Law and Safety Study Guide PDF

Law and Safety Section Study Guide Overall Advice: Read choices carefully. Often, wrong choices are just so blatantly wrong based on common sense Basic Definitions Cross Infection: Something patient can contract from another person or environment i.e. Practitioner touched patient A’s athle...

Law and Safety Section Study Guide Overall Advice: Read choices carefully. Often, wrong choices are just so blatantly wrong based on common sense Basic Definitions Cross Infection: Something patient can contract from another person or environment i.e. Practitioner touched patient A’s athlete’s foot, does not wash his hands, and then gives patient B a massage and now patient B gets a fungal infection. Or practitioner himself has a cut or rash and does not properly cover it with bandage or gloves before touching patient. To avoid a patient getting a cross infection from your office, always wash hands before and after contact with every patient and at any time you potentially contaminate yourself such as by touching “unclean” objects. Generally, use water and liquid soap between all your fingers and up the wrist. Then run water over to rinse off. If you are in a place without available sink, use alcohol based solution in the same way. Autogenous Infection: Something patient is already carrying is spread to other area of body i.e. Practitioner massages patient’s athlete’s foot and then decides to needle UB 1 and the patient gets fungus in the eye. To prevent both cross infections and autogenous infections, use only new, sterile needles and guide tubes. Sterile means that they are free of all microbial life. Also swab the area to be needled with 70% isopropyl alcohol. Also do not touch the needle shaft except with sterile cotton or gauze. Biohazardous Waste: Any waste that may present risk of infection to people i.e. blood spill In the event of a blood or body fluid spill, you must put on gloves, clean with a disinfectant once, followed by soap and water. Then dispose of rags/paper towels in biohazard bag. Medical waste disposal company will pick up. Do not put in regular trash. Small drops of blood such as on a cotton ball can go in regular trash container in treatment room. Disinfectants: Products that kill microbial life. Used on inanimate objects like a massage table and floor. Not on person. Universal Precautions: Many ways to state this but the basic idea is behave as though every patient has every infectious disease. Avoid blood, saliva, etc of all patients regardless of what you assume you know about their medical history. To do so, we handle needles very carefully at all times, removing them one at a time and disposing of them in sharp’s container so as to reduce risk of needle stick. In the event of a needle stick, report incident to clinic director so they can advise you of appropriate steps. In the event of sharp’s container spill, use gloves, forceps, and magnets to pick up, not bare hands. Use disinfectant to clean floor. Examples of Infectious Disease: Hepatitis 5 Types: A-E Methods of Transmission: Blood-borne transmission- Hepatitis B, C, and D -You catch these from body fluid contact such as a needle stick Oral-Fecal Transmission- A and E -You catch this from someone not washing after wiping and then making you a sandwich. Hepatitis A- Incubation period is 15-50 days. Incubation period, remember, means person has virus and may pass it on, but is not showing symptoms. Symptoms include very acute onset of High fever, Nausea/Vomiting, muscle aches, right upper quadrant pain, and possible jaundice -Generally runs its course and person fully recovers. There is no chronic state. There is a vaccine but it is not pushed since most people recover just fine. Hepatitis B- Incubation period is 50-180 days. Generally presents with flu-like symptoms such as fever, anorexia, body aches, etc and then can progress to jaundice and such. This can become a chronic liver disease however, and since it is highly contagious, the Center for Disease Control (CDC) recommends all healthcare workers be vaccinated. Hepatitis C- Incubation period is 20-90 days. This is the most common chronic blood borne viral infection in the US. Unlike A and B, this tends to present insidiously with GI symptoms and then leads to a chronic hepatitis 80% of the time. This can lead to liver failure. Unfortunately, there is not a vaccine yet. Hepatitis D- -You need Hep B to become infected with Hep D so a Hep B vaccine protects you from Hep D Hepatitis E-Similar to A. More common in developing countries. HIV: Spread by blood/body fluids to blood/body fluids contact. Retrovirus that attacks the T- Helper cells/CD4 lymphocytes and macrophages. Over time, the person becomes unable to mount an immune response against common microbes. At this time they are said to have AIDS. It may take many years to reach point of AIDS. Once they are at the point of AIDS, they become susceptible to opportunistic infections where otherwise harmless microbes become devastating to the body. There is approximately a.3% chance of contracting HIV from a contaminated needle stick. Remember, that for both Hepatitis and HIV there is an incubation period where the patient is contagious and the organism is multiplying, but they are not showing any symptoms. MRSA: This is an antibiotic-resistant skin infection. If you suspect patient has this, delay treatment and refer out to M.D. Patient Safety and Clinic Policy If you suspect a pneumothorax because patient is short of breath, has chest pain, pallor, cough, etc, remove needles and alert supervisor so they can call 911. If you pierce a vein, apply direct pressure for about 1 minute. If you pierce an artery, you may need to hold pressure for up to 5 minutes. For stuck, bent, or broken needle, you can try twirling needle, massaging surrounding muscles, inserting another needle in nearby muscle, changing patient’s position, using forceps, or pushing down on surrounding skin. If needle is broken under the skin, however, they must be referred to surgeon. If patient passes out or looks as though they may pass out, first thing to do is remove all the needles. Then lay them flat, elevate legs slightly, offer them some water. If not improving, alert supervisor so clinic can call 911. Always report any patient situation where the possibility, however remote, of a malpractice complaint exists to the clinic director. If you suspect any medical emergency such as heart attack, stroke, or anything where there is imminent danger of the patient becoming dead or permanently crippled, alert supervisor so they can have clinic call 911. A medical emergency includes if the patient states plans to commit suicide and they have a plan as to how they will carry it out. This requires 911 call. You do not need to call 911 if they do not have a specific plan, but rather make a more generalized statement about suicide. Students may only needle in pcom clinic or class with approved L.Ac. Supervision. You must always receive supervisor approval before needling any patient. In event of accidental needle stick, pcom will provide you with medical counseling to explain your options. Our scope of practice includes acupuncture, massage, moxa, gua sha, cupping, heat lamps, herbs etc. Other modalities such as homeopathy and spinal adjustments are not appropriate for clinic. PCOM does not allow bleeding techniques in the clinic. PCOM clinic dress code Must dress professionally or at least business casual with a clean lab coat, neatly trimmed beard, nails trimmed, and hair tied back. No shorts, sandals, sneakers, mini-skirts, etc. Also avoid heavy cologne as you are in small room with patients. If you ignore the dress code, you will be sent home and it is an unexcused absence. PCOM has a 100% attendance policy. Any missed shift, no matter the reason, must be made up. Patient Records All new patients must sign informed consent, notification of privacy policies, and arbitration form prior to treatment. HIPPA-The federal Health Insurance Portability and Accountability Act regulates the protection and privacy of patient’s health records. All records must be kept in a secure location and not shared with others outside of what is necessary for their treatment without their written consent. In the event of an error in charting, draw one line through the text, initial, and then put correct information. This way, there cannot be an argument made that you are hiding something. Everything is transparent. Must keep records for period of time specified by state law.