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Jones Health Law Podcast: Episode 9 – STEMulating Conversation with Software Architect Consultant, Ms. Keiana Chisholm

In this episode we are discussing Tech and STEM with Software Architect Consultant, Keiana Chisholm! Keiana Chisholm is a 12-year software architecture consultant for her firm, “Chisholm Perennial Solutions.” Her firm consults on software architecture and engineering with a focus on healthcare systems. She received a bachelor’s degree in health services administration from Florida International University in Miami, FL and a Master of Science in Health Informatics from Northeastern University in Boston, MA. Keiana also owns and operates “The STEM Kidz” a STEM toy focused e-commerce site. She founded the charitable initiative the “Chisholm Perennial International Foundation” in 2018, which promotes STEM advocacy in early education.

During our conversation, Ms. Chisholm discussed a range of topics including: (1) Defining a software architect consultant; (2) Working as a software architect consultant for large healthcare systems; (3) The presence of women and African-Americans in Tech and STEM; (4) The difference between a “build” and a “go-live”; (5) Hacking of hospital software and how to deal with that; (6) STEM toys that aid in the development of the brain and motor functions; (7) her efforts to advance tech opportunities in Nigeria through Chisholm Perennial Solutions International Foundation; and (8) and more.

We touch on a wide range of topics in this podcast that I know you don’t want to miss. Don’t forget to listen and share with anyone that you think would be interested in listening as well.

Contact:

Chisholm Perennial Solutions

Email: KeianaChisholm@cpsolutionsgroup.org

Instagram: @cpsgroup1

Web: www.cpsolutionsgroup.org

 

The Stem Kidz

Instagram: @tehstemkidz

Web: www.thestemkidz.com

 

Chisholm Perennial Solutions International Foundation

Instagram: cpsinternationalfoundation

Web: www.cpsolutionsfoundation.org

Do I Need A Permit to Utilize Sedation Dentistry in Florida?

What is Sedation Dentistry?

Sedation Dentistry is a mild to moderate level of sedation used to assist dental patients with attaining a temporary insensitivity to pain while remaining conscious. Typically, this is used for lengthier procedures and is also found to be very beneficial for patients that suffer from anxiety about having dental work done.

What are the different types of Sedation Used?

There are a few different types of sedation that can be used for dental procedures. The kind of sedation used depends on the treatment or procedure at hand and the level of anxiety the patient suffers from. There are also varying factors such as the patient’s weight and medical history.

Oral Sedation: With oral sedation, a pill is administered about one hour before a procedure so it has time to take effect. Usually, patients will feel tired and dazed. This is considered “minimal sedation”. It is possible to fall asleep while under oral sedation but not common. At most, it would be a light sleep and the patient can be easily awakened. This type of sedation is ideal for patients with fear or anxiety. It will affect memory and motor skills and, accordingly, patients must be advised against driving themselves home.

Inhalation Sedation: This is typically known as “laughing gas”. Nitrous Oxide is administered through a mask or nosepiece. It is a gas and the dosage is controlled by the dentist and begins to take effect almost instantly (within 3 to 5 minutes). This method merely calms the patient to sit through the procedure and may provide mild pain relief. Oral injections can be provided simultaneously with nitrous oxide. Once finished, oxygen is passed through the mask or nosepiece and the nitrous oxide is flushed out of the system. This is also considered “minimal sedation”.

Intravenous Sedation: Sedative Medications are pumped into the veins of a patient and through the bloodstream. This requires the monitoring of blood pressure, oxygen levels, and heart rate and is the most intense form of sedation allowed to be used in a dental office. This is considered “moderate sedation”. Patients typically fall asleep and have no memory of the procedure afterwards. It is not recommended to operate a motor vehicle after intravenous sedation. Patients should be advised to not eat or drink for 6 hours before having intravenous sedation.

General anesthesia can be used in a hospital or ambulatory setting. It is an unconscious sedation, and an anesthesiologist must be present. This is not very common for a dental procedure and cannot be performed in dental office.

When is Sedation Used in Dentistry?

Sedation is usually offered to patients who have some sort of anxiety about a procedure. It is also offered to minimize the amount of pain felt during a procedure. For lengthier or more painful procedures such as root canals, it is always recommended.

Who Can Utilize Sedation Dentistry?

