CHDD Guidelines

Checklist for daily clinical activities

  • Prepare for patients by reviewing records in Epic for patients assigned to you in the clinic schedule shared document; preparation should be completed on a previous day so that you only need to quickly review your patients prior to the planning meeting with your preceptor.
  • Arrive at clinic at the designated time dressed professionally and in good health with your CHDD key and office key and UW Medicine ID, allowing adequate time for equipment check/calibration and general preparation prior to meeting with your preceptor at 8:00am.
  • Unlock the test rooms (331/332, 339/340, 342) using the keys kept in the student desk in 341. Open ABR booth/331/332 only if patients are scheduled for an ABR that day. Unlock the supply cabinets (A, B, C, D) in room 342. Turn on test room lights and control room heaters and turn on all equipment in the 3 booths. Return the keys to the student desk.
  • Store your personal belongings in the small file cabinets in room 341 and put on your CHDD ID, which is kept at your desk. Store coats on door hooks. Personal cellphones should be stored in your personal backpack/bag and should only be used during your lunch time break.
  • Complete Verifit calibration on Mondays. Complete an equipment check of the 3 test rooms using the Pediatric Booth Guidelines. Complete 1st Tuesday monthly calibrations of Otodynamics OAE and Tympstar equipment.
  • At 8:00am each day, present to your preceptor your patient summaries/assessment plans.
  • Prepare speech audiometry material, questionnaire, family resources prior to each appointment.
  • Use appropriate personal and equipment hygiene with every patient
    • Wear a mask during all appointments; sanitize your hands before and after touching your mask. Replace your mask regularly.
    • Sanitize your hands on entry/departure to a test room and prior to touching the patient
    • At the end of every appointment, clean all equipment, chairs/tables and toys touched by the patient and family using gloves and sanitizing cloths. Return all toys to cabinets.
    • Dispose of all disposable foam eartips; clean reusable tips for tymps, OAE, otoscope
    • Clean earmold and hearing aid materials and arrange in sections of HA care kit
    • Turn on the air sanitizer in the test rooms and close the door between patients. At the end of the appointment, wash your hands with soap and water, if possible.
  • Escort the patient and parent in and out of every booth to help safely navigate the steps/thresholds. Escort the family from 3rd floor reception and back to either the elevator (audiology only) or front desk (teams).
  • Save all patient data with patient name and type of data and upload to shared folder on laptop.
  • At the end of the day:
    • Turn off all of the equipment and lights in every test room. Turn off air sanitizers and room heaters.
    • Put dirty laundry in the laundry bin in room 277.
    • Wipe down 341 student room desks, computers, microwave with a sanitizing cloth.
    • Lock control rooms with padlocks, lock cabinets in room 342, lock room 342 with key, and check door handle lock of 341. Return the door keys to student desk.
  • Report deadlines
  • First drafts of your reports should be completed by the end of the next workday.
  • Your preceptor will complete edits by the following day.
  • Wednesday is the final deadline for the reports of the week.
  • Attendance/Punctuality:
    • Regular attendance every week is a requirement and arranged absences must be approved by your preceptor during the first week of the quarter. If you are ill and will not be able to attend a clinic, contact your preceptor by email or phone as soon as possible so that accommodations can be made.
    • Students need to arrive to turn on equipment and meet to discuss patients at the time specified for the clinic day. Students who arrive late and are not present for patient discussion will not be permitted to remain in clinic that day.
  • Professional conduct:
    • You are expected to have professional conduct in your interactions with families, with fellow students, your preceptor, and colleagues at CHDD. Please dress appropriately in either scrubs or professional clothing with no open-toed shoes, non-sleeve tops or shorts. Tattoos should be covered, if possible. Working with children involves sitting on the floor, and a lot of bending and squatting; make sure your clinic outfit is comfortable and modest for your clinic maneuvers. You must wear your ID card at all times in the CHDD and UWMC buildings. UW Medicine and CHDD require a fragrance-free workplace, so do not wear any fragrances when you are in the building.
    • Clinic rooms are cell-free zones, so leave your cell phone with your personal belongings.
    • Computers in clinic rooms are for UW work only, not personal use. Printers can be used for printing clinical documents, but not for personal use.
  • Professional Self-care
    • Practice self-care in your personal life. Mindfulness and self-care are personal practices that keep you healthy and emotionally balanced and help you develop skills of positive regard and empathy for the families you work with. Audiologists are at risk for compassion fatigue and professional burnout.
    • Use self-care strategies during the workday. In the few minutes before an appointment, center yourself by using relaxation strategies like deep breathing to bring awareness to your thoughts about the session. Use a personal calming statement/affirmation.
    • Eat healthy foods and drink water throughout your workday to maintain your energy and health.
  • Disposal of patient information: Due to HIPAA regulations, you are required to appropriately dispose of all written and electronic information containing patient information at the end of every week. Delete all patient name and hospital numbers from files to be saved. If you have handwritten or printed documents containing patient information, these documents must be placed in the bins in the student office to be shredded.
  • Primary and secondary students: Clinic sessions will be conducted by the primary student assigned to the case, with the secondary student acting as the assistant during booth testing. During EMI, RECD measurement, and counseling conducted by the primary student, the secondary student will perform the HA electroacoustic evaluation and programming adjustments. Adjustments of assignments may be made as the clinic day progresses.
  • Patient population: Patients at CHDD are seen as part of the Pediatric Audiology Clinic, or as part of a number of interdisciplinary teams:
  • Pediatric Audiology: Children are seen in the Pediatric Audiology Clinic for a variety of reasons: re-screening after not passing an initial hearing screening, full evaluation after not passing several hearing screenings, hearing evaluation due to concerns about hearing and/or speech and language development, monitoring hearing due to a risk factor for late onset hearing loss, or for monitoring a permanent hearing loss. Children who use hearing aids are seen in clinic at various stages; at an initial diagnosis, as new users, and as experienced users. Typically, children with permanent hearing loss are seen every 3 months in the first year after diagnosis, every 6 months until age 5, and then yearly, thereafter. Children with unstable hearing or concerns about progress may be seen on a more frequent basis.
  • Interdisciplinary clinics: For children seen as part of an interdisciplinary team, hearing is evaluated to determine if hearing is contributing to the child’s development. You have 3 main objectives in reviewing records:
    • determine the child’s developmental level and appropriate test method
    • determine the child’s hearing and middle ear history
    • determine any risk factors for hearing change
  • Child Development Clinic (CDC): children for whom there are developmental concerns; Mondays and Tuesdays.
  • Infant Development Follow-up Clinic (IDFC) and Late and Moderate Preterm Babies (LAMB): children at risk due to prematurity or birth complications; Wednesday.
  • Cardiac and Down Syndrome Neurodevelopmental Follow-up Clinic (Cardiac): children at high risk due to a congenital cardiac defect and/or Down Syndrome; Tuesday.

