Podcast
Questions and Answers
What is the primary goal of risk reduction techniques in ambulatory healthcare offices?
What is the primary goal of risk reduction techniques in ambulatory healthcare offices?
- To reduce the probability of an unintended event causing injury, loss, or legal action (correct)
- To comply with state and local regulations only
- To ignore federal standards and guidelines
- To increase the likelihood of unintended events
Which of the following is an example of a risk reduction technique?
Which of the following is an example of a risk reduction technique?
- Not maintaining an Exposure Control Plan
- Not reporting communicable diseases
- Ignoring patient confidentiality
- Using CNT and Standard Precautions with every patient (correct)
What is the purpose of an Exposure Control Plan?
What is the purpose of an Exposure Control Plan?
- To ignore federal standards and guidelines
- To reduce the risk of exposure to toxic chemicals (correct)
- To increase the likelihood of unintended events
- To comply with state regulations only
Which of the following is a federal standard that practitioners must comply with?
Which of the following is a federal standard that practitioners must comply with?
Why is it important for practitioners to keep abreast of changes in the legal landscape of healthcare practice regulation?
Why is it important for practitioners to keep abreast of changes in the legal landscape of healthcare practice regulation?
What is the purpose of risk reduction techniques in ambulatory healthcare offices?
What is the purpose of risk reduction techniques in ambulatory healthcare offices?
Which of the following is a recommended risk reduction technique?
Which of the following is a recommended risk reduction technique?
What is the purpose of complying with federal standards and guidelines?
What is the purpose of complying with federal standards and guidelines?
What is the primary purpose of an Exposure Control Plan (ECP)?
What is the primary purpose of an Exposure Control Plan (ECP)?
Which of the following employees may be exposed to bloodborne pathogens?
Which of the following employees may be exposed to bloodborne pathogens?
What is the purpose of the Employee Exposure Determination section of the ECP?
What is the purpose of the Employee Exposure Determination section of the ECP?
What is included in the Methods of Implementation and Control section of the ECP?
What is included in the Methods of Implementation and Control section of the ECP?
What is the purpose of the Hepatitis B Vaccination section of the ECP?
What is the purpose of the Hepatitis B Vaccination section of the ECP?
What is the primary principle of applying CNT in a clinical setting?
What is the primary principle of applying CNT in a clinical setting?
How often must employees receive training on the OSHA BBP standard?
How often must employees receive training on the OSHA BBP standard?
What is the primary purpose of Standard Precautions?
What is the primary purpose of Standard Precautions?
What is the primary purpose of the OSHA Bloodborne Pathogens Standard?
What is the primary purpose of the OSHA Bloodborne Pathogens Standard?
What is the purpose of the Recordkeeping section of the ECP?
What is the purpose of the Recordkeeping section of the ECP?
When should hands be washed, according to Standard Precautions?
When should hands be washed, according to Standard Precautions?
How long must employee training records be maintained?
How long must employee training records be maintained?
What should be done with contaminated needles?
What should be done with contaminated needles?
What is the main goal of the Clean Needle Technique (CNT)?
What is the main goal of the Clean Needle Technique (CNT)?
What is the purpose of the Sharps Injury Log?
What is the purpose of the Sharps Injury Log?
What is required of healthcare workers, including acupuncturists, to prevent the transmission of bloodborne pathogens?
What is required of healthcare workers, including acupuncturists, to prevent the transmission of bloodborne pathogens?
What is the main goal of the Needlestick Safety and Prevention Act (NSPA)?
What is the main goal of the Needlestick Safety and Prevention Act (NSPA)?
Who is responsible for developing and implementing an ECP?
Who is responsible for developing and implementing an ECP?
What is required by OSHA standard 1910.1030(d)(2)?
What is required by OSHA standard 1910.1030(d)(2)?
What is the term for the procedures established by the CDC to prevent occupational exposure to bloodborne pathogens in healthcare settings?
What is the term for the procedures established by the CDC to prevent occupational exposure to bloodborne pathogens in healthcare settings?
What should be done if a healthcare worker's protective barrier becomes torn?
What should be done if a healthcare worker's protective barrier becomes torn?
What should be done with needle containers when they are two-thirds to three-quarters full?
What should be done with needle containers when they are two-thirds to three-quarters full?
What is the primary goal of an Exposure Control Plan (ECP)?
