Stocking PPE for Enhanced Barrier Precautions: a guide for nursing homes

What Enhanced Barrier Precautions are

Enhanced Barrier Precautions (EBP) are an infection-control approach for nursing homes. Staff wear a gown and gloves during high-contact care for residents who meet CDC’s criteria: residents infected or colonized with a multidrug-resistant organism (MDRO), and residents with wounds or indwelling medical devices [1]. CMS issued its EBP memo in March 2024, effective April 1, 2024 [2]. In 2025 CMS folded the guidance into the infection-control guidance surveyors use, and surveyors have applied it since April 28, 2025 [3].

EBP doesn’t require a private room. Residents aren’t restricted to their rooms or kept out of group activities [1].

When gowns and gloves are used

CDC lists these high-contact care activities: dressing; bathing or showering; transferring; providing hygiene; changing linens; changing briefs or assisting with toileting; device care or use (central line, urinary catheter, feeding tube, tracheostomy or ventilator); and wound care [1].

Where the PPE needs to be

CDC asks facilities to make PPE, including gowns and gloves, available immediately outside the resident room, and to ensure access to alcohol-based hand rub in every resident room, ideally both inside and outside [1]. For supply planning, that means every room on EBP becomes a stocking point, not just the central supply room.

What the rules don’t say

The federal infection-control rule requires an infection prevention and control program and a designated infection preventionist, but it doesn’t set a numeric glove stock level [4]. In California, Cal/OSHA adds requirements that matter for supply: PPE in appropriate sizes, readily accessible, with alternatives for employees allergic to the gloves normally provided [5], and procedures for an adequate supply of PPE in normal operations and foreseeable emergencies [6]. How much to stock is your facility’s decision.

A planning worksheet

These steps turn EBP into a supply plan. They’re a planning method, not clinical guidance; your infection preventionist sets the protocol.

1. Count stocking points. List the rooms and units currently on EBP, and where PPE is staged for each.
2. Estimate daily use. With your infection preventionist, estimate high-contact care episodes per resident per day and the gloves and gowns each episode uses under your protocol. Multiply by the residents on EBP in each unit.
3. Split gloves by size. Use recent deliveries to see how use divides across sizes; size runs are rarely even.
4. Set a par and a reorder point. Par covers expected use between deliveries plus a buffer you choose. Reorder when stock on hand falls to the use you expect during your supplier’s lead time, plus that buffer.
5. Plan for alternatives. Keep a documented alternative glove on hand for staff who need one [5].
6. Plan for disruption. Name a backup source and note how long it takes to deliver [6].

Documentation to keep on file

For each glove, keep the manufacturer’s spec sheet and the FDA 510(k) number, which you can check in FDA’s public database [7]. For gowns, keep labeling that states the gown’s intended use and level of protection [8].

How GTDI can help

We supply exam gloves, isolation gowns and alcohol-based hand rub from the major brands, quoted per case — and per 1,000 gloves — in the sizes you use. Every quote states the lead time, you can set a weekly or monthly standing order, and we tell you before anything changes. Whether we’re your main source or your backup, one representative follows each order through.

This guide is general information for supply planning. It isn’t clinical, legal or regulatory advice. Your infection preventionist and administrator set your facility’s policies.

Sources

1. CDC, “Implementation of PPE Use in Nursing Homes to Prevent Spread of MDROs,” last updated Mar 8, 2024 (reviewed Apr 2, 2024). https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/PPE.html
2. CMS, QSO-24-08-NH, “Enhanced Barrier Precautions in Nursing Homes,” Mar 20, 2024 (effective Apr 1, 2024). https://www.cms.gov/files/document/qso-24-08-nh.pdf
3. CMS, QSO-25-14-NH (revised Mar 10, 2025). https://www.cms.gov/files/document/qso-25-14-nh-revised-2025-03-10.pdf
4. 42 CFR 483.80, Infection control (eCFR, current as of Oct 1, 2026).
5. California Code of Regulations, Title 8, §5193, Bloodborne Pathogens (undated page; accessed Oct 4, 2026). https://www.dir.ca.gov/title8/5193.html
6. California Code of Regulations, Title 8, §5199, Aerosol Transmissible Diseases (current text; accessed Oct 4, 2026). https://www.dir.ca.gov/title8/5199.html
7. FDA, Premarket Notification 510(k) database (live database; accessed Oct 4, 2026). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm
8. FDA, “Medical Gowns” (content current as of Jan 17, 2024). https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/medical-gowns