Dana Carruth

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COVID 19 Safety Precaution Plan
Awaken Acupuncture – Ithaca, NY

 

Name of Business: Awaken Acupuncture

Industry Category for Reopen Phase:  Phase 2 professional services / Healthcare Services

Business structure: Sole-Proprietor

Number of Employees: 1

Protection for employees and patients

Describe adjustments to hours of operations and shift design to reduce the density of people in the office.

New hours of operation for seeing patients will include shifts with significant breaks between them.  Monday 11am-12:30pm, 12:30pm-2pm, 3pm-4:30pm. More hours may be added over time. These shifts will allow for patients to be appropriately staggered across 2 separated treatment rooms in shifts with time at the end of the shift to thoroughly clean all 2 rooms before the next round of patients arrive.  

Describe additional social distancing protocols implemented for employees (consider office workspace, interaction with patients, schedules,…)

I am self-employed with no other employees.  As I share an office with another business owner (a solo therapist who is using a similar plan), our workspaces will be separated by a minimum of 6 feet, which is able to be accomplished with our current behind-desk layout.  A 2nd desk has been set up in a treatment room for me to use when empty of patients to work on completing charts and other paperwork away from the public and other business associates. 

Tape on the floor at the reception desk has been applied to show the 6 foot mark between me behind the desk and patients to stand behind until their turn to check-in/out as needed.  

Online scheduling, invoicing and payment options have been instituted to reduce the need for patients to approach the desk for long periods and reduce social interaction between employees and patients..  

An area on the counter of the desk has been taped to show where on the desk patients should touch, and a sign posted to prompt them not to place items outside of the reduced surface area delineated.  

Practitioners and patients will be required to wear appropriate masks at all times when interacting with each other in both treatment rooms and at the reception desk.  

Describe additional social distancing protocols implemented for patients (consider waiting and reception areas, bathrooms, treatment spaces, scheduling, payment methods…)

When patients arrive at the office, they will immediately wash/sanitize their hands, take a disinfectant towel and go to their assigned and clearly marked treatment room for screening, thus eliminating time in the waiting room area prior to being seen.  

Patients who have finished their appointments, may leave the office after washing/sanitizing their hands. Patients may reschedule themselves online at awakenacupunctureithaca.com.  All unnecessary items have been removed from the waiting room and we ask you only sit where indicated by signage. Thank you.

Patients will be asked to utilize the bathroom only if needed, and directed to indicate with a flip sign that the bathroom has been used and needs to be re-cleaned when finished.  

Treatment rooms are single occupancy and not shared with multiple patients.  Rooms will be thoroughly cleaned and disinfected between patients. 

As indicated above, masks for practitioners and patients are required at all times, check-in/out procedures, scheduling, and invoicing/payments have been switched to online methods to reduce time at the front desk, and taped designated areas with delineated reduced surface areas and distances from the reception desk have been clearly marked for patient occupancy.  

Describe methods implemented to reduce, limit, or otherwise restrict non-essential travel for employees (consider work-from-home options, inter-office travel for multiple locations, schedules…)

This is a single-office practice and there is no travel expected during the work shift.  

I also have a home-office set up to do much of my administrative work from home as applicable.  Home office hours will include tasks including pre-screening, scheduling, and discussions with patients about their treatment plans and progress to reduce intake time during face-to-face interactions.  

Describe changes to service delivery implemented to reduce patient travel and time physically in the office. (Consider telehealth options, online invoicing/payment/scheduling…)

Phone calls, telehealth and zoom video call methods will be used as possible for patient consults and intakes prior to physical appointment times to reduce necessary face-to-face time in the treatment rooms.  

A dropbox system has been instituted for patients to pick up herbal prescriptions.

Changes to Physical Workspace

Describe policies for the use of Personal Protection Equipment (PPE) to be used by employees (masks, gloves, office clothing,…) while in the office.

Masks – practitioners will wear either N95/KN95 masks (as available) or disposable surgical masks at all times when interacting with others in the office, patients or associates.  Patients will be required to also wear a mask at all times when interacting with practitioners.  They may utilize home-made cloth masks, disposable surgical masks which will be provided to them if they do not have their own upon arrival.   

Gloves – as per CNT, CDC, and OSHA guidelines, acupuncturists are not required to wear gloves to perform acupuncture, and in fact, they could be a source of contamination and interfere with proper needling technique.  Therefore, gloves will not be used during the acupuncture treatment, but practitioners will engage in proper hand washing hygiene before and after each treatment and utilize Clean Needle Techniques outlined in the CNT Manual.  Gloves will be worn while cleaning/disinfecting the treatment rooms and office area, and while managing laundry.  

Eye protection – safety glasses may be used during acupuncture treatments.

Practitioners will wear clean, freshly laundered clothing each day at work.  Scrubs will be used as a uniform.  Scrubs/office clothing will be laundered at the end of the day. Lab coats or surgical gowns are not required for the risk level associated with private acupuncture practices.

Describe specific plans for appropriate cleaning and sanitation protocols (references to regulatory authorities related to the Acupuncture Industry and local health department requirements as appropriate are helpful. Consider cleaning of surfaces, treatment spaces, bathrooms, equipment, office spaces, air quality, laundry, etc.  Provide attachments for checklists used to document sanitation as appropriate for the office).

