CLINIC POLICIES AND PROCEDURES

1. CLINIC POLICIES AND PROCEDURES For Beginning Graduate Students

2. CLINICAL SERVICES • Complete diagnostic and therapeutic services are provided for children and adults with speech, hearing, and language problems.

3. Hearing services include • Hearing screenings • Hearing testing and counseling • Hearing aid evaluation and counseling • Hearing aid sales, orientation, and repair • Speechreading and auditory training • Speech and hearing conservation • Individual and family counseling

4. Speech-language services include • Speech and language testing for • Sound production problems • Voice disorders • Fluency disorders • Language delays and disorders • Swallowing and other oro- pharyngeal disorders • Speech and language therapy

5. Settings for our services • ASU Communication Disorders Clinic • Watauga Medical Center • Two Rivers School • Foothills Correctional Institute

6. Other settings we use • Watauga County Schools • Alexander County Schools • Burke County Schools • Caldwell County Schools • North Carolina School for the Deaf

7. Other settings we use • Blue Ridge Speech Pathology – children • Guardian Healthcare – adults • J. Iverson Riddle Developmental Center – adults • Wilkes Senior Village – geriatric • Aegis – geriatric adults

8. HIPAA FEDERAL LAW

9. ASHA Code of Ethics • Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally.

10. Individuals shall not reveal, without authorization, any professional or personal information about the person served professionally, unless required by law to do so, or unless doing so is necessary to protect the welfare of the person or of the community.

11. The client charts are protected by: • ASHA Code of Ethics • State Laws • Federal Laws (HIPAA)

12. Client charts contain protected health information. Which is any health information that identifies a client.

13. Each client in the Clinic has a chart. Student clinicians are responsible for helping to maintain these charts.

14. Each chart is arranged in chronological order And all charts must contain specific information.

15. Clear and Comprehensive Documentation is needed in each chart • To justify need for treatment • To document the effectiveness of treatment • To have a legal record of events

16. Client records are confidential.

17. They are not to be divulged to anyone other than members of the Clinic staff involved with the case unless a signed written release is in the chart.

18. Client records are not to be taken out of the Clinic areas. They must be protected at all times.

19. Areas interpreted to be in the “Clinic:” • Designated treatment rooms assigned to the clinic • Student Prep Room • Professional staff offices • Student Lounge

20. A chart must never be left unattended. If a student must leave the clinic area, return the chart!

21. Do not scratch out information if you make a mistake in the client record. • Draw a single line through the error. • Write “Error.” • Initial the mistake.

22. The penalties for a breach of confidentiality are severe • Student could receive a reprimand. • Student could receive a lower grade for class. • Student could be removed from the clinic setting totally (resulting in a failing grade).

23. QUESTIONS?

24. INFECTION CONTROL

25. Outpatient and inpatient health care facilities provide a unique setting that is conducive to the transmission of infectious agents.

26. What can be done to prevent the transfer of infectious pathogens in the health care workplace? • Constant cleaning of equipment, furniture and common use items and surfaces • Consistent use of barrier precautions and protective equipment • Frequent handwashing

27. What are Bloodborne pathogens? • Pathogenic microorganisms • Present in human blood • Can cause disease in humans • Include, but not limited to: • Hepatitis B (HBV) • Hepatitis C (HCV) • Human Immunodeficiency Virus (HIV)

28. Universal precautions vs Standard precautions • Universal precautions – treating all patients the same, all blood and other potentially infectious material as if infectious. • Standard precautions – treating all body fluids as if infectious (ASU’s recommended practice)

29. Bloodborne pathogen transmissions are • Highly preventable through • Common sense • Universal or standard precautions • Not sharing personal items • Barrier methods for sex • Eliminating needle sharing

30. Treat all human body fluids as potentially infectious

31. Preventative measures

32. Handwashing • Most effective method to prevent transmission of illnesses • Wash hand thoroughly even if wearing gloves • Pay special attention between fingers and around nails • Wash for 30 seconds • Let water run down toward finger tips

33. Handwashing • Use paper towel to turn off water and open door • Don’t touch sides of sink • If wearing re-usable gloves, wash and disinfect before removing from hands • If water not available, use waterless antiseptic hand cleaner, until you can wash

34. General Principles • It is prudent to minimize all occupational exposure to human body fluids. • Risk of exposure should never be underestimated. • Facilities should institute as many controls as possible to eliminate or to minimize exposure to bloodborne pathogens.

35. Personal protective equipment (PPE) • Must be provided to you at no cost, including training • Impermeable gloves are used anytime you might contact body fluids, avoid vinyl gloves (allows tiny holes) • Goggles should be worn if in danger of splashing of body fluids or when mixing and using disinfectant solutions

36. Gloves • Latex • Nitrile • Chloroprene • Avoid vinyl

37. Other personal protection equipment includes • Surgical masks • Face splash shield/goggles/eye protection • Lab coat/gown • Rubber or nitrile apron • Disposable booties or rubber boots

38. Recognizing tasks that may be hazardous • Oral-facial examinations • Changing diapers in the PLCC • Cleaning “mouthed” toys • Use of Nasometer, Videostroboscopy, or Laryngograph • Handling hearing aids

39. There is a written schedule for cleaning all equipment and working surfaces.

40. If eyes, nose, or mouth are splashed Irrigate with large amounts of water for 15 minutes

41. If an exposure occurs to the hands or skin • Wash area for at least 30 seconds • Rinse with running water for at least 10 seconds

42. QUESTIONS?

43. PROFESSIONAL DRESS

44. Students are expected to dress for a professional environment. • Clothing should not be potentially embarrassing. • Shoes or sandals must be worn. • Casual shorts, blue jeans, halter tops, and T-shirts are not permitted. • Clinical educator has the final word concerning dress.

45. All students must wear name tags. Including participant observers.

46. Check with the clinical educator in charge of the case if you are not sure of the appropriate dress.

47. EXPECTATIONS FOR PRACTICUM

48. The first practicum experience should be a relatively easy one with ASU clinical personnel.

49. You should complete: • Speech and language therapy hours • Some speech and language diagnostic hours • Aural rehab/hearing screening hours

50. Subsequent semesters should progressively become more demanding And students should demonstrate more independence.