Equipment Maintenance and Calibration

All equipment used in the provision of audiologic services will be maintained in accordance with
guidelines as established by the American National Standards Institute, American Speech-
Language-Hearing Association, American Academy of Audiology and Occupational Safety and
Health Administration. Equipment used in the calibration of all instrumentation used in the
provision of audiologic services will be calibrated annually to standards traceable to the
American National Standards Institute.

Updated 9-29-17
 Infection Control

Every possible effort will be made to minimize the risk of infection transmission between
patients as well as to and from caregivers. All clinic participants will follow these guidelines
when in the clinic. All cleaning and disinfecting shall be the responsibility of the audiology
graduate assigned to the clinic period, unless otherwise noted.

Disinfection and cleaning will be done DAILY unless otherwise noted.

A. Disinfecting testing equipment and ear impression tools

1. All circumaural headphones and bone conduction oscillators will be cleaned prior to
each use with a disinfectant towelette (Audio-Wipes or similar)
2. All foam inserts, impedance probe tips and OAE tips that are used will be removed from
the equipment AS SOON as testing is completed. Foam inserts will be thrown away and
dirty probe tips placed in the basin for later disinfection.
3. All otoscope specula will be considered single use items and disposed of after use.
4. Real ear probe tubes will be considered patient-specific use items. Place each client’s
PROBE TUBE in a plastic bag with their name on it and attach it securely in their chart for
future use. If probe tube will NOT be used with that client again, it is considered a single
use item and disposed of after use.
5. Impedance and OAE tips shall be disposed of if they are known or suspected to have
come in contact with blood, ear drainage, or any known infected area. All other tips
shall be used once, and then washed daily in the manner described below.
6. Ear light tips shall be wiped off before each use with disinfectant towelette.
7. Impression syringes, mixing bowls and mixing tools will be used once, then washed daily
in the manner described below.
8. Dirty tips, syringes and other tools to be cleaned shall be placed in a kidney basin
WITHOUT a paper towel. (The presence of a paper towel will indicate that the contents
are CLEAN.)

B. Daily Clinic Cleaning and Disinfecting

1. At the end of each ½ day clinic, the audiology student assigned to that clinic will
complete the following:
i. All counter and table tops shall be cleaned with a hospital grade
disinfectant (ENVY or similar) TWICE: Once to clean any gross
contamination. A second time, leaving the surface wet for the time
specified on the label.
ii. All dirty tips, syringes, mixing tools, etc., shall be soaked in a hospital
grade disinfectant (Sporox II or similar) for the time specified on the label
(usually ten minutes). They will be then rinsed in tap water no less than
FOUR times
iii. Clean tips, syringes, etc., will be placed in clean kidney basins to dry, with
clean paper towels under them. The presence of a paper towel indicates

Updated 9-29-17
 clean materials
iv. All clean and dry materials (usually from previous session) will be put
away

C. Hand Washing and Glove Use:

1. Thorough hand washing between each patient contact is REQUIRED
2. Protective gloves will be available. Their use is REQUIRED when the patient has a
draining ear, when blood is present, when sores or lesions are evident on the ear or
scalp, or when a medical history indicates an infectious disease. Gloves should also
be worn when cleaning infectious spills. Use at other times is permitted, but not
required.

D. Handling Hearing Aids and Ear Impressions:

1. All aids received that have been worn by a patient will be disinfected with a
towelette (Audio-Wipes or similar) prior to handling.
2. Protective gloves shall be worn when handling aids and molds worn by patients with
sore spots or abrasions in ear or known infections.
3. Hearing aids, molds and ear impressions are NEVER to be placed directly on the
counter or table. A clean paper towel or tissue will be put down first.

E. Disinfecting Motivational Toys:

1. Only non-porous toys will be used. (Wooden, stuffed and other porous toys are not
allowed, as they will not tolerate the recommended cleaning procedures).
2. All play audiometry toys used during a clinic shall be placed in a dirty toy bin or
bucket. At the end of clinic they shall be soaked in a bleach solution (1 Tablespoon
bleach per gallon of water) for 10-20 minutes. They will be then rinsed in tap water
and left out to air dry.

F. To Minimize risk of exposure to airborne infectious agents:

1. When a patient exhibits a chronic dry non-productive cough, they will be asked to
wear a disposable mask. Alternately, staff and students working with the patient
will wear disposable masks.
2. Masks will be located in both child and adult hearing clinics.

REFERENCES and RESOURCES

Kemp, R.J., & Roeser, R.J., (1998). Infection Control for Audiologists. Seminars in Hearing, 19(2),
195-204
Herb Wagner, University of Arizona Risk Management. (621-9009)Section 2: Clinic Services

Updated 9-29-17
 Straighten and Stock Program

All students doing clinic on campus are responsible for being sure that the rooms they use are
straightened, well-organized, and appropriately stocked. They are also responsible, on a
rotating basis, for doing the same for the common areas, including 107, the hearing aid shop,
the 4th floor grad lounge, and the Hodgeson computer lab.

This is the kind of stuff that is the responsibility of all audiologists in the real world. In the real
world, though, you have your own office, you put things away where you like them to be, and
are clearly on top of the stock of all things as you are the only (or nearly only) person using
them. It is much harder to keep track of things when we have 20+ people all working in the
same clinics!

Here is how it works:

Students are assigned to maintain the clinic spaces in which they work, plus at least one
additional common area. They work together with the other students also assigned to maintain
that area to insure that it is straightened and stocked at least once a week. They will indicate
their participation by indicating the date they did so, checking the section boxes, noting the
supplies ordered and their initials on the Straighten and Stock sheet in their assigned room.
Participation in the program will be reflected in their grade.