Room/equipment orientation

  • Review the Pediatric Protocol guidelines for age-appropriate testing and interpretation
  • Review the Chart Review guidelines
  • Review the Conversations guidelines
  • Review the Hearing Technology guidelines
  • Review the Equipment guidelines
  • Complete a room and supplies orientation
  • 1st floor of CHDD
    • Lunch room: tables/chairs, microwave and refrigerator and snack and drink machines.
    • CD150 classroom (across the courtyard): for in-person Monday LEND Seminars
  • 2nd floor of CHDD:
    • Front Desk and reception
    • Offices for clinical coordinators: 207, 208, 209
    • Testing and observation rooms for peds, psych, OT/PT, social work
    • Laundry room: 277
    • 2nd floor Conference Room for in-person team meetings: 246
    • LEND Trainee room: 245
  • 4th floor of CHDD
    • LEND faculty offices
    • Outdoor deck with couches/tables & chairs for breaks/lunch
  • 3rd floor of CHDD
    • Lisa Mancl’s office: 330
    • Student office: 341
      • Room/cabinet Keys: middle drawer of the student desk in 341.
      • Forms: chart review forms, and developmental checklists.
      • Resources: family resource notebook, hearing technology notebook
      • Computer: the computers in 341 have access to EPIC
      • Standing files of patient charts: charts for upcoming patients
      • File cabinet: patient charts for all permanent patients
    • Patient side (339) of behavioral test booth suite
  • Ear tips and tape for securing eartips, container for dirty tips
  • Centering toys for VRA
  • CPA toys
  • Control room (340) of behavioral test booth suite
    • audiometer, VRA reinforcer DVDs and control boxes, CDs/CD player for speech babble, blank audiograms, VRA worksheets
    • speech materials response books
    • outcome measure questionnaires
      • Room 342 test room/counseling room with Tympstar Pro, Verifit II, Otodyamics Otoport
        • Cabinet near door (C, D): Eartips, tools for cleaning OAE and tympanometry probes, Patient devices to be fit
        • Cabinet near table (A, B): laptop with Noah, GSI Suite (password=2020), earmold impression supplies, hearing aid/earmold cleaning repair materials, demo hearing technology; RIC receivers and domes
      • Rooms 331/332 ABR test room suite
        • Patient side (332): cabinet: Patient preparation materials (alcohol wipes, gauze pads and Nu-prep), eartips and tape, electrodes and clean pillowcases
        • Control room side (331) Biologic NavPro system, ABR worksheets and equipment guidelines.

 

Speech and Hearing Clinic Guidelines

 

 

 

Preceptors/contact info :

 

Susan Anderson, AuD,CCC-A SW # 61 206.543.1575 sjander@uw.edu
Lisa Illich MSCD SW #59 206.616.1990 lillich@uw.edu
Student work room SW #60 206.685.2187  

Overview

Students are expected to arrive prepared and professionally dressed at the clinic at least 30 minutes prior to the start of patient appointments. The student should arrive in sufficient time to prepare for the tasks expected during the clinic session. Please review client charts prior to your clinic (see below).  Client files may not be taken out of the Clinic as this violates HIPAA and Clinic policies.