What is the primary goal of an Exposure Control Plan (ECP)?
Why is it important to use infection prevention methods consistently for all patients?
Why is it important to use infection prevention methods consistently for all patients?
Which body fluids are included in Standard Precautions?
Which body fluids are included in Standard Precautions?
What is the purpose of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?
What is the purpose of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?
Who should participate in evaluating and implementing safety-engineered devices in healthcare settings?
Who should participate in evaluating and implementing safety-engineered devices in healthcare settings?
What is the responsibility of practitioners with regard to state statutes and regulations?
What is the responsibility of practitioners with regard to state statutes and regulations?
What is the purpose of incident reporting following an injury to a healthcare practitioner?
What is the purpose of incident reporting following an injury to a healthcare practitioner?
What is the classification of a cotton ball containing enough blood that it can be wrung out?
What is the classification of a cotton ball containing enough blood that it can be wrung out?
What is the term OSHA uses to refer to biohazardous waste?
What is the term OSHA uses to refer to biohazardous waste?
What is the ultimate goal of risk management in the practice of acupuncture?
What is the ultimate goal of risk management in the practice of acupuncture?
Who is considered a biohazardous waste generator?
Who is considered a biohazardous waste generator?
What is required of waste generators according to OSHA rules?
What is required of waste generators according to OSHA rules?
How must biohazardous waste be packaged, except for sharps?
How must biohazardous waste be packaged, except for sharps?
Where should biohazardous waste be stored?
Where should biohazardous waste be stored?
What is the best source for information and recommendations on local regulations regarding hazardous waste?
What is the best source for information and recommendations on local regulations regarding hazardous waste?
What is included in OSHA's definition of regulated waste?
What is included in OSHA's definition of regulated waste?
What should be done with biohazardous waste awaiting pick up?
What should be done with biohazardous waste awaiting pick up?
What is the importance of being familiar with local regulations regarding hazardous waste?
What is the importance of being familiar with local regulations regarding hazardous waste?
What is the duration for which the Hepatitis B Vaccine Declination Statement/Policy should be maintained?
What is the duration for which the Hepatitis B Vaccine Declination Statement/Policy should be maintained?
What is the primary purpose of the OSHA Hazard Communication Standard (HCS)?
What is the primary purpose of the OSHA Hazard Communication Standard (HCS)?
What is included in the Chemical List of a Hazardous Communication Plan?
What is included in the Chemical List of a Hazardous Communication Plan?
What is the purpose of reviewing and updating the Exposure Control Plan (ECP) annually?
What is the purpose of reviewing and updating the Exposure Control Plan (ECP) annually?
What is the purpose of the OSHA Consultation Program?
What is the purpose of the OSHA Consultation Program?
What should be done with items that are used during a patient visit but are not saturated with blood or OPIM?
What should be done with items that are used during a patient visit but are not saturated with blood or OPIM?
What is biohazardous waste?
What is biohazardous waste?
What should patients do with press tacks or other imbedded devices that they need to remove at home?
What should patients do with press tacks or other imbedded devices that they need to remove at home?
What is the purpose of the Material Safety Data Sheets (MSDSs)?
What is the purpose of the Material Safety Data Sheets (MSDSs)?
What is the purpose of reviewing standards regarding indoor air quality and fire safety in AOM practice locations?
What is the purpose of reviewing standards regarding indoor air quality and fire safety in AOM practice locations?
What is the best practice when sending a patient home with press tacks or other sharps?
What is the best practice when sending a patient home with press tacks or other sharps?
What is the duty of acupuncturists regarding their practice environment?
What is the duty of acupuncturists regarding their practice environment?
What should be included in the Company Policies regarding chemical exposures in the Hazardous Communication Plan?
What should be included in the Company Policies regarding chemical exposures in the Hazardous Communication Plan?
What is the purpose of the Hazardous Communication Plan?
What is the purpose of the Hazardous Communication Plan?
What should be provided for every staircase in an acupuncture practice?
What should be provided for every staircase in an acupuncture practice?
Why is carpeting in areas where biohazardous waste is generated or stored not recommended?
Why is carpeting in areas where biohazardous waste is generated or stored not recommended?
What should be maintained according to the manufacturer's instructions and local fire regulations?
What should be maintained according to the manufacturer's instructions and local fire regulations?
What should be readily available to the acupuncturist in the workplace?
