Infection Control, Safety, and Jurisdictional Requirements
This domain tests the everyday safety standards a DC clinic must meet: standard precautions, correct levels of reprocessing, sharps and exposure management, and the regulatory layers that apply on top of clinical technique.
Standard precautions
Hand hygiene before and after every patient contact and after glove removal. Gloves are worn for anticipated exposure and never substitute for hand hygiene. PPE is matched to the task. Respiratory etiquette applies. Sharps are handled safely, with no hand recapping. Spill kits are used for blood and body fluids, and soiled linen is handled away from the body.
Cleaning, disinfection, sterilization
Classify by the Spaulding scheme: non-critical items that touch intact skin - treatment tables, bands, walkers - need low-level disinfection; semi-critical items that touch mucous membranes need high-level disinfection; critical items entering tissue need sterilization. Always observe the manufacturer's contact time, because a wipe that dries in ten seconds has not disinfected. Single-use items such as needles and electrode pads are never reused across patients, and gel should not be dipped into from a shared container.
Exposure and safety
For a needlestick or splash: wash with soap and water, do not scrub or squeeze, report immediately, obtain source evaluation, and start HIV post-exposure prophylaxis as soon as possible, ideally within hours. Confirm hepatitis B status. Document the incident.
Jurisdictional layer
DC Health oversees practice, and the OSHA bloodborne pathogens standard applies to the clinic. Add electrical safety around modalities, emergency plans, and internal incident reporting.
Worked example
Mid-session, a PT finds a blood spot on a resistance band. Correct handling is to remove the band from circulation, clean it with an appropriate disinfectant at the labeled contact time or discard it, perform hand hygiene, and then continue care. Wiping it with a dry towel and carrying on is a break in standard precautions and a documented risk to the next patient.
Traps
Believing gloves eliminate the need for hand hygiene; disinfecting a surface and using it immediately; overfilling a sharps container; reusing single-use electrode pads between patients; assuming a visibly clean table is disinfected.