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Council of Colleges of Acupuncture and Oriental MediciCouncil of Colleges of Acupuncture and Oriental Medicinene PO Box 65120, Baltimore, MD, 21209 Phone: (410) 464-6040 Fax: (410) 464-6042 March 24, 2016 Dear CNT Applicant: We are pleased to inform you that you have been accepted to take the Clean Needle Technique course on April 24, 2016, at Florida College of Integrative Medicine, 7100 Lake Ellenor Drive, Orlando, FL, 32809. Please call (407)888-8689 for directions. This one-day course will focus on issues of safety within the scope of the practice of acupuncture, and will include the following components: a lecture on the theories, concepts and application of Clean Needle Technique as described in the CNT Manual, a demonstration of the practical application of CNT, a training session where each applicant can practice and perfect the utilization and employment of CNT, a written quiz and a practical exam. (NOTE: The lecture and the exam questions are based on the 7th edition of the Clean Needle Technique Manual for Acupuncturists. Studying from a previous edition of the Manual may result in lower exam scores.) Since this course is not intended to be your first needling experience, if you are currently enrolled in acupuncture school you must either have completed or begun a techniques course. If you have not completed or at least begun a techniques course, you should postpone the CNT course until you have completed this requirement. YOU MUST BE ON TIME. Registration will begin at 8 am. The lecture will begin at 8:30 am. If you arrive later than 8:30 am, you will not be allowed to take this administration of the course, and you will be required to re-pay and re-schedule your course date. In order to receive a certificate of completion, applicants must attend this entire course and may not miss any part of it. The course usually ends by 5 pm, but we cannot guarantee it, so please be prepared to stay until 6 pm if necessary. Purpose of the CNT Course National certification in the field of acupuncture requires an applicant to have successfully completed an approved CNT course. Although needling technique and safety is a required course at accredited acupuncture schools in the U.S., the NCCAOM as well as many state licensing boards recognize that independent verification of CNT competency by acupuncture practitioners is essential in the interest of public safety. CNT Course Objectives By the end of the CNT course, each participant will be able to: Demonstrate safe and effective needling skills Articulate/describe a clear understanding of what constitutes the clean field and demonstrate its correct set-up and maintenance Recognize and evaluate the safety risks applicable in the environment, and in the practice, of acupuncture and associated adjunct techniques Identify the common adverse effects (AE) of acupuncture, moxibustion, heat lamps, electro-acupuncture and cupping Apply the critical and highly recommended procedures to reduce AE for acupuncture Understand the disease transmission process, including blood borne pathogens and other infections that have been associated with healthcare settings in general and acupuncture specifically Name the critical features of preventing disease transmission in AOM practice locations Utilize best practices for hand hygiene for AOM procedures Recognize national safety standards, including OSHA BBP standard, that apply to the AOM office Establish a clean field for an acupuncture treatment Demonstrate correct hand-washing techniques in an acupuncture clinic setting Describe the etiology, major symptoms and prevention of the communicable diseases commonly seen in the acupuncture clinic setting. Demonstrate adequate clean needle technique in a house visit or an acupuncture clinic setting Required Reading Applicants must study the Clean Needle Technique Manual: Best Practices for Acupuncture Needle Safety and Related Procedures, 7th Edition, published by the CCAOM (recommended study time: fifteen hours). APPLICANTS MUST STUDY THE CNT MANUAL BEFORE COMING TO THE CNT CLASS. FAILURE TO DO SO WILL LIKELY RESULT IN FAILURE OF THE CNT COURSE. The Manual is available on our website as a PDF file at the following link: /downloads/7thEditionManualEnglishPDFVersion.pdf. Although it is not required, we recommend that applicants bring the Manual with them to the CNT course, in either printed form or stored on a digital device. You will NOT be allowed to refer to the Manual in any form during the written exam, but you may want to refer to it during the lecture portion of the course, or during breaks. If you would prefer a printed version, take a flash drive containing the file to a print-to-go center. The printing cost depends on the service centers cost per page and what features you request. The Chinese version of the CNT Manual is expected to be available by the end of 2015, and the Korean version is expected to be available in February of 2016. Faculty Each CNT course is administered and taught by one NCCAOM-certified and state-licensed instructor, assisted by examiners (at a ratio of 1:8 examiners to applicants) who have been NCCAOM-certified and hold a current state license, and administrative support personnel. Language The lecture, practical demonstration, written exam, and practical exam will be given in English at this course. Note to non- native English speakers: Applicants who intend to take the CNT course in English should be aware that the lecture and all instructions will be given in English only. Applicants are expected to have enough proficiency in the English language to be able to understand spoken English, as well as written English if the applicant is taking the written exam in English. Lunch Breaks Please bring lunch and/or snacks with you. There will be a break at some point in the afternoon. The instructor will explain how breaks and lunch will be handled during the orientation at the