What should be readily available to the acupuncturist in the workplace?
What should be in accordance with local codes?
What should be in accordance with local codes?
What should be done to all structures and equipment in an acupuncture practice?
What should be done to all structures and equipment in an acupuncture practice?
What is the primary purpose of maintaining treatment records in acupuncture?
What is the primary purpose of maintaining treatment records in acupuncture?
What should be included in the patient's treatment record?
What should be included in the patient's treatment record?
Why are treatment records considered legal documents?
Why are treatment records considered legal documents?
What should be done if a change needs to be made in a paper record during a treatment?
What should be done if a change needs to be made in a paper record during a treatment?
What should be included on every page of a chart?
What should be included on every page of a chart?
What should be used to write handwritten records?
What should be used to write handwritten records?
What should be done to prevent the loss of patient records?
What should be done to prevent the loss of patient records?
What is the purpose of including the date on every page of a chart?
What is the purpose of including the date on every page of a chart?
What should be included in the narrative notes?
What should be included in the narrative notes?
Why are treatment records protected against theft, fire, or water damage?
Why are treatment records protected against theft, fire, or water damage?
When documenting corrections in a chart, what should be done?
When documenting corrections in a chart, what should be done?
What should be avoided in a chart to prevent unauthorized access?
What should be avoided in a chart to prevent unauthorized access?
What is the purpose of documenting information in a chart?
What is the purpose of documenting information in a chart?
What should be used to record actual statements made by patients?
What should be used to record actual statements made by patients?
What should be done with excess empty space on a page in a paper chart?
What should be done with excess empty space on a page in a paper chart?
What is the recommended standard medical charting procedure?
What is the recommended standard medical charting procedure?
What should be included in the Assessment section of an AOM chart?
What should be included in the Assessment section of an AOM chart?
What should be recorded in the Subjective section of an AOM chart?
What should be recorded in the Subjective section of an AOM chart?
What should be done with a note added after the completion of a visit?
What should be done with a note added after the completion of a visit?
What is the purpose of documenting information objectively in a chart?
What is the purpose of documenting information objectively in a chart?
How soon can improvement be expected from a combination of acupuncture/moxibustion and cupping?
How soon can improvement be expected from a combination of acupuncture/moxibustion and cupping?
What is the purpose of planning in Treatment Plan?
What is the purpose of planning in Treatment Plan?
What should be included in a treatment record?
What should be included in a treatment record?
What is the purpose of implementing the AOM plan with the patient?
What is the purpose of implementing the AOM plan with the patient?
Why is it important to maintain accurate records of patient names and addresses in an investigation of an outbreak?
Why is it important to maintain accurate records of patient names and addresses in an investigation of an outbreak?
Under what circumstances can a practitioner release information about a patient?
Under what circumstances can a practitioner release information about a patient?
What is the purpose of the HIPAA Security Rule?
What is the purpose of the HIPAA Security Rule?
What is protected by the HIPAA Privacy Rule?
What is protected by the HIPAA Privacy Rule?
What is a 'covered entity' under HIPAA?
What is a 'covered entity' under HIPAA?
What type of information is included in Protected Health Information (PHI)?
What type of information is included in Protected Health Information (PHI)?
What is a critical requirement for every AOM office?
What is a critical requirement for every AOM office?
What is a recommended practice for acupuncture practitioners?
What is a recommended practice for acupuncture practitioners?
What should be done with biohazardous waste in an AOM office?
What should be done with biohazardous waste in an AOM office?
What is the primary purpose of the Notice of Privacy Practices (NOPP)?
What is the primary purpose of the Notice of Privacy Practices (NOPP)?
Which of the following is a requirement for the Notice of Privacy Practices (NOPP)?
Which of the following is a requirement for the Notice of Privacy Practices (NOPP)?
What is a critical component of Standard Precautions?
What is a critical component of Standard Precautions?
What is the primary principle underlying the concept of informed consent?
What is the primary principle underlying the concept of informed consent?
What should be done with a patient's medical record?
What should be done with a patient's medical record?
What is a recommended practice for dealing with mental health issues?
What is a recommended practice for dealing with mental health issues?
What is the purpose of disclosing the diagnosis to a patient as part of the informed consent process?
What is the purpose of disclosing the diagnosis to a patient as part of the informed consent process?
What should be posted in a prominent place in an AOM office?
