Subject: How to
use Support Personnel for Acupuncture Providers
Details:
If you could have support personnel assist you in your clinic (you are an L.Ac.), what would you have them do? What kind of support would be best for you? What does that look like (think ideal setting)?
Setting: Hospital clinic, outpatient. Imagine you and your clinic are preparing for a Joint Commission visit.
Since the overall scenario is preparation
for a Joint Commission visit, we will first include quality assurance factors and
industry standards.
Second, (and mostly what I want to hear) is what your opinion and ideas or examples are of this. The industry standards (or as much as I have been able to find so far--see below) are minimal.
Definitions
For purposes of this discussion “Acupuncture Providers” are
defined as:
1.
Are the only
personnel who use acupuncture needles or perform acupuncture procedures in the
clinic
2.
Have the following industry standards
in training:
a. Licensed
Acupuncturist. Graduated from an
ACAOM-accredited master’s or doctorate degree program. NCCAOM board certified.
What rules and standards currently govern this? What are some useful examples?
Training:
I. Medical assistant or nurse (RN, nursing assistant, Medic,
Corpsman)
Acupuncture specific training
needed?
No. not trained in an ACAOM-accredited program
(ie, not an Acupuncturist). Staff is
simply training in the usual medical assistant or related nursing program
training in their field, standard.
Duties and/or tasks for being
support personnel include:
(medics, corpsmen, nurses, nursing assistants, or
medical assistant staff who help)
i.
Bring patient to treatment room
ii.
Take vitals
iii.
Record vitals in electronic health record (EHR)
iv.
Set up acupuncture tx room
1. This
may include but is not limited to: set
up clean field, clean cupping supplies, set out and put away other equipment
such as e-stim machines and heat lamps
v.
Stand in/chaperone for provider as needed
vi.
One-on-one care as needed (ex: in high anxiety patients or some patients
with post-traumatic stress symptoms often request to not be left alone in a
room. Other kinds of special
cases. Support personnel may stay/sit in
room with patient while needles are retained during treatment.)
vii.
Clean up tx room post-procedure
As “support personnel”, these personnel would be subject
to the following trainings that may be tied into competencies or SOPs, if your
clinic feels it is necessary:
viii.
Standard precautions
ix.
Biohazard training
x.
Sharps training
xi.
How to set up a clean field (see CNT manual
reference)
xii.
How to store acupuncture needles
II. Acupuncture student (someone currently enrolled in an
ACAOM-accredited program)
Must
have business associate agreement, etc, paperwork on file with appropriate
hospital office for internship, externship, etc, with related school training
program.
Other
rules or regulations that may apply?
What does your support personnel document in the electronic health record (EHR)?
1.What should the support personnel document in the EHR before Acupuncturist arrives? Talk with your Acupuncture providers about what they
want. Recommend a minimum of appropriate
vitals such as: height, weight, blood
pressure, pain level, chief complaint
b. Anything
after visit?
Check
with your Acupuncture provider. He or
she may want to check in on symptom progress, homework, etc.
2. Should support personnel
have competencies to assist in acupuncture?
No. Support personnel should not be assisting
with actual needling. There currently is no standard that supports this.
Use of acupuncture needles must be by trained personnel. Currently the industry standard for trained
personnel is: licensed acupuncturist or
physician who has completed a medical acupuncture program
3. What would be in a pre-procedure checklist?
latest version of the Clean Needle Technique Manual
local hospital policies on handwashing
What other resources would you add?
4.
What would be in a post-procedure checklist?
I recommend the same resources as in #3.
Please write in the comments section other resources you would recommend.
Resources/References
Applying Clean Needle Technique (CNT) in an Acupuncture Treatment*CleanNeedle Technique Manual for Acupuncturists: Guidelines and Standards for theClean and Safe Clinical Practice of Acupuncture. 7th edition.