CLINIC POLICIES AND CLINIC POLICIES AND PROCEDURESPROCEDURES

For Beginning Graduate StudentsFor Beginning Graduate Students

CLINICAL SERVICESCLINICAL SERVICES

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

Hearing services includeHearing services include

Hearing screeningsHearing screenings Hearing testing and counselingHearing testing and counseling Hearing aid evaluation and counselingHearing aid evaluation and counseling Hearing aid sales, orientation, and Hearing aid sales, orientation, and

repairrepair Speechreading and auditory trainingSpeechreading and auditory training Speech and hearing conservationSpeech and hearing conservation Individual and family counselingIndividual and family counseling

Speech-language services Speech-language services includeinclude Speech and language testing forSpeech and language testing for Sound production problemsSound production problems Voice disordersVoice disorders Fluency disordersFluency disorders Language delays and disordersLanguage delays and disorders Swallowing and other oro-Swallowing and other oro-

pharyngeal disorderspharyngeal disorders Speech and language therapySpeech and language therapy

Settings for our servicesSettings for our services

ASU Communication Disorders ASU Communication Disorders ClinicClinic

Watauga Medical CenterWatauga Medical Center Two Rivers SchoolTwo Rivers School Foothills Correctional InstituteFoothills Correctional Institute

Other settings we useOther settings we use

Watauga County Schools Watauga County Schools Alexander County SchoolsAlexander County Schools Burke County SchoolsBurke County Schools Caldwell County SchoolsCaldwell County Schools North Carolina School for the North Carolina School for the

DeafDeaf

Other settings we useOther settings we use

Blue Ridge Speech Pathology – Blue Ridge Speech Pathology – childrenchildren

Guardian Healthcare – adultsGuardian Healthcare – adults J. Iverson Riddle Developmental J. Iverson Riddle Developmental

Center – adultsCenter – adults Wilkes Senior Village – geriatricWilkes Senior Village – geriatric Aegis – geriatric adultsAegis – geriatric adults

HIPAAHIPAA

FEDERAL LAWFEDERAL LAW

ASHA Code of EthicsASHA Code of Ethics

Individuals shall honor their Individuals shall honor their responsibility to hold paramount responsibility to hold paramount the welfare of persons they the welfare of persons they serve professionally.serve professionally.

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

The client charts are protected The client charts are protected by:by:

ASHA Code of EthicsASHA Code of Ethics State LawsState Laws Federal Laws (HIPAA)Federal Laws (HIPAA)

Client charts contain Client charts contain protected health protected health

information.information.

Which is any health information Which is any health information that identifies a client.that identifies a client.

Each client in the Clinic Each client in the Clinic has a chart.has a chart.

Student clinicians are responsible Student clinicians are responsible for helping to maintain these for helping to maintain these

charts.charts.

Each chart is arranged Each chart is arranged in chronological orderin chronological order

And all charts must contain And all charts must contain specific information.specific information.

Clear and Comprehensive Documentation Clear and Comprehensive Documentation is needed in each chartis needed in each chart

To justify need for treatmentTo justify need for treatment To document the effectiveness To document the effectiveness

of treatmentof treatment To have a legal record of eventsTo have a legal record of events

Client records Client records are are

confidentialconfidential..

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

Client records are not to be Client records are not to be taken out of the Clinic areas.taken out of the Clinic areas.

They must be protected at all They must be protected at all times.times.

Areas interpreted to be in the Areas interpreted to be in the “Clinic:”“Clinic:”

Designated treatment rooms Designated treatment rooms assigned to the clinicassigned to the clinic

Student Prep RoomStudent Prep Room Professional staff officesProfessional staff offices Student LoungeStudent Lounge

A chart must never be A chart must never be left unattended.left unattended.

If a student must leave the clinic If a student must leave the clinic area, return the chart!area, return the chart!

Do not scratch out information Do not scratch out information if you make a mistake in the if you make a mistake in the client record.client record.

Draw a single line through the Draw a single line through the error.error.

Write “Error.”Write “Error.” Initial the mistake.Initial the mistake.

