2016英文版洁针考试操作标准.pdf

CCAOM CNT Practical Exam Script but they will fail the practical if they receive another score of “1” during the exam. When fixing an error, the candidate actually needs to fix the error and not just state what they did wrong. Note: A candidate can theoretically pass the practical exam with all “1s with fixes”. 2 = Step was successfully completed. Step 1 Examiners instruction: “Show me your travel kit, set up your equipment and prepare any two points on your leg for the insertion of acupuncture needles. Tell me when you are ready for the next step.” Candidates response: A. Opens kit, shows content of each bag and items not in bags to examiner. B. Washes hands. C. Sets up the clean field, including needles, skin preparation supplies, cotton balls and any other clean items needed to needle the points. Sets up trash bag and sharps container. D. Moves clothing as needed for preparation of insertion site. E. If clothing has been moved or hands otherwise contaminated, washes hands. F. Cleans insertion sites as needed. If using alcohol to clean the insertion sites, allows the alcohol to dry. Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) A. Opens kit, shows contents of each bag and items not in bags to examiner. All of the following must occur: all required items are in kit all items fit easily inside sharps container and labeled waste bag are in separate sealable (ziplock) bags tweezers and hand cleanser are not in bags All required items are in kit, but one of the following errors is made: tweezers are inside a bag hand cleanser is inside a bag trash bag not labeled or labeled incorrectly sharps container lid not completely secure Any of the following errors are made: items are missing from kit wrong items are in the “clean”, “trash”, or “sharps” bags the sharps container is not in a bag sharps container lid fully open candidate cannot accurately identify items in kit two or more of the errors listed under “minimally acceptable” are made 0 1 1 with fix 2 Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) B. Washes hands. Washes hands with soap and water if available, using the procedures outlined in the Manual; or, if soap and water is not available, uses hand cleanser and rubs hands until dry. No more than one of the following errors is made: uses hand cleanser when soap and water is available uses insufficient amount of hand cleanser does not rub hands until completely dry washes hands with soap and water but does not scrub hands for at least 10 seconds washes hands with soap and water but turns off faucets with clean hands Either of the following occurs: candidate does not wash hands two or more of the errors listed under “minimally acceptable” are made 0 1 1 with fix 2 C. Sets up the clean field, including needles, skin preparation supplies, cotton balls, and any other clean items needed to needle the points. Sets up trash bag and sharps container. Sets everything up without any errors. No more than one of the following errors is made: sets out an insufficient number of needles trash bag or sharps container too close to or touching the edge of the clean field cotton balls or skin cleanser missing alcohol prep pad missing Any of the following occurs: clean field material is contaminated any major component missing (sharps container, trash bag, needles, clean field) two or more of the errors listed under “minimally acceptable” are made 0 1 1 with fix 2 D. Moves clothing as needed for preparation of insertion site. (Note: A site on the leg is preferred, but If, for religious or cultural reasons, a candidate is unable to utilize a point on their leg, they have the option of utilizing another area of the body.) Sufficient amount of skin is exposed to allow for clean insertion of two needles. Either of the following occurs: such a small amount of skin is exposed that it would be difficult to place two needles without either hands or needles touching the clothing clothing is moved in such a way that it is likely to move back to original position Insertion site remains covered with clothing. 0 1 1 with fix 2 Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) E. Washes hands if clothing has been moved or hands otherwise contaminated. If hand washing is needed, uses hand cleanser and rubs hands until dry, or washes hands with soap and water using the procedures outlined in the Manual. If hand washing is needed and any of the following occurs: uses insufficient amount of hand cleanser does not rub hands until completely dry washes hands with soap and water but does not scrub hands for at least 10 seconds washes hands with soap and water but turns off faucets with clean hands The candidate fails this step (receives a score of 0) only if hand washing is necessary but is not done. 0 1 1 with fix 2 F. Cleans insertion sites as needed. If using alcohol to clean the insertion sites, allows the alcohol to dry. (Note: Insertion sites must be visibly clean, but it is not required that sites be cleaned with alcohol or another preparation prior to needle insertion. If a candidate so chooses, they may state that the site was recently cleaned with soap and water.) One of the following must occur: selected skin site is clean (student explicitly states that the skin is clean) if skin is cleaned with alcohol, skin is completely dry before candidate indicates readiness for next step Either of the following occurs: selected points are probably clean (student did not explicitly state that the skin was clean, but there is no evidence it is dirty) if skin is cleaned with alcohol, the skin is not completely dry before candidate indicates readiness for next step Selected points are clearly contaminated and are not cleaned. 