The "Stock" part of this means that if a supply is low, or a cord is missing, YOU try to remedy
the situation - don't simply note on the form "low" or "missing"! Remember that there are
many people using the clinics, and programming cords (for example) may be "borrowed" from
one area and not returned.

If you have any questions about where things go or where to find supplies, please ASK! Your
preceptor or other students (especially 2nd or 3rd year) may be able to point you in the right
direction.

This is a RESPONSIBILITY, not an "option", but can be performed any time it fits your schedule
during the week, as long as it does not interfere with Clinic.

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 Clinic Preparation

It is the responsibility of all individuals who work in the Audiology Clinics to leave the audiology
suites, waiting room areas and all clinic areas in a clean and neat condition and to replace all
equipment in the proper location following test procedures. No food or drinks are allowed in
the clinic (except for water).

Daily Listening Check of Equipment:

Check Task
Inspect all earphone tubes, cables and power cords for cracks, visible wiring. If when
touching the audiometer you receive a shock or feel tingling in your fingers, this may
indicate a short. DO NOT USE THE AUDIOMETER UNTIL THE ISSUE IS RESOLVED.

Do exhaustive listening check with Insert Earphones

Throughout the listening check, slide fingers down from phone to jack jiggling lightly
especially around cord connections and listen for any static or intermittency. Do this
for both earphones.
Frequency Check
With the HL dial at 50 dB, check each frequency for purity of tones and to ensure no
crosstalk. Channel 1: Listen to all pure tones (up in frequency one earphone, down in
frequency other earphone). Then go to Channel 2 and listen to NBN (up in one
earphone and down in the other). Make sure sound is going into correct ear.
Linearity Check
Channel 1: With the frequency at 1000 Hz, turn the HL dial from 0-70 dB. Check for
equal changes of loudness. Notice if there are audible clicks with the changes of the HL
dial. Listen to both insert earphones and audiometer channels (pure tones in channel
1, narrow bands in channel 2).
Microphone Check
To check the microphone, press “mic”, set the dial to 50 dB and listen to the
examiner’s voice in each earphone. Listen for humming, static, or excessive
background noise. Be sure that the person talking is not “peak clipping” or it will
sound distorted.

Check other transducers

Do linearity check using the bone vibrator. Listen for any static as you gently jiggle
cord connections.
Do linearity check using both right and left supra-aural earphones. Make sure sound is
going to correct earphone. Listen for any static as you gently jiggle cord connections.
Do linearity check of right and left speaker in soundfield. Make sure sound is going to
correct speaker. Listen for any static or unwanted sounds.
***Note any problems you encountered and what needs to be done!**

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 Start-up and Preparation
AM students are required to arrive 30 minutes early in order to:

1. Turn on ALL equipment; Complete listening checks; Untangle all cords in booth
2. Review charts: physical paper chart and Lytec Notes. Please review your files at least 24
hours in advance of an evaluation, as noted above as additional preparation may be
necessary. Files are pulled each Friday for the following week and are located in the
GBC clinic office.
3. Prepare tools, hearing aids, forms, etc. for appointments
4. If you will be doing an AE (audiologic evaluation) be sure to have on hand an audiogram
(in case the computer goes down), pen, appropriate word recognition list (Mayo,
Spanish, NuChips, WIPI, etc.), manuals and recorded materials if necessary.
5. If you will be doing an HAE (hearing aid evaluation/consultation/selection/order),
research hearing aid options and (if possible) select a hearing aid no later than one day
before the evaluation. Gather impression material and tools, an otoscope, earmold
and/or hearing aid order forms and model hearing aids just prior to the appointment.
6. If you will be doing a hearing aid fitting and assessment, ensure that the patient’s aid(s)
are available. A listening check should be performed on all new hearing aids at least one
day prior to the fitting appointment. All hearing aids back from repair should have a
listening check and be electroacoustically evaluated to ensure they meet ANSI standards
at least one day prior to the appointment. Additionally, enter the patient’s data into
NOAH and complete pre-fitting adjustment using simulated real ear data. Gather the
hearing aid(s), batteries, earmold(s), scissors, tubing stretcher and screwdriver just prior
to the appointment. Check to make sure the medical clearance form has been obtained.
*Complete the laminated check-list*
PM students are required to arrive at least 15 minutes early to review files and prepare for
appointments.

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 Clinic Shutdown

Following clinic, all students are expected to:

1. Complete a chartnote in Lytec (C)
2. Ensure the face sheet is up-to-date and accurate (F)
3. Enter a recall appointment if needed (R)
4. “C,F,R” (post appointment client specific duties) should be documented as
completed for your supervisor in the manner they request.
C = Chart note. This is the appointment summary note that you will write in
Lytec.
F = Face Sheet. All patients who wear hearing aids/cochlear implants should
have an up to date face sheet in their physical chart.
R = Recall Appointment. A recall appointment for6 month/annual hearing aid
checks should be made at the time of the appointment (before adding an
additional recall, the student should ensure that an appointment is not already
entered to eliminate duplicate mailings).

5. Straighten booths (untangle headphone wires please!) and clinic area.

6. Clean video-otoscope specula, impression syringes, toys and work area, in
accordance with the infection control policy. (Standard otoscope specula and foam
insert-phone ear tips are thrown away after a single use.)
7. Turn off all equipment unless clinic will be held later that day in the same area.
8. Turn off all lights!

NOTE:
• EACH CLINICIAN is responsible for cleaning up after her/his own clinics – DON’T
ASSUME THAT SOMEONE ELSE WILL DO IT!
• THESE GUIDELINES ARE FOR ALL PERSONS UTILIZING THE HEARING CLINIC
EQUIPMENT FOR ANY REASON!
• If more than one person has clinic at a time, please workout amongst yourselves
who will be responsible for which duties.

Updated 9-29-17