The penalties for a breach of The penalties for a breach of confidentiality are severeconfidentiality are severe

Student could receive a Student could receive a reprimand.reprimand.

Student could receive a lower Student could receive a lower grade for class.grade for class.

Student could be removed from Student could be removed from the clinic setting totally (resulting the clinic setting totally (resulting in a failing grade).in a failing grade).

QUESTIONS?QUESTIONS?

INFECTIONINFECTION

CONTROLCONTROL

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

What can be done to prevent What can be done to prevent the transfer of infectious the transfer of infectious pathogens in the health care pathogens in the health care workplace?workplace?

Constant cleaning of equipment, Constant cleaning of equipment, furniture and common use items and furniture and common use items and surfacessurfaces

Consistent use of barrier precautions Consistent use of barrier precautions and protective equipmentand protective equipment

Frequent handwashingFrequent handwashing

What are Bloodborne What are Bloodborne pathogens?pathogens?

Pathogenic microorganismsPathogenic microorganisms Present in human bloodPresent in human blood Can cause disease in humansCan cause disease in humans Include, but not limited to:Include, but not limited to:

Hepatitis B (HBV)Hepatitis B (HBV) Hepatitis C (HCV)Hepatitis C (HCV) Human Immunodeficiency Virus Human Immunodeficiency Virus

(HIV)(HIV)

Universal precautions vs Universal precautions vs Standard precautionsStandard precautions

Universal precautions – treating Universal precautions – treating all patients the same, all blood all patients the same, all blood and other potentially infectious and other potentially infectious material as if infectious.material as if infectious.

Standard precautions – treating Standard precautions – treating all body fluids as if infectious all body fluids as if infectious (ASU’s recommended practice)(ASU’s recommended practice)

Bloodborne pathogen Bloodborne pathogen transmissions aretransmissions are

Highly preventable throughHighly preventable through Common senseCommon sense Universal or standard precautionsUniversal or standard precautions Not sharing personal itemsNot sharing personal items Barrier methods for sexBarrier methods for sex Eliminating needle sharingEliminating needle sharing

Treat all human body fluids as Treat all human body fluids as potentially infectiouspotentially infectious

Preventative measuresPreventative measures

HandwashingHandwashing

Most effective method to Most effective method to prevent transmission of illnessesprevent transmission of illnesses

Wash hand thoroughly even if Wash hand thoroughly even if wearing gloveswearing gloves

Pay special attention between Pay special attention between fingers and around nailsfingers and around nails

Wash for 30 secondsWash for 30 seconds Let water run down toward Let water run down toward

finger tipsfinger tips

HandwashingHandwashing

Use paper towel to turn off water Use paper towel to turn off water and open doorand open door

Don’t touch sides of sinkDon’t touch sides of sink If wearing re-usable gloves, wash If wearing re-usable gloves, wash

and disinfect before removing and disinfect before removing from handsfrom hands

If water not available, use If water not available, use waterless antiseptic hand waterless antiseptic hand cleaner, until you can washcleaner, until you can wash

General PrinciplesGeneral Principles

It is prudent to minimize all It is prudent to minimize all occupational exposure to human occupational exposure to human body fluids.body fluids.

Risk of exposure should never be Risk of exposure should never be underestimated.underestimated.

Facilities should institute as many Facilities should institute as many controls as possible to eliminate controls as possible to eliminate or to minimize exposure to or to minimize exposure to bloodborne pathogens.bloodborne pathogens.

Personal protective equipment Personal protective equipment (PPE)(PPE) Must be provided to you at no Must be provided to you at no

cost, including trainingcost, including training Impermeable gloves are used Impermeable gloves are used

anytime you might contact body anytime you might contact body fluids, avoid vinyl gloves (allows fluids, avoid vinyl gloves (allows tiny holes)tiny holes)

Goggles should be worn if in Goggles should be worn if in danger of splashing of body danger of splashing of body fluids or when mixing and using fluids or when mixing and using disinfectant solutionsdisinfectant solutions

GlovesGloves

LatexLatex NitrileNitrile ChloropreneChloroprene Avoid vinylAvoid vinyl

Other personal protection Other personal protection equipment includesequipment includes

