanced Barrier Precautions expand the use of PPE beyond situations where there is active infection to include use of PPE where colonization is present.

As a refresher, colonization exists where an MDRO has established comfortable residency in a host. In other words, there are no symptoms or active disease being caused by the organism in THIS host. That is not to suggest that it cannot cause symptoms and active disease in a different host. Thus, the need for Enhance Barrier Precautions to prevent transmission.

The July 12, 2022 update from CDC, entitled Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs) can be found here: In general, gown and gloves should be donned to provide high-contact resident care activities such as dressing, bathing, transferring, incontinence care, changing bed linens, wound care and device use or care such as central lines, urinary catheters, feeding tubes and tracheostomies.

For training on Enhanced Barrier Precautions or other infection prevention and control matters please reach out to our Certified Infection Preventionist at 724-256-8252 or

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