1、BSI Standards PublicationHealthcare provision bychiropractorsBS EN 16224:2012+A1:2014BS EN 16224:2012+A1:2014National forewordThis British Standard is the UK implementation of EN 16224:2012+A1:2014. It supersedes BS EN 16224:2012, which is withdrawn.The start and finish of text introduced or altered
2、 by amendment is indicated in the text by tags. Tags indicating changes to CEN text carry the number of the CEN amendment. For example, text altered by CEN amendment A1 is indicated by !“.The UK participation in its preparation was entrusted by Technical Committee SVS/18, Health and wellbeing servic
3、es, to Subcommittee SVS/18/1, Chiropractic services.A list of organizations represented on this committee can be obtained on request to its secretary.This publication does not purport to include all the necessary provisions of a contract. Users are responsible for its correct application. The Britis
4、h Standards Institution 2014.Published by BSI Standards Limited 2014ISBN 978 0 580 85820 8ICS 03.120.10; 11.020Compliance with a British Standard cannot confer immunity fromlegal obligations.This British Standard was published under the authority of the Standards Policy and Strategy Committee on 30
5、September 2012.Amendments/corrigenda issued since publicationDate Text affected28 February 2014 Implementation of CEN amendment A1:2014BRITISH STANDARDEUROPEAN STANDARD NORME EUROPENNE EUROPISCHE NORM EN 16224:2012+A1 January 2014 ICS 03.120.10; 11.020 Supersedes EN 16224:2012English Version Healthc
6、are provision by chiropractors Prestation de soins de sant par les chiropracteurs Bereitstellung von Gesundheitsleistungen durch Chiropraktoren This European Standard was approved by CEN on 10 May 2012 and includes Amendment 1 approved by CEN on 12 December 2013. CEN members are bound to comply with
7、 the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN-CENELEC Manage
8、ment Centre or to any CEN member. This European Standard exists in three official versions (English, French, German). A version in any other language made by translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management Centre has the same stat
9、us as the official versions. CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta
10、, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and United Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMIT EUROPEN DE NORMALISATION EUROPISCHES KOMITEE FR NORMUNG CEN-CENELEC Management Centre: Avenue Marnix 17, B-1000 Brussels 2014 CEN
11、All rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. EN 16224:2012+A1:2014 E2 Contents Page Foreword 5 Introduction .6 1 Scope 7 2 Terms and definitions .7 3 Service requirements . 10 3.1 Clinical practice 10 3.1.1 Clinical records . 10 3.1.2
12、Case history 10 3.1.3 Patient examination 10 3.1.4 Further investigation / diagnostic imaging 10 3.1.5 Clinical decision making and diagnosis 10 3.1.6 Plan of care 11 3.1.7 Referrals 11 3.1.8 Use of equipment 11 3.2 Core competencies . 11 4 Education . 13 4.1 Undergraduate chiropractic education. 13
13、 4.2 Graduate education programme . 13 4.3 Continuing professional development . 13 5 Code of ethics . 14 6 Organisation 14 6.1 Practical organisation of clinic facilities 14 6.2 Facility requirements 14 6.2.1 General . 14 6.2.2 Clinic and hygiene 14 6.2.3 Access to the clinic 15 6.2.4 Reception and
14、 waiting areas . 15 6.2.5 Toilet 15 6.2.6 Consultation and treatment room . 15 6.3 Equipment requirements . 15 6.3.1 Equipment . 15 6.3.2 Maintenance 16 6.4 Incident reporting and learning . 16 6.5 Quality assurance . 16 6.6 Insurance . 16 6.7 Professional association membership . 16 Annex A (inform
15、ative) Patient records . 17 A.1 Duty to keep patient records . 17 A.2 Content of patient records . 17 A.3 Correction of patient records 17 Annex B (informative) Recommended programme curriculum 18 B.1 General . 18 B.2 Curriculum model and educational methods 18 B.3 Basic biomedical sciences 19 BS EN
16、 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)3 B.4 Behavioural and social sciences, ethics and jurisprudence 19 B.5 Clinical sciences and skills 20 B.6 Clinical training 20 B.7 Assessment methods and regulations . 21 B.8 Curriculum level, structure and composition . 21 Annex C (informative) Code of
17、ethics . 23 C.1 Working with patients . 23 C.1.1 Good clinical care 23 C.1.2 Health promotion and self care 23 C.1.3 Raising concerns about patient safety . 23 C.1.4 Equality and diversity . 24 C.1.5 Keeping up to date 24 C.1.6 Teaching, training, appraising and assessing . 24 C.1.7 The chiropractor
18、-patient partnership 24 C.1.8 Communicating with patients 24 C.1.9 Communicating with other health professionals . 25 C.1.10 Preparing reports for third parties . 25 C.1.11 Children and young people 26 C.1.12 Vulnerable adults . 26 C.1.13 Dealing with relatives, carers and partners 26 C.2 Openness a
19、nd honesty . 26 C.2.1 General . 26 C.2.2 Maintaining trust in the profession . 27 C.2.3 Consent 27 C.2.4 Providing access to patient health records 28 C.2.5 Confidentiality 28 C.2.6 Discharging patients . 28 C.3 Working with colleagues 29 C.3.1 General . 29 C.3.2 Colleagues conduct and performance .
