College of Canada Holistic Natural Medicine



Clean Needle Technique Certification

It is essential that practitioners understand the mechanisms of disease transmission and know the characteristics of infectious diseases, particularly hepatitis and HIV, which are of particular concern in the health care setting. This knowledge underscores the need to use clean needle technique procedures for the protection of patients, practitioners and staff.

1. The Immune Response to Pathogens

- Autogenous Infections

- Cross-Infections

2. Hepatitis

- Hepatitis A (HAV)

- Hepatitis B (HBV)

- Hepatitis C (HCV)

- Hepatitis D (HDV)

- Hepatitis E (HEV)

3. Human Immunodeficiency Disease (HIV) / AIDS

CNT Protocol

-Always wash hands between patients

-Always use sterile needles

-Always establish a clean field.

-Always wash hands just prior to inserting needles if hands have been contaminated.

-Always immediately isolate used needles.

Details of CNT Certification

The 32 hour theory & 8 hour practice (DVD Training Included)

Textbook: Clean Needle Technique Manual for Acupuncturists

-Guidelines and Standards for the Clean and Safe Clinical Practice of Acupuncture- (National Acupuncture Foundation)


Below information is extracted from Promotion Sheets for Sterilization
issued by Toronto Public Health


For all types of premises:

Work areas should be well lit, clean and maintained in good repair.

Work surfaces contaminated with blood or body fluids must be cleaned and disinfected immediately using an intermediate to high level disinfectant.

Keep accidental blood and body fluid exposure records for at least one year.

Hands should be thoroughly washed using liquid soap and warm water between clients.

Drinking, eating or smoking is not permitted while working.

Ensure the area you will be working on is free from cuts, wounds or a rash.

Linens, towels and sheets must be laundered between clients and stored in a sanitary manner.

"Double dipping" of any cream, lotion or wax is not permitted - use a single-use applicator to dispense.

For premises providing invasive procedures such as tattooing, piercing, electrolysis, invasive facials and acupuncture:

New disposable gloves must be worn for each client.

Hands should be washed with liquid soap and warm water before and after removing gloves.

Discard all sharps, such as needles and razor blades into a puncture-resistant sharps container, labeled "biohazard" or that contains the universal biohazard symbol.

Sharps containers can not be discarded with municipal garbage.

Clean and disinfect head rests, worktables and chairs between clients using a low level disinfectant.

Keep client records for a minimum of one year.



Universal precautions pertain primarily to preventing the transmission of blood-borne diseases.

PSWs need to consider all clients as being potentially infected with a blood-borne disease.

PSWs who may be exposed to blood and body fluids should follow universal precautions to minimize the risk of exposure to blood-borne diseases.

Universal precautions practices should be applied when you are working with a client of handling blood or body fluids.

Remember: You do not have to see blood or body fluids on instruments for an infection to occur, therefore clean and disinfect or sterilize items between clients.

The following elements of universal precautions are very important:

1. Hand Washing. Wash hands before and after each client and after removing gloves.

2. Gloves. Wear gloves as a skin barrier. Gloves are not a substitute for hand washing.

3. Protective Clothing. If necessary wear gowns or aprons during procedures, where street clothing is likely to become soiled. Soiled gowns or aprons should be changed after each client.

4. Proper Handling of Sharps. Avoid recapping, breaking, bending or manipulating sharps, razors or blades in any way. Discard all sharps into sharps containers after use.

Personal Service Settings Cleaning Instruments

All instruments must be cleaned before disinfection or sterilization.

Disinfectants will not work properly if instruments are not cleaned first.


Disinfection of Instruments & Equipment

Disinfection is a process that involves killing most microorganisms.

Instruments and equipment MUST be cleaned before disinfections.

CHIM Therapy

- Sterile needles that come packaged with a plastic sheath (called a guiding tube) are highly recommended.

- The sheath is recommended because it helps guide the needle and will help keep your hands on the 'handle,' preventing accidental touching of the sterile part of the needle.

- Only use single-use, disposable, sterile acupuncture needles.

- Discard needles immediately after us into a labeled sharps container.

- Sharps containers can not be discarded with municipal garbage.

- Cleanse the skin with an antiseptic using a disposable swab.

