Infection Control, Safety, and Mandatory Reporting Obligations
Domain 9 covers the safety obligations attached to every patient encounter and the narrow but strict duties to report.
Infection control
- Use standard precautions with every patient: treat blood and body fluids as infectious regardless of diagnosis. Hand hygiene before and after contact; gloves for contact with non-intact skin and mucous membranes; eye protection when splashes are possible.
- Clean and disinfect tables, belts, weights, and modalities between patients; handle sharps with engineered devices and a defined exposure protocol.
- The OSHA Bloodborne Pathogens Standard imposes employer duties: an exposure control plan, hepatitis B vaccination offered at no cost, training, and post-exposure evaluation. Facility policy applies on top of state licensure rules.
Mandatory reporting
- Child abuse and neglect: Kentucky law imposes a reporting duty on everyone, including health professionals, when there is reasonable cause to believe a child has been abused or neglected. Report to the Cabinet for Health and Human Services or to law enforcement. Good-faith reports carry immunity; failure to report is itself an offense.
- Adult abuse, neglect, or exploitation of an adult with a disability is reportable under the adult protective services statutes.
- Confidentiality is not a barrier: HIPAA permits disclosures required by law.
Worked example
A home health patient has a spiral bruise on the arm and a caregiver who answers every question. Reasoning: the therapist does not investigate or confront; reasonable cause to suspect abuse triggers a report, with the observation documented factually in the record.
Traps
- Waiting to "confirm" before reporting - the standard is reasonable cause, not proof.
- Promising a patient absolute secrecy before a disclosure.
- Assuming infection control belongs only to a designated nurse.