The guideline for Chaperones in patient care was updated this month in Policy Central. This guideline outlines the process of leveraging a support person (Chaperone) when requested to ensure that patients are examined in a comfortable, secure and professional manner and to help prevent misunderstandings or false accusations regarding a physical exam.

PURPOSE:

To ensure that patients are examined in a comfortable, secure, and professional manner, and to help prevent misunderstandings or false accusations regarding a physical exam.

BACKGROUND:

Information on patient needs collected during an initial and subsequent clinic visit can help staff coordinate and plan for care. For a patient with a cultural- or religion-based modesty issue, the presence of a chaperone can mitigate concerns when care is provided by staff of the opposite sex. A chaperone may lessen fears of any patient undergoing a sensitive exam. Chaperones are strongly encouraged for any potentially sensitive exam on a patient with a pertinent psychiatric history, altered mental status, or for selected minors.

GUIDELINE:

1. Any patient may request the presence of a support person to provide emotional support and/or alleviate fear during a visit or procedure. The provider will determine any limitations on the presence of a support person (ex. Where they stand) as well as prohibiting in cases where a support person would compromise safety or is medically/therapeutically contraindicated.

2. Any patient may request and be provided with a chaperone for all or part of a physical exam. For pelvic or endovaginal examinations, this guideline should be communicated to every patient, preferably though a conversation initiated by the intake clinic staff or the physician/practitioner.

3. A provider may determine on an individual basis to proactively offer or to have the clinic provide a chaperone for a breast, rectal, or other potentially sensitive exam, taking into account the physician-patient relationship, patient complaint, and a patient's pertinent medical history.

4. A health professional of the gender of the patient's choosing should serve as a chaperone whenever possible.

5. If a chaperone is provided, a separate opportunity for private conversation between the patient and physician should occur. Inquiries and history-taking, especially those of a sensitive nature should be kept to a minimum during the examination.

REFERENCES:

1. Adapted from UW Medicine | University of Washington Medical Center (Review Date 11/27/2017)

2. The Joint Commission, Jan 7, 2001, Advancing Effective Communication,Cultural Competence, and Patient-and-Family-Centered Care: A Roadmap for Hospitals

The document in Policy Central is located HERE on SharePoint. Note: you may need to log in first with your VMC credentials to access it.