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      Joint Program Provider Policies & Procedures for Hands On CE Activities Involving Live Patients

      To ensure compliance with AGD-PACE Standards for hands-on CDE activities involving patients, Joint Program Providers will be required to provide CE Zoom with the written policies and documents demonstrating compliance with items 1-12 below.

      Hands-on CDE Activities Involving Live Patients


      1. For CDE Activities where patient treatment is involved, either by course participants or instructors, patient protection, Joint Providers must ensured the following: 
        1. Prior to the course that participants possess the basic skills, knowledge and expertise necessary to assimilate instruction and perform the treatment techniques being taught in the course. 
        2. Informed consent from all patients is obtained in writing prior to treatments
        3. Appropriate equipment and instruments are available and in good working order
        4. Adequate and appropriate arrangements and/or facilities for emergency and postoperative care exit. 
        5. Confidentiality of patient health information must be maintained. 
      2. in an effort to mitigate risks and avoid potential adverse outcomes CE Zoom strongly encourages Joint Providers to research the appropriate location/setting when developing and moving forward with a CDE Activity involving hands-on with live patients (i.e. hotel ballroom, private office, higher educational/school based setting, foreign countries)
        1. CE Zoom encourages Joint Providers to review, CDC: Appendix A: Infection Prevention Checklist for Dental Settings: Basic Expectations for Safe Care (https://www.cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/appendix-a.html) to evaluate a facility/location for the hands-on with live patients portion of the CDE Activity and its compliance with the above minimum standards.
        2. Location site/facilities shall be evaluated to determine access to basic emergency equipment (first aid kit, blood pressure measuring device, Oxygen), proximity to emergency medical care facilities and access to other additional items shall be considered such as: SDS repository, AED, Medical Emergency Kit
      3. In order to meet course objectives patients should be screened prior to the course to ensure the presence of an adequate number of individuals with conditions requiring the type of treatment relevant to the course content. 
        1. Clear written criteria shall be created informing CE Zoom of the process for screening and selecting of patients to be involved in the CDE Activity. Joint providers are encouraged to favorably consider the following criteria when selecting patients; appropriate age, noncomplex medical history, ASA classification (I-II), presence of oral conditions that meet the course objectives, location and if they are current patients of record belonging to a dental home. 
      4. Instructors supervising the treatment of live patients must be legally authorized to treat the patient in the jurisdiction in which the program occurs and comply with all applicable laws.
        1. Instructors and Instructor Assistants will be required to submit proof of active, current, unencumbered license/permit/certification in the jurisdiction in which the CDE Activity involving hands-on with live patients will be held. 
        2. CE Zoom strongly encourages thorough research of the practice act law/rules of the jurisdiction to determine the appropriate scope of practice and what level of supervision is required relative to the CDE activity.
      5. If the course will also have student course participants perform hands on treatments on live patients, the student course must be legally authorized to treat the patient in the jurisdiction in which the program occurs and comply with all applicable laws.
        1. Student course participants will be required to submit proof of active, current, unencumbered license/permit/certification in the jurisdiction in which the CDE Activity involving hands-on with live patients will be held.
        2. In the event the student course participants may not have proper authorization within the Jurisdiction of the CDE Activity. CE Zoom strongly encourages thorough research of the practice act law/rules of the jurisdiction to determine what appropriate authorizations are needed. (I.e temporary permits, restricted licensure or written authorization from appropriate licensing body allowing the CDE hands-on treatment of live patients).
      6. Sufficient clinical supervision must be provided during patient treatment to ensure that the procedures are performed competently. 
        1. CE Zoom acknowledges treatment involving complex irreversible procedures on patients may require more clinical supervision than noncomplex reversible treatments performed on patients. CE Zoom will work closely with program instructors and content developers to determine how many individuals are needed to ensure the safe and competent treatment of patients. A post treatment evaluation by a qualified clinical supervisor should be considered prior to the completions of the patient treatment portions to additionally ensure safe and compete treatment was administered by the student course participant. 
      7. An individual(s) responsibility for completion of treatment by a qualified clinician, should any question of the course participant’s competence arise, should be identified.
      8. ‘Post Treatment Care Instructions,’ must be distributed to all patient participants. This may be part of the Patient consent form or a separate document as long as the patient maintains access to the information following their participation. The instructions must, at a minimum contain,
        1. The names and contact information (phone and email address) of the Individual(s) responsible for the management of complications and providing any additional necessary post-course treatment. Can be the practitioner who treated the patient during the course or arrange an alternative specific individual(s) responsible, it the treating practitioner is no longer available. 
        2. Post treatment instructions for patient home care relative to the treatments performed as part of the CDE Activity. Consideration include; if local anesthesia was used, changed in bite, causes for concern, tender tissues, normal sensitivities, eating/drinking/diet, oral hygiene habits, follow-up appointments..etc
      9. There can be no compromise in adequate and appropriate provisions for care of patients treated during CDE activities; aseptic conditions (where the procedure dictates) and appropriate equipment/instruments, must be provided.
        1. CE Zoom acknowledges treatment involving complex irreversible surgical procedures on patients may require more clinical and aseptic facilities than noncomplex nonsurgical treatments performed on patients. CE Zoom is committed to ensuring that any CDE Activity involving hands-on with live patients always follows the most current CDC guidelines for infection control and prevention in the Dental Health Care Setting. Joint Providers are encouraged to oversee that course Instructors, Instructor assistants and student course participants are complying with the CDC guidelines for Standard Precautions when treating live patients. 

      *Guidelines for Infection control in Dental Health-Care Setting -2003, can be accessed here: https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf

      1. Protocol for handling medical emergencies during patient treatment including procedures for access to emergency care equipment/facilities shall be provided to CE Zoom.  
        1. CE Zoom will required all instructors and instructor assistants and clinical supervisors participating in the hands-on with live patients portion of the CDE Activity to hold current active certifications in Basic life support for the healthcare professional (CPR-HCP) or higher certifications (ACLS, PALS) if pediatric individuals are patient participants and the use of moderate anxiolysis or deep sedation will be utilized. 
        2. Considerations for preparedness include, Identification of individual(s) responsible for: 
          1. Handling any medical emergency and directing fellow instructors/staff in the delegation of duties in management of the emergency.  
          2. Ensuring the facility has access to basic emergency equipment and if that equipment is sufficient for the management of non-dental medical emergencies. (See above Section D(2)(b))
          3. Being familiar with materials used during the procedure, the medical health history of the patient(s) and have on hand access to Essential Emergency Drugs to include but not limited to: Oxygen, Epinephrine, Nitroglycerin, Antihistamine, Albuterol, Asprin..etc. or any Additional Emergency drugs (Atropine, Morphine, Naloxone, Lorazepam..etc.)

      2. Joint Providers, Instructors and participants must have adequate liability/Malpractice insurance. 
      3. Patient Informed Consent, shall contain the following information: 
        1. The training situation
        2. Nature and extent of the treatment to be rendered
        3. List of risks or harms that may result from the procedures
        4. Available alternative procedures
        5. The right to discontinue treatment
        6. The name and contact of information for the clinician(s) responsible for answering questions, addressing concerns and providing any necessary completion of treatment and post-treatment care. 

      *To ensure compliance with AGD-PACE Standards regarding hands-on CDE activities involving patients, Joint Providers will be required to provide CE Zoom with your written policies and documents supporting how you will comply with items 1-12 under this Section (D). See Appendix of this document for required submissions.