Cleaning and sanitizing protocols are in place in accordance with the recommendations outlined by the CCAOM Clinic Infection Control Advisory 2020, which references current CDC guidelines as well.  

Between each patient: 

  • Surfaces in treatment rooms, waiting room, reception area and bathroom will be cleaned and sanitized between each patient using EPA-approved disinfectants used with proper contact and dwell times.
  • Treatment tables are covered with cleanable, vinyl covers that are disinfected between each patient and covered with table linens that are changed between each patient following proper laundry protocol (see attachment).  
  • Checklists for treatment room and bathroom cleaning/sanitizing will be utilized and initialled after each cleaning session, and filed in office records for documentation.  (See attachment). 
  • Decorative rugs, drapes, and textile decorations in the treatment rooms have been removed.

Daily: 

  • Carpeted reception area cleaned with appropriate EPA-approved cleaner and vacuumed.  Vinyl plank floors in the treatment rooms and tile floors in the bathroom will be mopped daily and between patients as required with EPA-approved cleaner.   

Describe hand-washing policies for employees and patients.

Patients and Practitioners are required to wash hands immediately upon entering the facility, after treatment, after using the bathroom facilities, and before/after doffing/donning their mask.  Practitioners additionally must wash hands or use sanitizer upon entering and leaving the treatment room, before and after treatment applications, before and after donning/doffing gloves, and before and after cleaning activities.  

Posters/signs are posted at entry, front desk and bathroom to educate all on proper hand hygiene. (See handout)

Processes to meet changing public health obligations

Describe pre-screening and day-of-appointment screening processes for employees and patients implemented to identify potential cases of COVID-19 (include attachments of scripts, checklists or protocols used in the office as appropriate).

Pre-screening:  Patients will be called 48 hours prior to appointments to confirm appointment and engage in pre-screening using attached script and checklist (see attached) as recommended by the CDC.  Pre-screening checklists will be signed and uploaded to the patient chart for the appointment or stored in a daily pre-screening office file.  

Day-of-Appointment Screening:  Upon arrival, patients will be immediately screened for symptoms of illness using the attached screening checklist which includes body temperature with a forehead thermometer, oxygen saturation levels with a pulse oximeter, and questions about presenting signs or symptoms (see attached) as recommended by the CDC. Screening checklists will be uploaded for  documentation on the patient’s chart.  

Describe policies in place for employees and patients who do not pass pre-screening or screening protocols upon arrival (include resources given for contacting further medical care as appropriate and consider appropriate time-lines for individuals to be able to return to the office). 

Patients who do not pass one or more items on the pre-screening or screening checklist will be instructed that their appointment must be rescheduled and referred to their primary care physician (PCP) for evaluation.  If the patient does not have a regular primary care provider, they will be referred to their local county health department and/or the NY COVID website and hotline (1-888-364-3065).  Patients will be followed up with via phone call to confirm contact with medical services has happened within 48 hours. 

Patients will be given a report of findings from the screening to bring to their medical evaluation (see attached).

Patients will be given an educational handout about COVID19, and resources for self care (see attached). 

Patients will be informed of the earliest date recommended for them to reschedule their appointment, and this date will be documented as a red flag in the patient’s chart to prevent premature rescheduling. 

Describe sick-leave policies for employees. 

As a solo practitioner who is self-employed, I do not receive paid “sick-leave”.  

I will self-screen daily using the same screening checklist I use for my patients.  If at any time I develop symptoms or have a suspected exposure to COVID 19, I will immediately cancel scheduled patients until I can be appropriately evaluated and/or tested.  I will cancel appointments for the duration of time indicated by my PCP and the CDC depending on evaluation results.  

Describe methods and resources used to remain current on local mandates and requirements.

Daily checks of the NY Coronavirus 19 webpage.

Daily checks of the Tompkins County Health Department page

Frequent checks of resources provided by state and local professional organizations

Frequent review of CDC and OSHA guidelines 

Describe resources used to educate employees and patients of the policies, circumstances, risks, and liabilities surrounding COVID19 and other infectious diseases (include documents, website links, postings, and handouts as appropriate).  

All Patients, new and current, will receive and sign the COVID19 Treatment Waiver (see attached). 

Patient Handouts are developed and available for distribution as needed including the resource websites and documents developed by the CDC, and NY.gov (see attached)

Educational Signs are posted in waiting room, treatment rooms, bathroom, and at the reception desk as appropriate(see attached)

Copies of this plan are readily accessible upon request by patient or official, as well as posted on the Awaken Acupuncture website

Describe policy for frequency of review of this Safety Precaution Plan.

This plan will be reviewed by me weekly during the official time of pandemic classification by NYS.  Once this pandemic period is over, this plan will be reviewed annually in the fall of each year to prepare for the typical upcoming cold and flu season.  This plan will be initialled and dated with each review and/or reprinted with a  “Last reviewed” statement date on the plan for review documentation.

References used in this Safety Precaution Plan

Attached Resources

*This document is a living plan, intended to be reviewed regularly and subject to change according to the changes in the environment and local, state, and national regulations.