0 1 1 with fix 2 Step 2 Examiners instruction: “Please insert one 1-inch long needle (approximately 30 mm) and one 1.5 inch long needle (approximately 40 mm) into the two points you have selected and prepared. Once inserted, please rotate each needle no more than 360 degrees. After both have been inserted and manipulated, let me know that you are ready for the next step.” Candidates response: A. Removes needles from the clean field; if necessary, inserts needles into guide tube, handle first. B. Inserts needles. C. Rotates each needle. Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) A. Removes needles from clean field. If necessary, inserts needles into guide tube, handle first. All of the following must occur: chooses proper needle sizes removes needles from the clean field one at a time maintains sterility of the needle shaft if guide tube is used, puts needle in guide tube, handle first uses minimal hand movements in and around the clean field Either of the following occurs: reaches more than once into clean field to withdraw each needle one of the needles is the wrong length Any of the following errors are made: both needles are the wrong length removes both needles from clean field at the same time and one is held in hand while the other is inserted puts needle into guide tube, point first gesticulates with needle before needle insertion 0 1 1 with fix 2 B. Inserts needles. Both of the following must occur: maintains sterility of the needle shaft inserts needle to proper depth Inserts one of the needles at the wrong depth (too shallow to stand up). Either of the following errors are made: does not maintain sterility of the needle shaft inserts both needles at the wrong depth (too shallow to stand up) 0 1 1 with fix 2 C. Rotates each needle. Rotates both needles no more than 360 degrees in any one direction. Rotates either needle more than 360 degrees in any one direction. Any of the following errors are made: does not rotate needles at all rotates only one of the needles lifts and thrusts rather than rotates either of the needles touches either needle shaft during manipulation 0 1 1 with fix 2 Step 3 Examiners instruction: “Please remove the needles and clean up your equipment. You are done with this patient and for the day. Complete your demonstration by packing up your equipment.” Candidates response: A. Withdraws needles. B. Disposes of used needles in sharps container. C. Applies pressure (closes the hole) with clean cotton to both needle sites. D. Disposes of trash in trash bag. E. Washes hands. F. Re-packs travel kit, including proper hand washing. Note: The order of the withdrawal of needles and the “closing of the hole“ with a cotton ball does not matter from a CNT perspective. It is OK to: (1) remove the needles, dispose of them in the sharps container, then apply the cotton; (2) remove the needles and apply cotton then dispose of the needles in the sharps container; or (3) apply pressure with the cotton ball as the needles are being removed, then dispose of needles in the sharps container. In all 3 scenarios, the cotton ball goes in the trash bag. Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) A. Withdraws needles. (Note: Both needles can be removed at the same time, or one at a time, as long as the next step is placing those needles in the sharps container.) Withdraws both needles without coming into contact with needle shaft. Withdraws both needles, but accidentally comes into contact with needle shaft. Any of the following errors are made: fails to withdraw both needles gesticulates with used needles in hand inserts used needles into cotton ball before disposing of the needles 0 1 1 with fix 2 B. Disposes of used needles in sharps container. Disposes of both used needles in the sharps container. Drops one or both needles (misses the sharps container) but then picks up needle(s) with tweezers and disposes of the needle(s) properly. Any of the following errors are made: throws needles in trash bag puts used needles onto clean field puts used needles onto treatment tray or table 0 1 1 with fix 2 C. Applies pressure (closes the hole) with clean cotton to both needle sites. (Note: The holes can be closed either before the needles are put in the sharps container, or after the needles are disposed of.) Closes both needle sites with clean cotton. N/A (either both holes are closed properly or they arent). Any of the following errors are made: does not apply pressure applies pressure with finger(s) instead of cotton uses alcohol swab instead of cotton closes one hole properly but not the other 0 2 (Note: The ORDER of withdrawing needles and “closing the holes“ is a techniques question, not a safety question, and should not affect scoring.) Response Proficient (2) Minimally Acceptable (1) Fail (0) Grade (examiner to check one box) D. Disposes of trash in trash bag. Disposes of trash properly. N/A (either trash is disposed of properly or it isnt). Does anything other than dispose of trash in pro