I. POLICY

It is the policy of Primary Care Associates of Appleton, Ltd. (“PCAA”) to provide and utilize patient chaperones when requested or necessary during sensitive examinations, procedures, and care.

II. POLICY PURPOSE

A. The purpose of this policy is to provide a consistent, standard, and safe care environment, and to comply with Wisconsin Administrative Code MED 10.03(2)(fm). There can be physical, psychological, and cultural reasons why chaperones may be requested or needed. This policy promotes respect for patient dignity and the professional nature of the examination. Health professionals should only perform sensitive examinations, procedures, or care in accordance with this policy.

B. A chaperone may be provided to help protect and enhance the patient’s comfort, safety, privacy, security, and/or dignity during sensitive examinations or procedures. The chaperone may also be present to provide assistance to the health professional with the examination, procedure, or care.

C. A chaperone’s presence may also provide protection to health professionals against unfounded allegations of improper behavior. A health professional may request a chaperone for any examination or procedure.

III. DEFINITION OF CHAPERONE

A. A chaperone is a person who acts as a witness for a patient and a health professional during a medical examination or procedure. A chaperone should stand in a location where the chaperone is able to assist if needed and can observe the examination, therapy, or procedure.

B. A chaperone may be a health care professional or a trained unlicensed staff member.

C. Whenever possible, the chaperone should be the gender the patient feels most comfortable with.

D. Family members or friends of an adult patient should not be expected to undertake any chaperoning role in normal circumstances. A family member may be present during sensitive examinations or procedures if it is the expressed desire of the patient but should not serve as a chaperone for the purposes of this policy. For vulnerable adult patients, an accompanying caregiver, social worker, or group home escort can be present along with a chaperone to alleviate potential stress to the patient.

E. Family members CANNOT act as the chaperone for adolescent patients nor can family members opt out of a chaperone on behalf of their adolescent child.

IV. POLICY STANDARDS

An adult or pediatric patient, or a pediatric patient’s parent or legal guardian, may request a chaperone for any examination or procedure. Additionally, a health professional may request a chaperone for any examination or procedure, at the health professional’s discretion, with the patient’s consent. If the patient does not consent to the presence of a chaperone, the health professional may decline to perform the exam or procedure.

V. PROCEDURE ACTIONS

For examinations or procedures, the following practices should be followed:

A. The scope of the examination and the reasons for examination should be explained to the patient. If appropriate, written information clearly stating why and how the procedure is to be performed should be available for patient education.

B. If a patient with decision-making capacity declines a part of or the whole examination, it should not be done. The refusal should be noted in the chart.

C. The health professional should provide privacy for a patient to dress and undress, if clothing must be removed for the exam or procedure.

D. The health professional should generally not assist with removing or replacing the patient’s clothing, unless the patient is having difficulty and/or requests assistance. The chaperone may also be available for such assistance.

E. A patient should be provided with an adequate gown or drape for any exam or procedure requiring removal of clothing.

F. A chaperone has the right to stop a procedure, examination, or care if they feel that the health professional’s behavior is inappropriate or unacceptable. A chaperone who witnesses inappropriate or unacceptable behavior on the part of the health professional will immediately report this to PCAA Administration Department, even if they did not stop the procedure while it was ongoing.

G. It is the responsibility of the health professional to ensure accurate records are kept of the clinical contact, which also includes records regarding the use of a chaperone.

H. Health professional non-compliance with this chaperoning policy should be reported to PCAA Administration Department.

I. The Notice of Chaperone Policy attached to this policy will be posted in our waiting area and/or exam rooms where sensitive examinations and/or procedures are likely to take place.