Clinical Kit 16/11/2013 - WA Health Department - Common Sense Prevails

Hi,

Over the past few months I have been in communication with the WA Health Department in an attempt to clear up the situation of what regulations dry needlers and acupuncturists need to be aware of in WA.

While physiotherapists and chiropractors are registered under Australian Health Practitioners Regulation Authority (AHPRA), in WA there is also a separate "Skin Penetration Code of Practice” (the Code) written in 1998 and based upon a NH&MRC 1986 document. The base NH&MRC document has since been updated several times, most recently in 2011.

The Skin Penetration Code of Practice specifies who the code covers and specifically who it excludes.

It reads;
"APPLICATION OF THIS CODE, This Code applies to:
a) All persons who perform skin penetration procedures;
b) The premises in which such skin penetration procedures are performed;
c) The business of cleaning and/or sterilising appliances for the purpose of skin penetration.

Notwithstanding the above this Code does not cover those persons who penetrate the skin in the following professions:
a) Dentists who have been registered as dentists pursuant to the Dental Act of 1939;
b) Medical practitioners registered pursuant to the Medical Act 1894;
c) Podiatrists registered pursuant to the Podiatrists Registration Act of 1984 or;
d) Nurses registered pursuant to the Nurses Act of 1992."

However since the Code was written things have moved on, physiotherapists and chiropractors in addition to medical practitioners, nurses, dentists and podiatrists have national regulation, but as they aren't 'written into' the Exemptions Code, it has left a grey area.

A grey area relates to swabbing. The Code states that ;

"Prior to any skin penetration procedure the area to be penetrated shall be wiped with a sterile disposable swab containing an approved disinfecting solution. The skin should be allowed to dry for 30-60 seconds."

Yet in the NH&MRC's 2013 Immunisation Handbook swabbing is not required, rather clean skin is okay to needle into, and dirty skin requires cleaning with soap and water. In the same way the 'Infection prevention and control guidelines for acupuncture practice: AHPRA Chinese Medicine Registration Board (Board 2013)' also a non swab policy.

Clarification came through today from Satori Healey A/Health Liaison Officer, Office of the Deputy Premier, Hon Dr Kim Hames MLA, Minister for Health stating that;

"The Department of Health has advised that all national medical professional boards have been amalgamated under the Australian Health Practitioners Regulation Authority (AHPRA). Therefore the exemption under the Health (Skin Penetration Procedures) Regulations and associated Code of Practice now extends to all medical professionals registered with AHPRA. This includes pharmacists and physiotherapists."

Thank you to Dr Hames's office, our local member Graham Jacobs and his helpful assistant Jodie in gaining this clarification. It means that dry needlers and acupuncturists in WA can now choose to swab or not swab, based upon clinical grounds not an archaic piece of policy.

Doug Cary FACP

Specialist Musculoskeletal Physiotherapist

email doug@aapeducation.com.au

ph/fx 08 90715055

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