clinic manual

Question 1

what are the general responsibilities of the observer?

Answer 1

• clean the treatment room before & after each treatment
• supply treatment rooms with suppies like moxa, alcohol, paper gowns, table paper, cotton swabs, cotton balls, linaments
• provide support for the treatment process
• provide support for the clinic process through filling herbal formulas (with supervision)

Question 2

what are the observer’s goals with respect to patient care?

Answer 2

• observe all phases of clinical care & participate under the guidance of the intern & supervisor
• exhibit caring, compassionate, and respectful behaviors in patient care

Question 3

what are the observer’s goals with respect to medical knowledge?

Answer 3

show basic understanding of the 4 examinations, acupuncture point & herb functions, and their application to patients

Question 4

what are the observer’s goals with respect to practice-based learning & improvement?

Answer 4

assess own performance in the clinic for needed improvements, and implement those improvements using appropriate information literacy skills

Question 5

what are the observer’s goals with respect to interpersonal & communication skills?

Answer 5

demonstrate good communication skills with clinic faculty, staff, patients, and other students

Question 6

what are the observer’s goals with respect to professionalism?

Answer 6

demonstrate familiarity with clinic policies, procedures, and paperwork

Question 7

what are the observer’s goals with respect to systems-based practice

Answer 7

demonstrate basic knowledge of practice & delivery systems

Question 8

what are some other requirements concurrent with observation in the clinic?

Answer 8

• complete prerequisite courses
• complete of clinic orientation
• complete HIPAA training
• complete “clinic observer orientation check list” by week 3
• obtain a current 8-hour adult & child CPR and first aid card
• document hepatitis B vaccination or sign waiver

Question 9

what is an informed consent form?

Answer 9

• for new patients, it must be signed by both patient & practitioner prior to the start of treatment
• it clarifies that the practitioner has explained the nature of treatment, the risks of treatment, alternatives to treatment, benefits of treatment, etc

Question 10

what is an arbitration form?

Answer 10

it clarifies that in the case of a dispute, the dispute will be settled via arbitration (as opposed to in court)

Question 11

what is HIPAA?

Answer 11

• stands for “Health Insurance Portability & Accountability Act”
• describes in detail the patient’s rights and the clinic and practitioner’s responsibilities with respect to HIPAA and private health information

Question 12

what are some rules regarding the privacy of a patient’s case or treatment?

Answer 12

• never discuss cases in public areas
• never use patient names or identifying info
• never disclose that a patient is visiting the clinic (other than to your supervisors and/or assistants)
• never share any details about the patient’s condition to clinic staff members

Question 13

if a patient approaches you at a coffee shop, can you mention their case or treatment?

Answer 13

no, unless the patient voluntarily brings it up first

Question 14

can patient charts be removed from the building?

Answer 14

no, they cannot be removed from the building (and they really should not be removed from the clinic floor)

Question 15

can patient charts be photocopied?

Answer 15

no, unless:

• for educational purposes and with proper obscuring of any identifying info
• under subpoena
• under express written consent of patient

Question 16

what must be done when photocopying patient charts?

Answer 16

obscure any identifying information by covering it with opaque material prior to photocopying

Question 17

under what circumstances are PCOM students and supervisors allowed to clinical information?

Answer 17

• to communicate with other health care providers using the same chart to treat a patient
• as a reference for treatment of future illnesses
• as a training tool for student trainees
• to evaluate the quality of patient care through review & analysis
• as a research tool for both educational & treatment development purposes
• for documentation to conform to government regulations
• for follow-up care of patients with long-term illnesses and assessment of efficiency of care given

Question 18

under what circumstances are clinical students allowed to handle patient charts?

Answer 18

• to perform patient intake
• to prepare herbal prescriptions
• to obtain information for educational purposes (need to complete the “chart file request form,” and this can only be done if the intern has been actively involved in the patient’s care)

Question 19

what kind of pen or pencil must be used on medical charts

Answer 19

black ink only (no other color is acceptable; no pencils)

Question 20

T or F: nothing must be left blank on the chart

Answer 20

true (if you don’t have specific data, write NA or explain why)

Question 21

what is the proper way to make a correction on the chart?