What should be posted in a prominent place in an AOM office?
What is the primary purpose of obtaining written consent from patients?
What is the primary purpose of obtaining written consent from patients?
What is the purpose of disclosing reasonable treatment alternatives to a patient as part of the informed consent process?
What is the purpose of disclosing reasonable treatment alternatives to a patient as part of the informed consent process?
What is the primary reason why oral consent may be difficult to prove in court?
What is the primary reason why oral consent may be difficult to prove in court?
What is a critical requirement for AOM office personnel?
What is a critical requirement for AOM office personnel?
What is the threshold for disclosing risks and consequences of a treatment as part of the informed consent process?
What is the threshold for disclosing risks and consequences of a treatment as part of the informed consent process?
What is the purpose of disclosing the prognosis without treatment as part of the informed consent process?
What is the purpose of disclosing the prognosis without treatment as part of the informed consent process?
What should be done with patient information?
What should be done with patient information?
Why is informed consent particularly important in acupuncture and other techniques that may cause damage to the body?
Why is informed consent particularly important in acupuncture and other techniques that may cause damage to the body?
What is a recommended practice for performing certain procedures?
What is a recommended practice for performing certain procedures?
Which of the following is a legal duty of a practitioner with respect to protected health information?
Which of the following is a legal duty of a practitioner with respect to protected health information?
What is the primary cause of slips, trips, and falls in healthcare settings?
What is the primary cause of slips, trips, and falls in healthcare settings?
What should be done in response to a bodily fluid spill?
What should be done in response to a bodily fluid spill?
What is the purpose of state laws regarding reporting communicable diseases?
What is the purpose of state laws regarding reporting communicable diseases?
What is the purpose of checking with the local public health office regarding reporting requirements for communicable diseases?
What is the purpose of checking with the local public health office regarding reporting requirements for communicable diseases?
What is strongly recommended for all acupuncture practitioners to maintain?
What is strongly recommended for all acupuncture practitioners to maintain?
What should be included in a first aid kit for employee use?
What should be included in a first aid kit for employee use?
What is the primary goal of preventing trips and falls in healthcare settings?
What is the primary goal of preventing trips and falls in healthcare settings?
What is the primary reason for having policies in place for dealing with minor and major health issues in treatment settings?
What is the primary reason for having policies in place for dealing with minor and major health issues in treatment settings?
Why is it important to have access to an Automated External Defibrillator (AED) in treatment settings?
Why is it important to have access to an Automated External Defibrillator (AED) in treatment settings?
Study Notes
Office Procedures for Risk Reduction
Federal Standards and Guidelines
- OSHA's Bloodborne Pathogens Standard:
- Protects healthcare workers from infections, including HBV and HIV
- Requires use of personal protective equipment, hand hygiene, and safe handling of sharp objects
- Applies to all healthcare professionals, including licensed acupuncturists
- CDC's Standard Precautions:
- Includes hand hygiene, use of personal protective equipment, safe injection practices, and respiratory hygiene/cough etiquette
- Applies to all healthcare workers
Exposure Control Plan (ECP)
- Required by OSHA for all healthcare facilities, including acupuncture practices
- Covers preventing the spread of bloodborne pathogens, including HBV vaccination
- Must include:
- Written policies
- Program administration
- Employee exposure determination
- Methods of implementation and control
- Regulated waste
- Hepatitis B vaccination
- Post-exposure evaluation and follow-up
- Employee communication
- Employee training
- Recordkeeping
- Hepatitis B vaccine declination statement/policy
OSHA's Hazardous Communication Standard
- Requires development and dissemination of information about hazardous chemicals in the workplace
- Applies to all healthcare/acupuncture practice settings
- Covers:
- Container labeling
- Chemical list
- Material Safety Data Sheets (MSDSs)
- Employee training and information
- Hazardous non-routine tasks
- Policies regarding informing other employers/contractors
Other Hazards
- Indoor air quality and fire safety standards apply to most AOM practice locations
- Electrical equipment usage is regulated by state and federal standards
- Practitioners should review standards and applications annually
Disposing of Biohazardous Waste
- OSHA regulates the handling and disposal of biohazardous waste
- Requires:
- Written plan for handling and disposal
- Employee training program
- Packaging and labeling of biohazardous waste
- Separation and disposal of sharps
- Storage of packaged waste in a designated area
- State and local regulations may be more stringent than OSHA regulations### Hazardous Waste Management
- Some governments require permits and inspections for offices that generate hazardous waste, including acupuncture practices.
