TTUHSC School of Medicine
HSC Home SOM Home

This page is currently under construction. All-Campus Ambulatory Care Policies and Procedures are currently being developed. Links will be added as policies are approved. If you find a broken link on this page, please notify Tim.Hayes@ttuhsc.edu. Thank you for your understanding.


Link to Lubbock Campus Policies


School of Medicine Clinical Affairs

All-Campus Policies and Procedures



1. Leadership

back to top

2. Emergency Procedures

back to top

3. Patient Care

back to top

4. Medication Management

back to top

5. Management of Information

  • 5.01 - Medical Records Documentation & Confidentiality
  • 5.02 - Medical Records Format
    • 5.02.A - Medical Records Standard Format
  • 5.03 - Authentication of Entries into the Medical Record
  • 5.04 - Primary Care Patient Summary List
  • 5.05 - Medical Record Forms
  • 5.07 - Securement of Medical Records
  • 5.08 - Access to the Medical Records Department
  • 5.09 - Release of Health Record Information
  • 5.10 - Guidelines for Destruction/Disposal of Protected Health Information
  • 5.11 - Retention & Retirement of Medical Records
  • 5.12 - Adoption Records
  • 5.15 - Medical Records Abbreviations
  • 5.16 - Charges for Services Rendered to Outside Agencies
back to top

6. Patient Rights

back to top

7. Infection Prevention & Control

  • 7.01 - Infection Prevention & Control Plan
  • 7.02 - Standard Precautions, Exposure Control Plan
  • 7.03 - Hand Hygiene
  • 7.04 - Infection Control, Waiting Room
  • 7.05 - Disposal of Needles/Sharps
  • 7.06 - Disposal of Biohazardous/Infectious Waste
  • 7.07 - Management of Blood & Bodily Fluid Exposures
  • 7.08 - Cleaning of Blood Soiled Areas
  • 7.09 - Incidental Housekeeping
  • 7.10 - Sterilization Procedures, Autoclaves
  • 7.11 - Cleaning of Patient Exam Room
  • 7.12 - Linen and Supply Storage
  • 7.13 - Cleaning of Pediatric Toys and Equipment
  • 7.14 - Cleaning of Staff Lounge/Break Room
  • 7.15 - High Level Disinfection for Reuseable Instruments
  • 7.16 - Clinical Waste Disposal Procedures for Infectious Waste
  • 7.20 - Employee Communicable Disease
    • 7.20.A - CDC Suggested Work Restrictions
    • 7.20.B - Clinic Tuberculosis Exposure Control
  • 7.21 - Communicable Diseases Reporting
    • 7.21.A - Notifiable Conditions Report Form
  • 7.22 - Nosocomial Infection Tracking
    • 7.22.A - Nosocomial Infection Communication Form
    • 7.22.B - CDC Definitions for Nosocomial Infections
  • 7.23 - Clinic Tuberculosis Exposure Control
    • 7.23.A - Regimen Options for the Treatment of Tuberculosis
back to top

8. Performance Improvement

back to top

9. Management of Human Resources

  • 9.01 - Credentialing and Provider Enrollment Process
  • 9.10 - Medical Students Guidelines for Patient Care
  • 9.20 - Definition of Nursing
  • 9.21 - Nursing Service Purpose, Philosophy & Objectives
  • 9.22 - Nursing Care Standardization
  • 9.23 - Nursing Service Organizational Description
  • 9.24 - License Verification, Registered Nurse, LVN
  • 9.25 - Definitions and Limitations for GN, GVN & NA's
  • 9.26 - Nursing Orientation
    • 9.26.A - Nurse Manager Orientation Checklist
    • 9.26.B - General Nursing Orientation Checklist
    • 9.26.C - Nursing Orientation Checklist
    • 9.26.D - Nursing Orientation Evaluation
  • 9.27 - Nursing Compliance
  • 9.28 - Nursing Dress Code
  • 9.29 - Competency Validation
  • 9.30 - Resource Pool Staff
  • 9.31 - Nursing Budget Responsibilities
  • 9.50 - Volunteer Program Philosophy, Objectives & Organizational Structure
  • 9.51 - Volunteer Historical Summary
  • 9.52 - Volunteer Orientation, Departmental Responsibilities
    • 9.52.A - Volunteer Orientation Checklist
    • 9.52.B - Volunteer Competency Monitor
  • 9.53 - Recruiting of Volunteers
  • 9.54 - Volunteer Rights and Responsibilities
  • 9.55 - Volunteer Job Descriptions
    • 9.55.A - Greeter
    • 9.55.B - Clerical Assistant
    • 9.55.C - Lab Assistant
    • 9.55.D - Storytellers
    • 9.55.E - Clinic Assistant
back to top

10. Environment of Care

  • 10.01 - Safety Management Plan
  • 10.10 - Security Management Plan
  • 10.20 - Hazardous Materials and Waste Management Plan
  • 10.30 - Emergency Preparedness Management Plan
  • 10.40 - Life Safety Management Plan
  • 10.50 - Medical Equipment Management Plan
  • 10.51 - Medical Equipment Management
  • 10.60 - Utility Systems Management Plan
back to top
Download Free Adobe Reader Get Adobe Reader Adobe Acrobat Reader is required to view items marked with this icon:
Please click on the left image to download the free version.