beginning of the day. Cancellations If the request for cancellation is received 15+ days before the course date, the refund will be $125. If the request for cancellation is received 8-14 days before the course date, the refund will be $100. If the request for cancellation is received 1-7 days before the course date, the refund will be $25. Applicants must submit all cancellations in writing according to this schedule in order to be eligible for any refund. Applications will not be rolled into the following year. Refunds will be issued within 30 days of cancellation. If you do not show up for a class, or if you arrive past 8:30 am, you will not receive a refund, except in the case of a documented illness or documented personal or family-related emergency. To avoid additional fees, please call the CCAOM office within 7 days after the scheduled CNT course date if this situation occurs. Switching Course Dates If the request to switch course dates is received 15+ days before the originally scheduled course date, the switch fee will be $25. If the request to switch course dates is received 8-14 days before the originally scheduled course date, the switch fee will be $50. If the request to switch course dates is received 1-7 days before the originally scheduled course date, the switch fee will be $125. All requests to switch course dates must be made in writing. Dismissal from the Course Appropriate classroom decorum is expected on the part of CNT applicants at all times. CNT instructors are authorized to dismiss from the course any applicant who is disruptive or otherwise behaves in an inappropriate manner, or who engages in cheating during the written examination. An applicant who is dismissed must re-apply and re-pay for the course. Written Exam There will be a fifty question, multiple-choice written exam on the contents of the Clean Needle Technique Manual (7th Edition). Successful completion of this exam requires 39 or more correct answers. Please note that some questions on the written exam may pertain to material contained in the Manual that will not necessarily be covered in the lecture. Applicants who fail the exam will not be allowed to continue with the CNT course that day and will need to re-take and re- pay for the course in the future. An outline of the exam based on the content of the Clean Needle Technique Manual follows this letter. The exam is available in English, Chinese, or Korean, but if an applicant wishes to take the exam in Chinese or Korean, this must be noted on their application form. Applicants will not be allowed to change the language of their written exam on the day of the course. Cheating Applicants who are found to be cheating on the written exam will be immediately dismissed from the course. No refunds will be given to anyone who has been found to be cheating during the CNT exam. Please note that no electronic devices of any kind, including translation devices, will be allowed to be used during the written exam. Practical Exam In the practical exam portion of this course you will be expected to establish a clean field and demonstrate clean needle technique on yourself using the treatment protocols discussed in the Clean Needle Technique Manual (7th Edition). Each applicant will be required to demonstrate an insertion with a one inch needle and another insertion with a 1.5 inch needle, into his/her own leg. An examiner will read the enclosed Practical Exam Script to guide you through the demonstration. The examiner will grade each step of the script during the exam. Applicants who fail the practical exam will be allowed time to practice the techniques and will be given one make-up exam. If an applicant fails to pass the practical exam during the second attempt, he/she will be required to re-take and re-pay for the entire course at a later date. There will be ample time for practice of these techniques as well as instruction and supervision. During the practical exam portion of this course, since we cannot examine everyone at once, you may be required to wait for a period of time before being tested. Please study the Practical Exam Script very carefully before the day of the course. Appropriate Dress Please wear comfortable clothing and remember that you will need to demonstrate clean needle technique on yourself somewhere on your leg. Be prepared for possible temperature changes, as climate control is often unpredictable. Do NOT wear open-toed shoes, as this presents a hazard when working with acupuncture needles. Certificates of Completion A certificate of completion will be sent to you approximately 6-8 weeks after the course date. If you would like to receive your certificate early, please call the CCAOM office for instructions. If you would like us to send verification of CNT course completion to an agency on your behalf, please refer to our website for instructions (), or call the CCAOM office. Please note that if you do NOT receive your certificate within 2 months after course completion, you should let the CCAOM office know. Requests for certificates that are made more than 6 months after course completion must be accompanied by a $10 fee. Challenging Written Exam Questions Deadline: Certificates of CNT course completion are mailed to candidates within two months after the date of the CNT course. Therefore, any questions or comments regarding examination content or administration must be submitted in writing to the CCAOM no later than seven business days after the course. Examination Content: If you believe there is an error in a particular question or have comments about other specific aspects of examination content, submit your concern in writing to the CCAOM within seven business days after the course date. Include your name, address, course date and location, and a description of the specific question you are concerned about. Examination Administration Conditions: Should you experience any environmental difficulties during the administration of