20、 29 C.3.3 Respect for colleagues . 29 C.3.4 Sharing information with colleagues 29 C.3.5 Delegation and referral . 29 C.3.6 Honesty and trustworthiness . 30 C.3.7 Providing and publishing information about chiropractic services 30 C.3.8 Writing reports and giving evidence . 30 C.3.9 Research. 30 C.3
21、.10 Financial dealings . 31 C.3.11 Conflicts of interest . 31 BS EN 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)4 C.4 Health and safety 31 C.4.1 General . 31 C.4.2 Evidence-based care 31 !Annex D (informative) A-deviations“ . 32 Bibliography . 35 BS EN 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)5 F
22、oreword This document (EN 16224:2012+A1:2014) has been prepared by Technical Committee CEN/TC 394 “Project Committee - Services of chiropractors”, the secretariat of which is held by ASI. This European Standard shall be given the status of a national standard, either by publication of an identical t
23、ext or by endorsement, at the latest by July 2014, and conflicting national standards shall be withdrawn at the latest by July 2014. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. CEN and/or CENELEC shall not be held responsible
24、for identifying any or all such patent rights. This document supersedes EN 16224:2012. This document includes Amendment 1 approved by CEN on 12 December 2013. The start and finish of text introduced or altered by amendment is indicated in the text by tags !“. According to the CEN/CENELEC Internal Re
25、gulations, the national standards organisations of the following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland,
26、 Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and the United Kingdom. BS EN 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)6 Introduction The World Health Organization (WHO) defines chiropractic as a
27、primary contact healthcare profession concerned with disorders of the neuromusculoskeletal system, particularly the spine, and the effect of these disorders on the function of the nervous system and on general health. Treatment encompasses a wide range of interventions, but emphasis is placed on man
28、ual methods of care. The chiropractic profession has evolved in Europe and occupies an important position in both primary and secondary healthcare provision. It is therefore imperative that chiropractic services are delivered at the highest attainable level. The principal objective of any standard f
29、or healthcare services ought to be that users of any given service can be confident of a level of care that assures reproducible quality throughout the profession. Clinical governance, the determination of monitoring healthcare provision and ensuring maintenance of standards therefore form one of th
30、e cornerstones of care. This standard is concerned with the provision of chiropractic services. It aspires to set a standard that provides optimum levels of patient management, patient safety, clinical and cost effectiveness and ethical practice. It also defines a level of education consistent with
31、producing chiropractors who are competent to comply with the standard. It is not intended to be a guideline, although information contained might inform the development of guidelines for individual nations and national organisations. Finally, this standard encourages that services provided by chirop
32、ractors be subjected to regular review through an evidence-based approach and a commitment to supporting and acting upon clinical research. This European Standard does not supersede national legislation. BS EN 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)7 1 Scope This European Standard specifies req
33、uirements and recommendations for healthcare services provided by chiropractors. 2 Terms and definitions For the purposes of this document, the following terms and definitions apply. 2.1 assessment health professionals evaluation of a disease or condition based on the patients subjective report of t
34、he symptoms and course of the illness or condition, along with the objective findings including examination, laboratory tests, diagnostic imaging, medical history and information reported by family members and other health professionals 2.2 audit review and assessment of healthcare procedures and do
35、cumentation for the purposes of comparing the quality of care provided with accepted standards 2.3 biopsychosocial model model that refers to the interactions between biological, psychological and sociological factors 2.4 capacity ability of a patient to understand, remember and consider information