 Schedule: Students have access to the Clinic scheduling software Clinic Note through any Computer.    Login access will be set up and shared the first week of clinic

Chart Review

To the extent possible, please review charts before the day of the appointment; remote viewing of charts (from CHDD) is possible for the most part.   This clinic is transitioning to EMR and charts are being scanned in as used.     A chart review template exists for your used for your reference. A formal submission is not expected.    You should identify the areas of concern and significant history if any. You should also anticipate the potential outcome of the evaluation (i.e., medical referral, hearing aid referral, etc.) It is impossible to accurately predict a session based on chart reviews; however this will allow you to start developing an “anticipatory” mindset to help you make decisions quickly during an appointment.

Reflections/Debriefing: You may be requested to submit a reflection periodically.  Reflections are useful for both your learning as well as for your preceptor to understand where you are in your learning.  Debriefing will occur weekly, if not on a daily basis while you are getting used to clinic routines and protocols.

 Daily routine for Diagnostic Clinic :

Check Clinic Note for the schedule.

Check out patient charts from SW55  if not found in ClinicNote. ( retrieve from File drawers or locked cabinet.  PLACE an OUT CARD in place of a file, when removed from Filing cabinet)

Hearing aid repairs and drop-offs: Retrieve from the front office any hearing aids dropped off by patients, or received from repair the previous day.   Do this in the morning and/or mid-day.   (see the protocol book for guidelines to check-in repairs/drop-offs, etc)

Booths/Equipment:

Be sure all equipment that you may need is turned on or set out (i.e. Audiometers, Verifit, Otoflex, ultrasonic cleaner, earmold supplies, etc).   Perform listening check on equipment periodically to check for functionality.

Place an otoscope(s) in the test booth, fitting room, etc as need.

Forms : Set up forms based on chart review (Consent forms, case history, hearing aid forms, etc.    If a patient is scheduled for a hearing aid fitting, complete  PRE_Fitting steps.  SEE HEARING AID FITTING section in the protocol book for details.

Reports/Documentation

Reports are due by the end of the day unless otherwise arranged with your preceptor.   You will be given desk time each day for report writing, charting, etc.    Reports are shared with your preceptor via shared folder on OneDrive.      Notes for how to upload files to ClinicNote will be provided separately.

 Closing down for the day:  

Log off   all workstations.

Shut down all audiometric equipment.  In the booths, include shutting down the power to the booth.  Instructions are posted in each booth.

Lock the file cabinets and HA cabinet in 55

TURN OUT the LIGHTS and Lock the doors

SAFETY/INFECTION CONTROL

You are expected to abide by the guidelines per UWMC Training modules, in addition, there is an infection control guideline in the UW SPH infection control notebook located in clinic. Current guidelines include use of personal protective equipment and sanitizing of all equipment, furniture, doors/knobs, etc.

Conferences/Communication

Your preceptor will communicate and provide feedback to you on a regular basis in one or more of the following ways:

through wrap up sessions at the end of clinic

during a weekly conference

in response to your reflection logs

Absences

Be sure to let your preceptor know as soon as possible if you are ill and not able to make it to clinic. Communicating via email, voice mail and leaving a message with the clinic front desk   is the best way to make sure we know of any emergency that arises. Please make arrangements for non-emergency needs i.e. medical visits, interviews, etc with your preceptor. Please provide your preceptor with a contact number should the need arise to cancel clinic due to their absence.

Per our expectations for attendance, all planned absences must be discussed with the preceptor early in the quarter and the procedures to submit a request to be absent should be followed.

Professionalism

We have expectations related to dress and demeanor consistent with the professional environments that you will encounter outside of this clinic.

Professional demeanor includes addressing ALL clients by a title (Mr., Ms., etc) unless they are younger than you. If the individual does not want to be addressed in a formal way, they will give you permission to do otherwise.

When greeting your patient, introduce yourself with FULL NAMES.

Remember to project your voice and speak clearly – you are the model for ‘clear speech’.

Professionally dressed does not include jeans, t-shirts, flip-flops, athletic or canvas shoes or revealing cuts.  Please check hemlines, necklines, waistlines, etc. prior to clinic.

Shoes worn during clinic should be in good shape and clean. No open toed shoes!  Open-back shoes such as clogs and mules are acceptable.

Earrings should be in good taste.  Oral or facial piercing (tongue, lip, eyebrow, nose) must be removed.

Some clients are sensitive to scents – do not wear perfume or cologne during your clinic.

 

SUMMARY OF EXPECTATIONS:

Basic competencies expected of all students in the diagnostic/hearing aid practicum:

Adhere to professional protocols:

Ethical practice

Dependability

Punctuality

Confidentiality

Communication

Accountability

Personal appearance and behavior in the clinical setting (see above)

Preparation for each session: read the chart, be familiar with basic test protocol, practice probable tests ahead of time, have necessary paperwork ready. Bring your clinic notebook if needed to help you with masking and other protocols.

Familiarity with equipment:  audiometers, immittance bridges, and test box/real-ear systems.

Ability to complete audiologic evaluation including:

Case history

Tympanometry

Acoustic reflex threshold and decay testing (by end of 2nd quarter)

Speech threshold

Puretone AC and BC testing

Word recognition tests

PI-PB function if needed

Observe and model preceptor’s counseling techniques.

Select and order hearing aids with assistance

Respond promptly to communications.