The Florida Board of Dentistry allows dentists to administer a small dose of oral sedation without having advanced training or permitting. A single dose of a medicine is allowed up to the maximum dosage per patient weight. Dentists are also allowed to supplement with nitrous oxide. This is considered “minimal sedation”. Formal advanced training in sedation is required to administer “moderate sedation”. This is done through an internship or an approved course. Dental professionals must complete 60 hours of didactic instruction on a minimum of 20 patients, and an inspection of the office must be performed including a demonstration of an emergency drill before any permit is issued with the Board of Dentistry. To administer “deep sedation” or general anesthesia, a dentist must complete a residency in General Anesthesia an receive a permit from the Board of Dentistry. Pediatric sedation requires a completely separate permit and training requirements.

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

 

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

Do I Need a Biomedical Waste Permit for my Clinic?

Biomedical Waste Permit Regulations

Biomedical waste is the inevitable outcome in most health care offices. Professionals in the health care field need to keep up to date information on the regulations for handling any type of biomedical or hazardous/chemical waste that is a result of services provided. While the most obvious concerns are those of public safety and possible health risks, if not stored or disposed of properly, this waste can also result in thousands of dollars in fines.  There are many types of health care waste to consider: biohazard, chemical, pathological, chemotherapy waste, etc. The waste produced by each office will determine the proper treatment and disposal. The Department of Health along with the state’s environmental and health departments regulate the storage, containment, treatment, and disposal of biomedical waste.

What is Biomedical Waste?

According to the State of Florida’s Bureau of Community Environmental Health, Biomedical waste is defined as any solid or liquid waste that may present a threat of infection to humans. The term includes, but is not limited to, nonliquid human tissue and body parts; laboratory and veterinary waste that contains human-disease-causing agents; discarded disposable sharps; human blood and human blood products and body fluids; and other materials that in the opinion of the Department of Health represent a significant risk of infection to persons outside the generating facility. The term does not include human remains that are disposed of by persons licensed under Chapter 497.

Biomedical Waste Storage and Containment

In Florida, biomedical waste generated from a facility cannot be stored for more than 30 days. The period of allowable storage begins from the moment a non-sharp article of biomedical waste is thrown into a red bag or a sharps container or when a sharps container is sealed. All containers, bags, or packages of waste must be clearly identifiable with the international biomedical waste symbol. All contained waste must remain sealed until treatment occurs. If a container should be ruptured, the original package must be placed into a new container without disrupting the original packaging. Any indoor storage area for biomedical waste must have restricted access and be described in the operating plan.  Outdoor storage areas must be clearly identifiable with the international biomedical waste symbol and have some form of security or protection against theft or vandalism. All symbols must be red, orange, or black and have a contrasting background color. All symbols must be a minimum of 6 inches in diameter.

Disposal of Biomedical Waste

Packages that are compacted should be incinerated or treated via approved treatment process. Other treatments must be approved via written request by the Department of Health. There are various treatment options available: treatments by gas, steam, chemical, dry temperatures, or microwaving are all approved and available. Waste may be disposed by transporting to a sanitary sewer system, an onsite sewage treatment disposal system. The disposal systems must be approved by the Department of Environmental Protection or the Department of Health.

Permitting

All facilities housing biomedical waste shall obtain an annual permit from the Department of Health. The form DH 4089, Application for Biomedical Waste Generator Permit/Exemption and the corresponding fees should be submitted to the local Department of Health facility. This permit needs to be renewed annually no later than September 30th of every year. If any facility eliminates less than 25 lbs of biomedical waste within a 30 day period, it is exempt from having to obtain permits and fee requirements. To qualify for exemption, documentation proving the weight of the waste generated for a 30 day period must be provided. After applications are submitted, the Department of Health will conduct an inspection of the facility to ensure compliance with section 381.0098 of the Florida Statutes. After inspection, the Department will notify if the facility is eligible to receive exemption.

Sharps Storage, Containment and Disposal

A permanently mounted sharps container is mandated by the state of Florida for businesses that use and dispose of needles. It must be labeled with the approved phrases of the international biomedical waste regulations. Containers must always be readily available and as close to the location of use as possible. The container should be disposed of once ¾ full to avoid any potentially dangerous contamination.

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

 

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

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