the examination (e.g., too hot, too cold, too noisy, problem with examination instructions, etc.), you are obligated to resolve your concern with the instructor during the administration of the exam. Resolution of Complaint: The CCAOM will evaluate all complaints and a written response will be issued within 45 days of receipt of the complaint. Appealing Examination Decisions: Candidates may appeal the decision by sending a letter describing the justification for the appeal. The CCAOM must receive the appeal within 30 days of the candidates receipt of CCAOMs initial decision. The CCAOM CNT Committee will review the appeal request, and the candidate will be notified of the committees decision within 30 days after receipt of the appeal. Required Items You must bring the following items with you to the CNT course: 1. Personal identification in the form of a photo ID. 2. Travel kit. The enclosed instructions will tell you exactly how to assemble your travel kit, which you will need to bring with you to this course. The CCAOM does NOT endorse the purchase or sale of any commercially-prepared travel kits; each applicant is responsible for assembling their kit according to the enclosed specifications. Applicants are subject to failure for improperly-prepared travel kits. If you have any questions about the course or these instructions, please call the office at 410-464-6040. We hope your participation in the CCAOM CNT course proves to be a valuable experience. Sincerely, Paula Diamond, CCAOM CNT Program Manager CNT Exam/Lecture Outline as based on the Clean Needle Technique Manual (7th Edition) Part 1: 20% of exam I. Minimizing adverse effects and events associated with AOM practice: a. Identify adverse effects (AE) of acupuncture b. Identify critical and highly recommended procedures to reduce AE for acupuncture c. Identify adverse effects of moxibustion d. Identify critical and highly recommended procedures to reduce AE for moxibustion e. Identify adverse effects of cupping f. Identify critical and highly recommended procedures to reduce AE for cupping g. Identify adverse effects of heat lamps h. Identify critical and highly recommended procedures to reduce AE for heat lamps i. Identify adverse effects of electro acupuncture j. Identify critical and highly recommended procedures to reduce AE for electro acupuncture Part 2: 20% of exam II. Clean Needle Technique a. Identify the general CNT procedure for therapeutic needling b. Identify components of the clean field c. Know proper practitioner hand hygiene requirements on the treatment setting d. Recognize the requirements for skin preparation prior to needling e. Recognize skin afflictions that constitute contraindications to acupuncture and adjunctive therapies f. Recognize the need for use of gloves and finger cots g. Identify the steps for safe needle withdrawal h. Recognize the required management of used sharps and other used equipment i. Implement safety practices to prevent needles being left in a patient j. Identify variations of the CNT protocol for the: i. Office setting ii. Hospital or multi-disciplinary setting iii. Public health setting iv. Travel setting k. Implement best practice protocols for: i. Acupuncture needling ii. Moxibustion iii. Cupping iv. Bleeding v. Heat lamps vi. Plum blossom/seven-star/cutaneous needling Part 3: 20% of exam III. Healthcare Associated Infections: a. Identify healthcare associated infections i. Blood borne viral infections ii. Airborne healthcare infections iii. Specific infections reported to be associated with acupuncture and related techniques b. Recognize mechanisms of disease transmission i. Autogenous infections ii. Cross infections c. Hepatitis A: i. Identify signs and symptoms of hepatitis A infection ii. Recognize methods to prevent the spread of hepatitis A iii. Identify public safety measures for hepatitis A infections (e.g.: immunization, cleaning, etc.) iv. Identify hepatitis A specific: 1. Transmission 2. Incubation period 3. Chronic active infection state (if any) 4. Sequelae 5. Vaccine availability 6. How long the virus lasts on common surfaces d. Hepatitis B: i. Identify signs and symptoms of hepatitis B infection ii. Recognize methods to prevent the spread of hepatitis B iii. Identify public safety measures for hepatitis B infections (e.g.: immunization, cleaning, etc.) iv. Identify hepatitis B specific: 1. Transmission 2. Incubation period 3. Chronic active infection state (if any) 4. Sequelae 5. Vaccine availability 6. How long the virus lasts on common surfaces e. Hepatitis C: i. Identify signs and symptoms of hepatitis C infection ii. Recognize methods to prevent the spread of hepatitis C iii. Identify public safety measures for hepatitis C infections (e.g.: immunization, cleaning, etc.) iv. Identify hepatitis C specific: 1. Transmission 2. Incubation period 3. Chronic active infection state (if any) 4. Sequelae 5. Vaccine availability 6. How long the virus lasts on common surfaces f. Hepatitis D: i. Identify signs and symptoms of Hepatitis D infection ii. Recognize methods to prevent the spread of Hep D iii. Identify public safety measures for Hep D (e.g.: immunization, cleaning, etc.) g. Hepatitis E: i. Identify signs and symptoms of Hep E infection ii. Recognize methods to prevent the spread of Hep E iii. Identify public safety measures for Hep E (e.g.: immunization, cleaning, etc.) h. HIV: i. Identify signs and symptoms of HIV infection ii. Recognize methods to prevent the spread of HIV iii. Identify public safety measures for HIV (e.g.: immunization, cleaning, etc.) iv. Identify HIV specific: 1. Transmission 2. Incubation period 3. Chronic active infection state (if any) 4. Sequelae 5. Vaccine availability 6. How long the virus lasts on common surfaces i. Herpes Simplex Virus: i. Identify signs and symptoms of HSV infection ii. Recognize methods to prevent the spread of HSV iii. Identify public safety measures

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