COVID-19 has been a wake-up call for everyone. Different professions and parts of our community are going to experience different aspects of this wake-up call. One of the biggest changes this awakening forced in our clinic was an overhaul of our infection control tools and procedures. These changes have utility beyond COVID-19, of course, and because of that we put a lot of time into effort into the process.
The changes across our business have been profound. In this document, we want to inform you about our approach to building sanitation, practitioner hygiene and personal protective equipment (PPE).
Our primary sources of information
We consulted a variety of sources of information over the last three months. Eventually, we settled on the following organizations' information as representing the best spread of approaches, ideologies and specialties.
- American Society of Acupuncturists (ASA)
- National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
- Council of Colleges of Acupuncture and Oriental Medicine (CCAOM)
- Esthetics Council (EC)
- Associated Bodywork & Massage Professionals (ABMP)
- Centers of Disease Control (CDC)
- World Health Organization (WHO)
- Using all of the sources of information listed, and in connection with our many advisors, we have developed a set of policies, procedures and tools that we feel give the best chance of limiting our being part of generating a new outbreak of COVID-19 in our community.
- Eric Grey has been chiefly responsible for the work on infection control itself in his role as the Safety & Privacy Director of Watershed Wellness.
- Eric is evaluating relevant sources of information nonstop and is also in daily dialogue with practitioners all over the world, in all types of clinical contexts, at all levels of experience. ALL OF OUR POLICIES, PROCEDURES AND TOOLS ARE SUBJECT TO REVISION AT ANY TIME.
Staff basic practices, training & support
Our practitioners are the heart of our clinic, and are also the most likely to contract a viral illness from patients due to their extended contact in an enclosed space. Because of that we have created extensive documentation for practitioners to help guide them as they navigate our new clinical reality. We have done hands-on training, and will retrain / refresh frequently as well as be monitoring everyone during the early months of implementation of these protocols.
Practitioners are encouraged, above all, not to come to work if even slightly ill, and to follow commonsense hand and cough hygiene practices not just at work but elsewhere as well. There are stringent protocols regarding hand hygiene, PPE and behavior when practitioners are engaged in patient care.
Sanitation & Linens
We use a disinfection product called mperial. It has very low toxicity and is readily biodegradable. It has been shown to be broadly antiviral and is on the EPA registered list of healthcare facility disinfectants. You can read more about this product here and here.
Our clinic's cleaning practices start at the 3rd floor elevator door. While we are not technically responsible for the elevator, hallways or bathrooms, we have included some limited disinfection of high touch surfaces in those areas for the duration of the pandemic.
Within Suite #308 cleaning is done frequently on all high touch surfaces, and at least twice a day anywhere people have been. Frequency will depend on patient volume and the overall situation with regards to the COVID-19 pandemic.
The treatment rooms are disinfected rigorously between every patient. Our sanitation protocol includes a changeout of all linens (including blankets), cleaning of all surfaces, increased air filtration and the use of a non-ozone producing UV light and filter to radically reduce the possibility of any microbe transferring between patients, or from the practitioner to the patient.
We have engaged a professional laundry service, Alsco, to handle our linens. You can learn more about their services and standards here. We have also made changes to the treatment tables themselves, creating disinfectable non-porous surfaces anywhere patients may have contact.
We have additional disinfection steps for nearly everything in the clinic including:
- Glass fire cups, guasha and other Chinese medicine treatment implements
- Our personal items including phones and keys
- Anything patients contact, including cups, iPads and hand sanitizer pump handles
We are asking that all patients wear at least cloth face coverings, otherwise we provide a fresh surgical mask for them. You can read about this and other patient related changes on this page.
Practitioners must wear at least a KN95 mask at all times while working with patients, and at least a cloth mask when in staff-only spaces. Practitioners are instructed on how to wear, evaluate and store their masks and we currently have plenty of masks to meet demand. We encourage everyone to be masked with a KN95 for as much time as possible while on site.
Many practitioners have opted into the use of surgical scrubs or labcoats in order to minimize potential contamination of their personal clothing. These are laundered appropriately. All practitioners are encouraged to follow rigorous procedures for bringing personal items into the clinical area, as well as taking items home with them from the clinic.
Practitioners have an ample supply of nitrile gloves for their use, but are not required to use them for all patient contact. Practitioners are trained as to proper use of disposable gloves, and always dispose of them prior to leaving the treatment room.
While eye coverings are not required for Chinese medicine practitioners, we do have goggles and face shields available for use in appropriate circumstances. These are sanitized and reused following manufacturer guidelines.
Filtration and airflow
We have added high quality HEPA filters to all treatment rooms and have rearranged our treatment room layout so the majority of rooms have an opening window to allow for fresh air. Ventilation is one of the most important pillars of infection control for a virus like this, so it's a good thing our clinic sticks out in the middle of the windy Columbia River.
We have altered our scheduling policies and the layout of the schedule itself to minimize the number of practitioners and patients on site at any one time. The utility of this method will improve with everyone's efforts to get and stay on time throughout the day.
Patient appointments will be slightly shorter to allow for a timely changeover. Your help in leaving the treatment room promptly after your treatment will be greatly appreciated.