Don’t turn that page! Capt John Hall penned this article while stationed at Wilford Hall Medical Center. His paper was recogized by the hospital’s infection control service and was distributed throughout the entire medical center! Capt Hall is now stationed at RAF Lakenheath.
The field of Audiology is expanding in leaps and bounds. As professionals and clinicians all of us strive to keep up with the latest breakthroughs in technology and diagnostics. The idea of the Au.D. acknowledges our desire to obtain parity with other paramedical fields such as optometry and dentistry. The current explosion of knowledge in our field certainly warrants such recognition. We are well on our way to obtaining such a goal. The concern arises, however, that in our daily clinical practice we may be overlooking some key essentials in sterilization and cleanliness which can adversely affect our image hindering our progress towards clinical doctorate level credibility.
There should be no mistake about the fact that patients form opinions and impressions about a business or profession from the moment they enter the waiting room. All of us can recall our own experiences in this regard, both positive and negative. There is nothing that makes me more nervous than to sit in the waiting room in a dentists office that has stains on the carpet and vintage 1970s style decor. More important is the organization and appearance of the exam rooms. If supplies are all stored in disarray on the counters and dental tools are left exposed with fingerprints on them it’s time to say “No thanks, doc!” and take off.
In contemporary times, none of us, neither patient nor clinician, can be accused of being too cautious when in comes to protecting ourselves from potential sources of infection. Our awareness has been heightened very recently by newspaper articles and TV broadcasts informing us of new varieties of antibiotic resistant bugs that are surfacing at an alarming rate. Many of these nasties such as TB and influenza were once thought to be under control a decade ago, but the newer strains are more robust and resilient. Both the Centers For Disease Control (CDC) and the National Institute of Health (NIH) are giving these new strains top priority investigation, and many infection control programs in our nations hospitals are cracking down via routine screenings and universal precautions.
Back to the dentists office–Just as none of us would expect to have our teeth worked on in such an office, none of our patients would enjoy arriving for audiological consultation under similar circumstances. Their understanding of infection control may not be as complete as yours, but rest assured that their awareness of infection risks from poorly kept medical facilities and equipment is no less pervasive. Most patients today are well educated and cautious. Sound booths complete with dirty fingerprint marks, tangled headphone wires, and filthy tympanometry probe tips in plain view are not going to help your credibility or facilitate your patients trust in your professional skills. Dirty tools and unkempt areas are not the standard of care in the dental or optometry offices and audiology settings should be no different.
If we take notice of well maintained medical office we find that cotton swabs, gauze, and alcohol preps (etc.) are maintained in some type of permanent container. Counter tops are dust-free and cleaned regularly. Clean tools and implements (consider: otoscopes, speculas, wax loops, etc.) are all neatly available on steel trays or resting on some type of barrier (either decontaminated or recently cleaned) such as paper or a towel. All used instruments have their proper place as well. Hospital infection control agencies advise placing used implements inside covered containers (stainless steal or plastic) until they can be cleaned and decontaminated. All disposable material contaminated with human secretions or tissue is disposed of in red bio-hazard plastic bags (consider: cerumen management, cleaning hearing instruments, real ear probe tubes, etc.). Used sharps such as needles and blades are placed in rigid special containers for disposal or decontamination. Audiologists should take no less care.
Once you have earned a patients trust in your professional skills, evaluating, counseling, and treating a patient is much easier. Establishing such a rapport with your patients begins in the waiting room and builds throughout the evaluation.