has become another option that can be con-sidered when choosing the right table for your practice. Studies have shown that the design and décor in your clinic can impact your patients’ therapeutic experience. 5 It can also have an effect on staff productivity and morale, which, in turn, will influence how your staff interact with your patients. 6 John Triantos relates that, in the earlier years of chiropractic table manufacturing, the fabrics used to upholster the tables var-ied widely in durability and quality – and health-care settings is called the “double-rub” test and can help monitor how long the upholstery will last from being rubbed in the clinic. Basically, notes Triantos, the higher the double-rub rating – that is, the more rubs the upholstery can withstand before its fibres begin to break – the lon-ger the life that can be expected from the material. Scores can usually be found on manufacturers’ swatch samples. Be reminded, however, that along with rubbing down the table, you should When looking for a table – be it the first table or a new one to add to a growing clinic – DCs are advised to plan ahead, establish needs and budget, understand safety and maintenance guidelines, and consider costs of unexpected repairs. colour was often not an element that com-manded much consideration. Older tables, then, might clash with contemporary clinic décor – not to mention that they may not meet infection control requirements for cleaning and surface maintenance, a topic that will be discussed later in this article. Triantos goes on to say that starkly bright colours may also present somewhat of a shock-element for patients entering an adjustment room and suggests that chiro-practors who wish to explore contempo-rary colour possibilities – other than black – consider lighter, more soothing colours. He cautions, however, that although lighter colours may blend with your dé-cor and be pleasing to the eye, they may stain easily and make maintenance more of a challenge. provide every new patient with a fresh sheet or slipcover so as to avoid bringing that patient in contact with pathogens from a previous patient. leaks on air and hydraulic lines. Grease and lubrication frequency depends on the manufacturer. Less expensive tables will need more oil and grease. For the best care, practitioners should ask the manufacturer what type of main-tenance their table needs, and if clean-ing and maintenance is provided by the manufacturer. Alternatively, a DC can ask the repair centre how to clean the table and its components and what issues might arise during cleaning. As well, consideration must be given to the location of repairs for electric and hydraulic tables – that is, does someone come in and clean it, or does the table need to be sent out. If the table needs to be sent out, the DC must make provision for this, either by cancelling patients or by having another table available while one is out for repair. Finally, the chiropractor will have costs for maintaining the table in coming years – and these need to be considered, as well, when purchasing the table. These may include, but are not limited to, repairs beyond warrantly and reupholstering. THE RUB ON KEEPING IT CLEAN Health-care workers, including those in non-acute settings such as chiropractic clinics, are required to observe infec-tion control guidelines in practice. 7 This means chiropractic tables may require frequent and rigorous cleaning, whether or not sheets and/or slipcovers are used. Because of this, Triantos also recom-mends that, when purchasing an adjust-ing table, cleaning regimen of the table cover must be considered. Important questions a DC needs to ask: is the table easy to clean and what is the moisture resistance of the material? There are tests designed to assess up-holstery. A good one for table coverings in 18 • CANADIAN CHIROPRACTOR | OCTOBER 2012 SAFETY AND MAINTENANCE To avoid injuring patients, chiropractic table elements are constructed with safety in mind. “Safety issues are usually governed by Health Canada, a government agency that classifies chiropractic adjusting tables as Class 1 medical devices. This means they represent the lowest risks,” says Gary Holub, media relations officer at Health Canada. “There is also a yearly routine required for medical devices,” continues Holub, “whereby their manufacturers must en-sure they have appropriate post-market procedures in place for distribution re-cords, compliant handling, mandatory problem reporting and recalls.” He adds that to hold a valid medical de -vice establishment licence, establishments must submit an application, with fee for an-nual review, to Health Canada every April 1. What does this mean to the chiroprac-tor who purchases the table? The manufac-turer and/or distributor of your chiroprac-tic table must have checks and balances in place to ensure that the table you purchase comes with the assurance of safety, in order to protect you and your patients. Another yearly process involves table maintenance and may be provided by the manufacturer or distributor of your ta-ble. Checks should be made annually for SOME CLOSING THOUGHTS Triantos counsels young chiropractors to make their first table their main table. The second table in a two-room clinic can help as an overflow table . . . and so forth. As well, doctors who are shopping for their first table when opening a clinic, or changing their décor in their treatment rooms, are warned that shopping only two weeks before opening may not give them enough time. In short, when looking for a table – be it the first table or a new one to add to a growing clinic – DCs are advised to plan ahead, establish needs and budget, under-stand safety and maintenance guidelines, and consider costs of unexpected repairs. Next to his/her hands, the chiroprac-tic adjusting table may be the single most important piece of equipment that a DC uses in practice. It can leave a patient with an impression of what your practice is all about. Shop around, choose wisely and don’t hesitate to turn to the experts in this field for advice. Speaking with other chi-ropractors and some industry leaders can help you get a good overview of what’s available and what’s right for you.• For article with references, please visit the Cur-rent Issue page at www.canadianchiropractor.ca. www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor October 2012: Page 18
