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CAAA Safety Handbook

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CAAA Safety Handbook Safety Handbook for Alberta Acupuncturists 2017 1 Copyright © 2017 by the College and Association of Acupuncturists of Alberta Materials in this handbook may not be reproduced, displayed, modified or distributed without the expressed written permission of the copyright owner. All rights reserved. 2 Table of Contents SECTION 1: OVERVIEW ------------------------------------------------------------------------------------ 6 1.1 Introduction. -------------------------------------------------------------------------------------------------------- 6 1.2 Content. --------------------------------------------------------------------------------------------------------------- 6 1.3 Credits and Acknowledgements. ------------------------------------------------------------------------------ 6 1.4 Copyright. ------------------------------------------------------------------------------------------------------------ 7 1.5 Disclaimer. ----------------------------------------------------------------------------------------------------------- 7 SECTION 2: INFECTION PREVENTION & CONTROL -------------------------------------------------- 8 2.1. Introduction. ------------------------------------------------------------------------------------------------------- 8 2. 2 General Principles of Infection Prevention and Control. ------------------------------------------ 9 2.2.1 A Look at Potential Biological Hazards at Acupuncture Clinics. --------------------------------------- 9 2.2.2 Contamination and Cross-contamination in the Acupuncture Clinic. ------------------------------ 12 2.2.3 Common Risks for Infection in the Acupuncture Clinic. ---------------------------------------------- 14 2.3 Routine Practices. ------------------------------------------------------------------------------------------------ 15 2.3.2 Respiratory Etiquette. --------------------------------------------------------------------------------------- 16 2.3.3 Hand Washing. ------------------------------------------------------------------------------------------------ 17 2.3.4 Alcohol Based Hand Rub ------------------------------------------------------------------------------------ 17 2.3.5. Hand Washing Facilities ------------------------------------------------------------------------------------ 19 2.3.6 Antiseptic Agents. -------------------------------------------------------------------------------------------- 19 2.3.7 Personal Protective Equipment (PPE). ------------------------------------------------------------------- 19 2.3.8 Safe Handling and Disposal of Sharps. ------------------------------------------------------------------- 20 2.4 Additional Precautions (Transmission-based Precautions). ---------------------------------------- 21 2.4.1 Patient Management ----------------------------------------------------------------------------------------- 21 2.4.2 Additional Precautions for Infectious Patients --------------------------------------------------------- 21 2.4.3 Droplet Transmission Precautions ----------------------------------------------------------------------- 21 2.4.4 Contact Transmission Precautions ----------------------------------------------------------------------- 21 2.4.5 Airborne Transmission Precautions ---------------------------------------------------------------------- 21 2.5 Cleaning, Disinfecting, Sterilizing. --------------------------------------------------------------------------- 22 2.5.1 Cleaning the Environment. --------------------------------------------------------------------------------- 22 2.5.3 Cleaning Blood Spills ---------------------------------------------------------------------------------------- 23 2.5.4 Laundering Sheets, Towels or Other Linens ------------------------------------------------------------ 23 2.5.5 Cleaning, Disinfecting and Sterilizing -------------------------------------------------------------------- 24 2.5.6 Cleaning Instruments and Equipment ------------------------------------------------------------------- 24 2.5.7 Sterilizing, Disinfecting ------------------------------------------------------------------------------------- 27 Low-level disinfectants will kill some bacteria, some fungi, and some viruses (e.g., HBV, HCV) but it is not effective against Mycobacterium tuberculosis, fungi, or spores. ----------------------------------- 31 2.5.8 Sterilization --------------------------------------------------------------------------------------------------- 31 2.5.8 Clinic Waste and Linen Management --------------------------------------------------------------------- 33 2.6 Safety Responsibilities of Practitioners and Staff ------------------------------------------------------- 34 2.6.1 Training -------------------------------------------------------------------------------------------------------- 34 3 2.6.2 Immunization ------------------------------------------------------------------------------------------------- 34 2.7 Blood-borne Diseases: Precautions, and Exposure Management ---------------------------------- 35 2.7.1 Blood-Borne Pathogens, Exposure Management. ------------------------------------------------------ 35 SECTION 3: RISK MANAGEMENT AND OCCUPATIONAL HAZARDS CONTROL IN THE ACUPUNCTURE CLINIC ----------------------------------------------------------------------------------- 37 3.1 Introduction ------------------------------------------------------------------------------------------------------- 37 3.2 General Considerations. --------------------------------------------------------------------------------------- 37 3.3 Risk Management in and around the Clinic. -------------------------------------------------------------- 38 3.4 Air Quality Control----------------------------------------------------------------------------------------------- 39 3.5 Risk Management: Emergencies. ---------------------------------------------------------------------------- 39 3.5.1 Emergency Actions. ------------------------------------------------------------------------------------------ 39 3.6 Communication with Patients; Patient Records. -------------------------------------------------------- 41 3.6.1 Patient Records. ---------------------------------------------------------------------------------------------- 41 3.6.2 Use, Disclosure and Transfer of Patient Records. ------------------------------------------------------ 44 3.6.3 Patient Records Retention. --------------------------------------------------------------------------------- 44 3.6.4 Electronic Patient Records.--------------------------------------------------------------------------------- 44 3.6.5 Termination of the Practitioner-Patient Relationship. ------------------------------------------------ 45 3.6.6 Informed Consent. ------------------------------------------------------------------------------------------- 45 3.7 Patient Privacy and Duty to Report ------------------------------------------------------------------------- 46 SECTION 4: SAFE PROCEDURES AND RISK MANAGEMENT FOR ACUPUNCTURE AND ACUPUNCTURE RELATED TECHNIQUES ------------------------------------------------------------- 47 4.1 Acupuncture ---------------------------------------------------------------------------------------------------- 47 4.1.1 Introduction: Clean Needle Technique (CNT). ---------------------------------------------------------- 47 4.1.2 Basic Principles of CNT ------------------------------------------------------------------------------------- 47 4.1.2.1 Hand Washing ---------------------------------------------------------------------------------------------- 47 4.1.2.2 Pre-sterilized Disposable Instruments (Needles) --------------------------------------------------- 48 4.1.3 Clean Needle Technique (CNT) Procedure. ------------------------------------------------------------- 48 4.1.4 Acupuncture Treatment in an Unfamiliar Setting. ----------------------------------------------------- 49 4.1.5 Aseptic Technique ------------------------------------------------------------------------------------------- 50 4.1.6 Hygienic and Safe Removal of the Needle --------------------------------------------------------------- 51 4.1.7 Other Equipment --------------------------------------------------------------------------------------------- 51 4.1.8 Managing Needlestick Accidents (see also 2.7.1 Blood-Borne Pathogens, Exposure Management. P.35) ------------------------------------------------------------------------------------------------- 52 4.1.9 Contraindications and Precautions for Acupuncture. ------------------------------------------------- 54 4.1.10 Additional Precautions ------------------------------------------------------------------------------------ 56 4.2 Management of Adverse Reactions to Acupuncture Treatment ------------------------------------ 57 4.3 Moxibustion ------------------------------------------------------------------------------------------------- 62 4.3.1 Introduction --------------------------------------------------------------------------------------------------- 62 4.3.2 Precautions and Contraindications for Moxibustion. ------------------------------------------------- 62 4.3.3 Management of Burns Resulting from Moxibustion. -------------------------------------------------- 63 4 4.4 Cupping and Gua Sha. ----------------------------------------------------------------------------------------- 63 4.5 Plum Blossom Needling, Bloodletting Technique ------------------------------------------------- 63 4.6 Tuina --------------------------------------------------------------------------------------------------------------
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