Surgical masksSurgical masks Face splash shield/goggles/eye Face splash shield/goggles/eye

protectionprotection Lab coat/gownLab coat/gown Rubber or nitrile apronRubber or nitrile apron Disposable booties or rubber Disposable booties or rubber

bootsboots

Recognizing tasks that may Recognizing tasks that may be hazardousbe hazardous

Oral-facial examinationsOral-facial examinations Changing diapers in the PLCCChanging diapers in the PLCC Cleaning “mouthed” toysCleaning “mouthed” toys Use of Use of Nasometer, Nasometer,

Videostroboscopy, or Videostroboscopy, or LaryngographLaryngograph

Handling hearing aidsHandling hearing aids

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

If eyes, nose, or mouth If eyes, nose, or mouth are splashedare splashed

Irrigate with large amounts of Irrigate with large amounts of water for 15 minuteswater for 15 minutes

If an exposure occurs to the If an exposure occurs to the hands or skinhands or skin

Wash area for at least 30 Wash area for at least 30 secondsseconds

Rinse with running water for at Rinse with running water for at least 10 secondsleast 10 seconds

QUESTIONS?QUESTIONS?

PROFESSIONALPROFESSIONAL

DRESSDRESS

Students are expected to dress for Students are expected to dress for a professional environment.a professional environment.

Clothing should not be Clothing should not be potentially embarrassing.potentially embarrassing.

Shoes or sandals must be worn.Shoes or sandals must be worn. Casual shorts, blue jeans, halter Casual shorts, blue jeans, halter

tops, and T-shirts are not tops, and T-shirts are not permitted.permitted.

Clinical educator has the final Clinical educator has the final word concerning dress.word concerning dress.

All students must wear All students must wear name tags.name tags.

Including participant observers.Including participant observers.

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

EXPECTATIONSEXPECTATIONS

FOR PRACTICUMFOR PRACTICUM

The first practicum experience The first practicum experience should be a relatively easy one should be a relatively easy one

with ASU clinical personnel.with ASU clinical personnel.

You should complete:You should complete:

Speech and language therapy Speech and language therapy hourshours

Some speech and language Some speech and language diagnostic hoursdiagnostic hours

Aural rehab/hearing screening Aural rehab/hearing screening hourshours

Subsequent semesters Subsequent semesters should progressively should progressively

become more demandingbecome more demanding

And students should demonstrate And students should demonstrate more independence.more independence.

BY the time you reach the BY the time you reach the third semester of clinicthird semester of clinic

You should be responsible for You should be responsible for establishing your own independence.establishing your own independence.

..

Inclement weather Inclement weather policypolicy

Check with your clinical educator Check with your clinical educator at the beginning of the semester at the beginning of the semester for the options that you should for the options that you should

consider.consider.

Students are responsible Students are responsible for placing important for placing important

information in their files.information in their files.

Files are located in the clinic Office.Files are located in the clinic Office.

Student files (in the Clinic) Student files (in the Clinic) should contain:should contain:

Clock Hours – Keep an Extra Clock Hours – Keep an Extra Copy!Copy!

TB Test within one yearTB Test within one year Confirmation of HIPAA, infection Confirmation of HIPAA, infection

control, & CPR trainingcontrol, & CPR training Student evaluation (grade) Student evaluation (grade)

informationinformation Insurance confirmationInsurance confirmation

Student files (in the Clinic) Student files (in the Clinic) should contain:should contain:

Confidentiality statementConfidentiality statement Criminal background checkCriminal background check Speech prerequisite results Speech prerequisite results

(sign up today)(sign up today)

The Clinic Office also The Clinic Office also maintains contact information maintains contact information on every graduate student in on every graduate student in the Communication Disorders the Communication Disorders Program.Program.

QUESTIONS?QUESTIONS?

Purchases you need to make Purchases you need to make before the beginning of clinicbefore the beginning of clinic

Name badgeName badge LanyardLanyard CPR trainingCPR training InsuranceInsurance Criminal background checkCriminal background check

$95.00$95.00

For any questions For any questions concerning policies and concerning policies and

proceduresprocedures

Check Check www.cdclinic.appstate.edu