Infection control, safety, and public health obligations
Standard precautions
The Board expects chiropractic offices to follow current CDC and OSHA standards: hand hygiene before and after every patient, clean tables and equipment between patients, fresh linens or barriers for each patient, and proper handling of blood and body fluids. Staff with direct patient contact need bloodborne-pathogen training and must be offered hepatitis B vaccination.
Equipment and environment
- Disinfect tables, belts, and adjusting instruments with an EPA-registered disinfectant using the labeled contact time.
- Sterilize or use single-use items for any procedure that breaks the skin; dispose of sharps in a rigid container.
- Keep clean and dirty supplies separate.
- Maintain a written exposure-control plan and post-exposure procedures.
Public health duties
- Do not treat a patient with an active transmissible condition that poses an office risk without appropriate precautions; defer and refer when needed.
- Report notifiable communicable diseases as state law requires.
- Follow emergency protocols and keep emergency contact information available.
Worked example
A patient arrives with a draining, uncovered skin lesion on the low back where you would place your hands. Correct answer: do not proceed with skin-contact treatment; defer, refer for medical evaluation, document the decision, and disinfect any surface contacted. Infection control takes priority over completing a scheduled visit, and the record must show why care was deferred.
Traps
- Reusing linens or using one towel as a table cover for multiple patients.
- Cleaning tables only at the end of the day.
- Treating through an undiagnosed rash.
- Having no written exposure-control plan or training records.