Infection Control, Recordkeeping, and Practice Standards
Domain 7 collects the operational standards: how the office controls infection, how records are built, and which requirements attach to equipment and modalities.
Standard precautions
Apply standard precautions to every patient, not just those with known bloodborne disease. That means hand hygiene before and after contact, gloves whenever blood or body fluids may be present, and appropriate gowns, masks, and eye protection. Use single-use items once; disinfect tables and equipment surfaces between patients; handle linens as contaminated; place sharps in rigid containers and manage regulated waste properly. The office needs a written exposure control plan, hepatitis B vaccination offered to at-risk staff, and post-exposure evaluation and follow-up; the federal bloodborne pathogens standard applies to chiropractic offices.
Sterilization
Clean, then disinfect, then sterilize - debris left on an instrument defeats the cycle. Run each autoclave load with a chemical indicator and perform biological spore testing at least weekly, logging every result.
Radiography and equipment
X-ray machines must be registered with the Department of Health and meet the radiation control rules in Chapter 64E-5, F.A.C.; personnel monitoring badges and documented technique charts are part of that compliance. Every image needs a written interpretation in the record.
Recordkeeping standards
Entries must be contemporaneous, legible, patient-identified, and signed and dated with credentials. Capture chief complaint, history, examination, diagnosis, plan, modality parameters, response, referrals, and consent.
Worked example
A weekly spore test comes back positive. Reasoning: sterilization has failed and nothing processed in that unit is sterile, so stop using the autoclave, quarantine or reprocess affected items, have the unit serviced or recalibrated, retest until results are negative, and document the whole sequence. Continuing to use it while "watching" the next test is the failure mode examiners test.
Traps
- Equating wiping a table with disinfection or sterilization.
- Assuming gloves replace hand hygiene.
- Charting "treatment as tolerated" with no parameters, response, or objective findings.