Answer 21

• draw ONLY ONE LINE through the error

- then write your initials and the date of the correction

Question 22

T or F: all interactions with patient, including phone & email conversations, must be charted

Answer 22

true - need to fill out the “chart continuation form”

Question 23

as a practitioner, what is the best way to avoid misunderstanding about sexual misconduct?

Answer 23

ask for permission and receive verbal consent before touching near or on any sensitive areas like the lower abdomen, genitals, breasts, or buttocks

Question 24

T or F: observing Universal Precautions means that all needles are assumed to be potential sources of exposure to any known or blood-borne pathogens such as HIV and Hepatitis B or C

Answer 24

true

Question 25

T or F: upon withdrawal, every needle should be immediately placed in a red sharps container

Answer 25

true

Question 26

T or F: it is okay to place used or open packages of needles in the pockets of a lab coat

Answer 26

false

Question 27

T or F: it is okay to reuse needles, even on the same patient

Answer 27

false – only use needles once, even if on the same patient

Question 28

T or F: you only need to wash hands after patient contact

Answer 28

false – hands must be washed before AND after every patient contact (that means before entering the room and after leaving the room, even if you enter and leave 4 times during the course of the treatment)

Question 29

T or F: all points must be cleaned, with special attention to the ear, using 70% isopropyl alcohol before inserting needles

Answer 29

true

Question 30

at what level should the sharps container be sealed & returned to the clinic office?

Answer 30

when it is 2/3 full

Question 31

T or F: notify the front office if you are treating a known MDRO (multi drug resistant organism”), so the patient can be taken to an “isolation” room upon arrival instead of the waiting room

Answer 31

true

Question 32

T or F: it is important to lay out a clean field prior to treatment

Answer 32

true

Question 33

what are some conditions that cannot be treated in the PCOM clinic?

Answer 33

• obstetric conditions
• cancer
• epilepsy
  (to clarify, we can treat symptoms associated with these conditions, but we cannot say we are “curing” the patient)

Question 34

what should you immediately do if the fire alarm goes off?

Answer 34

• remove needles from patient
• if it is a false alarm, check in on patient to let them know they can ignore it, and provide option to remove needles early
• check with your supervisor on next steps

Question 35

what are the steps to take if a needle stick injury occurs?

Answer 35

• immediately clean & decontaminate the affected areas
• disinfect the area with Betadine or another brand of 10% povidone-iodine solution
• immediately call the appropriate number for medical follow-up and consultation (ask front desk for list)
• immediately inform the supervisor and the Center for Disease Control & Prevention

Question 36

what is the most common cause of burns in the PCOM clinic? how do we prevent this?

Answer 36

• improper use of heat lamps is the most common cause of burns
• don’t use a space lamp near the heat lamp
• don’t put the heat lamp too close to the skin
• secure the lamp’s position by properly tightening the nuts

Question 37

T or F: always let patients dress and undress in private, even if they are completely comfortable with you in the room

Answer 37

true – turn your back to them immediately, say “I’ll let you get ready and come back shortly”, then leave the room as soon as you can

Question 38

what are the proper steps to take when you need to needle points on the lower abdomen

Answer 38

• inform the patient you will be needling in their lower abdomen, place a towel across their groin, and ask them to unbutton & unzip their pants
• after they’ve unbuttoned & unzipped, tuck the towel over the top of their pants (but only tuck once)

Question 39

T or F: if a patient acts inappropriately, the practitioner should use appropriate clinical patient management techniques such as not answering personal questions, maintaining appropriate patient-practitioner boundaries, and not accepting gives

Answer 39

true

Question 40

T or F: if a patient acts inappropriately, the practitioner should make sure that he/she is not alone with the patient by asking an observer, assistant, or associate intern to always be in the room

Answer 40

true