CITCM Student Clinic Changes

January 2014

Resolving Bottlenecks

Intern’s Role: Concise Tx Presentations, positive findings only, focus on CC, most effective point combinations for treatment, new patient tx record

Supervisor’s Role: keep presentation on task, be professional but brief in treatment room, patient interviewing is the student’s role.

Administrative Changes: Assigned Rooms, staggered starts (February onwards)

Paperwork

Clinic Hours - hours will be confirmed using new clinic hours tracking sheets, these audited records will be kept on campus and an official record will be generated for your clinic hours requirements.

We are currently, confirming hours with a focus on second year to determine, who is eligible to begin treating patients as Interns

(Record of completion of observation hours).

Sign-off sheet for hours

See sample in Clinic

Record of Completion

This document is awarded to Second Year students who have completed 180 Student Clinic Hours. See Janice if you need to verify hours to receive it

Hours this semester

First Year: (60) 4 hrs/wk = 1 shift Second Year: (60) 4 hrs/wk = 1 shift Third Year: (120) 8 hrs/wk = 2 shifts Fourth Year: (150) 12.5 hrs/wk = 3 shifts

Make-up hours would be in addition to these times. Catch up now it only gets harder as you progress in years.

Paperwork cont’d

Location change: Paperwork you need for appointments will be kept in file folders in the case presentation area so that the front desk isn't overwhelmed with groups of students.

Check-list for room clean up and transition. Review after every appointment. Interns will help when time is available, observers will ensure room transition is completed properly.

Room Checklist

Paperwork cont’d

Sign-in sheets- please ensure you sign-off on your hours using the official record at every shift.

New format for the patient record, it is structured around reinforcing knowledge required for passing the Pan Canadian Exam. If used properly, it should also help with being concise in case presentations.

Patient Record

See sign off sheet in clinic. Changes to this form are expected, please use it for a few weeks and share feedback and suggestions.

Paperwork cont’d

Your CITCM Student Clinic Record Book...What should you do with it?

Keep using it to fill out your case study information. You can continue to record your hours to keep your own personal record. Expect some additional paperwork to be implemented later in the semester related to preparing for the Board Exam.

Legalities

Privacy barrier - Addressing patient confidentiality and privacy concerns, while doing case presentations.

Signature sheets - so we have a permanent record of who used patient files and performed treatment. Please sign if you haven’t already.

Intern Responsibilities

Be Professional in demeanor and attire. Know your limits. Request Supervisor

assistance or observation if needling an area that you are not comfortable with (for example: GB20, CV22, eye points).

Patient Interviewing is your responsibility; take clear, concise, legible notes. Remember to sign any treatment records that you work on. The Patient Record is a legal document.

Intern Responsibilities cont’d Patient Case Presentations to the Clinic Supervisor. Be focused;

summarize your symptoms and signs including your thoughts on Syndromes, Diagnosis and Treatment points.

Second Year Interns, final treatment points selected will be determined by the Clinic Supervisor for Second.

Third Year Interns suggest treatment plan. A Supervisor may suggest alternate points for treatment.

Fourth Year Interns are expected to come up with treatment plans that they can explain and defend to the Clinic Supervisor.

(Remember you are practicing under the Supervisor’s license.)

Intern Responsibilities cont’d Patient treatment. You may be partnered with

another Intern, find an effective professional way of communicating with each other during patient treatment.

If partnered, only one person needle at a time. May request that an Observer assist with room

transitions, room stocking and clean-up to maintain your patient appointment timing. Remember, Observers are there to assist with Clinic flow. However, if you have time, work together to complete these tasks. Maintaining a professional clinic environment is part of your job too.

Intern Responsibilities cont’d

Share your knowledge and mentor. In a professional manner you can explain the treatment; what and why you are performing certain tasks to the patient and Observers in the treatment room.

Report any incidents or irregularities during treatment or appointments to the Clinic Supervisor, immediately.

Record your Intern hours and have them signed off.

Interns Don’t

This is a TCM and Acupuncture Student Clinic, therefore the modalities you use in treatment will be those that you are training for and are being evaluated on at CITCM. Other modalities of treatment are not appropriate to use in Student Patient Clinic, even if you are a trained therapist in other techniques.

Referrals are not made without consultation with the Clinic Supervisor. All referrals must be documented in the patient record.

Point Location Incorrect location = poor treatment = poor pass rate

Restructuring for success on the regulatory exams. Written CITCM results were the best in the Country! (75% pass rate)

Alberta is poor across the province with point location. (only 45% pass rate)

We are going back to basics, stickers, stickers, stickers! If you’re not sure, look it up before you go in or ask CS and they

will show you on the model.

Supervisor Responsibilities

Creating a positive learning environment Positive interaction with students and limited

interaction with patients Preserving patient confidence in interns Keeping instructional opportunities and

discussion outside of treatment rooms Checking points, supervising cautionary

points.

Do No Harm!

Infection Control Patient Safety Accurate point location Proper Technique

Breaking the Chain of Infection

Vulnerable Host – immunization, treatment Infectious Agent –clean/disinfect Reservoir – people, water, equipment Portal of Exit – droplet secretions Transmission –contact (direct, indirect,

droplet, airborne) Portal of Entry – wound care, gloves

Handwashing

http://www.toronto.ca/health/cdc/resources/pdf/handwashing_poster.pdf

Personal Protective Equipment

Gloves (Donning and Doffing) Masks Glasses Lab Coats

CITCM and The Flu

H1N1 concerns, pandemic strain There are over 1,000 confirmed cases in Alberta. 10 confirmed deaths. At this point, Alberta Health Services is now

assuming all cases of the flu are of the H1N1 pandemic strain. We are just at the beginning of the flu season, and can expect to see many more cases.

If you are ill with flu like symptoms, you will be asked to leave the school.

H1N1 cont’d

In the clinic: Infection control is of primary importance. Be diligent with hand washing, the use of hand sanitizer and disinfection of surfaces and areas of contact. If a patient is displaying signs of the flu, have them wear a mask for the duration of the appointment.

Prevention is the best defense. Respiratory Etiquette, vaccinations and anti-

viral formulas.

Common Signs & Symptoms

Common Symptoms: Cough and fever that comes on quickly, feeling tired, body ache, sore throat, runny nose, headache, not being hungry.

For a child with the flu, also be aware if they are not eating or drinking enough, not waking up and interacting with others, and is irritable, not wanting to be held.

Contact Albert Health link ; Toll-free: 1-866-408-5465 (LINK)

Edmonton: 780-408-5465 (LINK) Calgary: 403-943-5465 (LINK)

H1N1 Serious Symptoms: Emergency

Send to Emergency SOB, rapid breathing, or difficult breathing,

chest pain, sudden dizziness or confusion, severe or continued vomiting, high fever lasting more than three days.

Dresscode

Reminders on professionalism and safety- hair don’t touch it, - Professional attire (no yoga pants, t-shirts, jeans, short skirts) see student handbook for complete list of expectations. If you are not professional, you may be asked to leave clinic and change. Please come prepared.

Labcoats and Name Tags No boots or outdoor footwear in clinic

Other Duties

Supervisor requests Down-time list

Safety Committee

This semester will be starting safety committee.

Representatives and Alternates

Lunch and Learn Sessions

Infection Control in the Clinic Thursday, January 23 @ 12:30 Monday, January 27 @ 12:30

Both sessions will be the same. Try to attend one, you will receive Clinic Hours for attending.

Conclusion

Be respectful Be professional Be safe

Questions??