- When an electro-stimulation machine is used, the clippers that attach to the handle of the needle, must be cleaned and disinfected with an intermediate of high level disinfectant between clients.

- You do not have to see blood or body fluids on instruments for an infection to occur.

- Linens, towels or sheets must be laundered between clients.

- Clean and disinfect head rests, worktables and chairs between clients using a low level disinfectant.

- New disposable gloves must be worn for each client.



- Sterilization is a process that involves killing ALL forms of life, including blood-borne viruses such as hepatitis B, hepatitis C and HIV.
- Instruments that pierce or penetrate the skin or hold sterile items must be sterile. These items are called “critical items.”
- Critical items must be sterilized because they pose the highest risk of spreading blood borne diseases.
- Instruments MUST be cleaned before sterilization.

Approved methods of sterilization:
For all sterilizers, instruments must be packaged and the sterilizer must be intended for wrapped instruments as per manufacturer’s specifications.
- Chemical Autoclave: Uses heat and a chemical solution under pressure to sterilize.
- Steam autoclave: Should be CSA approved with a drying cycle for the packaging.
- Autoclaves with print outs are highly recommended.
- Dry heat sterilizer: Must have a functioning thermometer and instruments must be packaged.

Mechanical sterilizers must be monitored

1. Biological Monitoring

-Send spore tests to a laboratory monthly.

-Heat resistant bacterial spores test the sterilizer.

2. Chemical Monitoring

-Use heat sensitive tape with each load.

-The tape oly identifies processed instruments.

-Tape does not indicate sterilization.

3. Physical Monitoring

-Record keeping after each load.

Methods not approved for sterilization:
Glass-bead “sterilizer”
Ultraviolet light (“UV Sterilizer”)
Ultrasonic cleaner
Pressure cookers or cooking ovens
Boiling water





Blood and body fluids may contain pathogens such as hepatitis B virus (HBV), hepatitis C
virus (HCV), or human immunodeficiency virus (HIV).

What is considered an exposure?
1. a needle stick or cut from a sharp object
2. blood and/or body fluid contact with broken skin (open cut, wound, rash), or
3. blood and/or body fluid contact with eyes, nose or mouth.

What to do if there is an exposure:
1. Wear single-use gloves prior to handling or dressing a client’s wound.
2. Wash the exposed skin surface with water and soap. If the area is bleeding, allow it
to bleed freely. After cleaning the wound, apply a skin antiseptic and cover with a
clean dressing or bandage.
3. If there has been a splash onto a mucous membrane (eyes, nose, mouth) flush the
area thoroughly with water.
4. The person exposed must immediately contact a physician.
5. Document all incidents and keep records on site for one year and on file for 5 years.

What information needs to be documented when there has been an exposure?
1. Full name (first and last), mailing address and phone number of the person
2. Full name of PSW (first and last) involved in the incident.
3. Date of injury/exposure.
4. Details of the exposure including where on the body the injury/exposure occurred
and how the injury/exposure occurred.
5. Action taken.


Blood-borne Diseases

? Blood-borne diseases such as hepatitis B, hepatitis C and the human
immunodeficiency virus (HIV) are transmitted from person to person through
infected blood and body fluids, such as semen, vaginal secretions, and in some
cases, saliva.
- Hepatitis B virus can live in or on metal, cotton or glass for 1-2 weeks.
- You do not have to see blood or body fluids on instruments for an
infection to be transmitted.
- Always clean and disinfect or sterilize instruments and equipment between clients
to reduce the possibility of transmitting blood-borne diseases.
- Sometimes a person with a blood-borne disease may not show symptoms right
away or at all, but they can still spread the disease to others.
- Some people may not even know they are infected with a blood-borne disease,
therefore assume all clients are potentially infected with a blood-borne disease and
follow routine practices. (Refer to additional “Routine Practices” fact sheet)
- Always wear gloves during invasive procedures and wash your hands after
removing the gloves once the procedure is completed.
- Only use sterile and single-use needles and blades. Discard used needles and
blades into a labeled sharps container.
- There are no vaccines that protect against hepatitis C and HIV.
- There is a vaccine available that protects against hepatitis B.
Immunization with the hepatitis B vaccine is strongly recommended for all PSW.

Mixing of Chlorine (Bleach): Making a solution for Disinfection


** You can attend this program via on-line or practice it on your own