36、 provided to them 2.5 care interventions that are designed to improve health 2.6 case history detailed account of a persons history which results from the acquisition of information through interview, questionnaires and assessment of appropriate medical records 2.7 chaperone person who is present du
37、ring a professional encounter between an health professional and a patient EXAMPLE Family members or another member of the healthcare team. 2.8 chiropractic health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects
38、 of these disorders on the function of the nervous system and general health Note 1 to entry: There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation. Note 2 to entry: Taken from WFC Dictionary definition 11. BS EN 16224:2012+A1:2014 EN 1622
39、4:2012+A1:2014 (E)8 2.9 chiropractic institution educational establishment dedicated to the provision of chiropractic education and training 2.10 clinical guidelines systematically developed statements designed to assist both practitioner and patient decisions about the appropriate healthcare for sp
40、ecific clinical circumstances 2.11 clinical record document which relates to the diagnosis, assessment and care of a patient 2.12 consent acceptance by a patient of a proposed clinical intervention after having been informed of all relevant factors relating to that intervention 2.13 continuing profe
41、ssional development CPD means by which members of a profession maintain, improve and broaden their knowledge and skills and develop the personal qualities required in their professional lives 2.14 delegation asking someone who is not a regulated health professional to provide care on a chiropractors
42、 behalf 2.15 diagnosis identification of a disease or illness resulting from clinical assessment 2.16 diagnostic procedure structured procedure that exists to enable a chiropractor to arrive at a diagnosis which may include physical examination, diagnostic imaging and laboratory tests 2.17 discharge
43、 release of a patient from a course or programme of care 2.18 evidence-based care clinical practice that incorporates the best available evidence from research, the expertise of the practitioner, and the preference of the patient 2.19 formal education educational activity at established recognised f
44、ormal systems of elementary, secondary or higher education Note 1 to entry: Compare with the ISO 29990:2010, definition 2.15 “non-formal education“ 4. 2.20 further investigation additional clinical study which contributes to the assessment of a patient and which may include diagnostic imaging and la
45、boratory tests BS EN 16224:2012+A1:2014 EN 16224:2012+A1:2014 (E)9 2.21 graduate education programme GEP dedicated framework for the continuing education of new graduates of chiropractic institutions during their initial period in practice 2.22 health state of complete physical, mental, and social w
46、ell-being and not merely the absence of disease or infirmity Note 1 to entry: Specified in the preamble to the “Constitution of the World Health Organization“ 6. 2.23 health promotion provision of information on healthier lifestyles for patients, and how to make the best use of health services, with
47、 the intention of enabling people to make rational health choices and of ensuring awareness of the factors determining the health of the community 2.24 medical device instrument, apparatus, appliance, material or other article, either used alone or in combination, including the software necessary fo
48、r its proper application and intended by the manufacturer to be used for human beings Note 1 to entry: This definition is in accordance with Council Directive 93/42/EEC 7 and with EN ISO 13485:2003 1. 2.25 neuromusculoskeletal interaction between the nervous system, musculature and skeletal framewor
49、k of the body 2.26 patient confidentiality right of an individual to have information about them kept private 2.27 patient examination assessment of a patient with the intention of reaching or reviewing a diagnosis or plan of care 2.28 plan of care plan designed to deliver therapeutic benefit to patients following diagnosis 2.29 primary contact practitioner healthcare professional qualified to undertake a process of assessment, diagnosis and care in the absence of a formal referral from another registered healthcare provider 2.30 professional development continuum o