- Used needles and contaminated waste must be disposed of by a licensed service, and proof of disposal may be required.
- Practitioners may need a permit to transport contaminated waste, and must ensure that hazardous waste is transported by an approved carrier.
Safety Considerations
- Acupuncturists must ensure that their practice environment is safe for patients and employees, following recognized standards established by OSHA.
- Key areas to focus on include:
- Maintenance of floors, passages, and stairs
- Provision of handrails and adequate lighting
- Regular inspection and maintenance of equipment and structures
- Compliance with local electrical and construction codes
- Proper disposal of biohazardous waste
- Availability of safety equipment and first aid facilities
Recordkeeping
- Patient records should be complete, accurate, and up-to-date, including treatment records, medical history, and consent documentation.
- Records should be protected against theft, fire, or water damage, and should be maintained in a secure and confidential manner.
- Key elements of a treatment record include:
- Patient information and demographics
- Past medical history and allergies
- Family history and social history
- Dated and signed records of every visit
- Flow sheets and narrative notes
- Consent documentation and treatment plans
- Records should be written in black or blue ink, with corrections marked clearly and initialed.
Confidentiality
- Practitioners must maintain confidentiality of patient information, with exceptions for discussions with other healthcare professionals or reporting of communicable diseases or abuse.
- The HIPAA Privacy Rule protects individually identifiable health information, and practitioners must provide a notice of privacy practices to patients.
- Key elements of a notice of privacy practices include:
- Description of how protected health information may be used and disclosed
- Patient rights and practitioner obligations
- Contact information for further information
Informed Consent
- Informed consent is authorization by the patient or their legal representative for a medical procedure or treatment.
- Practitioners must ensure that patients are fully informed of the risks and benefits of a procedure, and must obtain consent before treatment.
- Informed consent is a key element of the practitioner-patient relationship, and is essential for protecting patients' autonomy and rights.### Informed Consent
- Five basic elements must be disclosed to patients in a language they can understand:
- Diagnosis, including reservations
- Nature and purpose of proposed procedure or treatment
- Probable risks and consequences (more than 1% occurrence)
- Reasonable treatment alternatives
- Prognosis without treatment
- A valid, written consent must include:
- Signature
- Procedure details
- Addressing nature, alternatives, risks, consequences, and patient understanding
- Date
Safety Practices
- All patients should be treated the same by following Standard Precautions
- Preventing trips and falls:
- Slips occur due to lack of friction or traction
- Trips occur due to objects causing loss of balance
- Prevention involves good housekeeping, quality walking surfaces, proper footwear, and pace of walking
- Response to bodily fluid spills:
- Evacuate personnel, block area, and use gloves
- Surround spill with paper towels, absorbent material, and dispose of in hazard waste
- Clean and disinfect area with detergent and EPA-approved disinfectant
- First aid:
- Acupuncture practitioners should be prepared to deal with minor and major health issues
- Maintain active CPR certification and have access to an AED if possible
- Policies and training for dealing with minor cuts, bleeding, allergic reactions, and burns
Mental Health Issues/Suicide
- Practitioners should evaluate healthcare situations for preparation
- Legal reporting requirements in some states regarding mental health issues and suicide
- Having a plan and policy in place for dealing with these circumstances
Summary of Recommendations
- Critical: Every AOM office must have a written Bloodborne Pathogens Exposure Control Plan and Hazardous Communication document
- Critical: All AOM office personnel must follow Standard Precautions
- Critical: Every AOM office must comply with fire department regulations, Building and Safety codes, and State and Federal standards
- Critical: All AOM offices must create, maintain, update, and train personnel on possible exposures to infectious agents and other hazards annually
- Critical: All AOM offices must prepare, maintain, and implement a written plan to identify and handle biohazardous waste
- Critical: Patient records should be kept of all patient visits and treatments performed
- Strongly Recommended: Practitioners should require written consent before instituting clinical procedures
- Strongly Recommended: Every AOM office should have a simple first aid kit and post a list of emergency numbers
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Description
This quiz covers federal and legal standards required for ambulatory healthcare offices, including OSHA and CDC guidelines. It's a resource for practitioners to locate sources and examples for federal standards.
