Patient Safety and the Audiologist

As audiologists and health care professionals, we are ethically bound to prioritize patient safety, uphold professional integrity, and advocate for equitable care. Principle of Ethics I of the Code of Ethics and Principle of Conduct I of the Code of Conduct state that ASHA-certified individuals “shall honor their responsibility to hold paramount the welfare of persons they serve professionally” (Code of Ethics).

Ethical considerations—such as informed consent, confidentiality, and equitable access—must guide every clinical decision and patient interaction. Additionally, audiologists must adhere to state laws, if applicable, that exist regarding duties to report suspected abuse or neglect of patients.

Moral distress is when institutional constraints, limited resources, or conflicting responsibilities hinder the audiologist’s ability to provide optimal care. Recognizing and addressing moral distress is essential to maintaining professional well-being and preserving ethical standards.

Health care professionals may experience moral distress during times when

• systemic or institutional policies or practices limit a clinician’s ability to provide the care that they believe is needed or
• a facility or organization asks health care professionals to participate in practices that do not align with standards of care, the ASHA Scope of Practice in Audiology, ethical standards, and/or billing standards.

Documentation of clinical services and patient information is essential for maintaining crucial lines of communication between providers, clinical staff, patients, payers, and family members. Documentation should always be comprehensive, readable, and clear—to prevent (a) breakdown in communication or (b) lack of—or loss of—information about patient services and care.

• A breakdown in communication can create a risk to patient safety throughout their clinical services.
• Unclear or absent documentation increases the risk of delayed patient care, payer denials, misdiagnosis, and inadequate intervention.

For further guidance and suggestions, refer to ASHA’s Documentation of Audiology Services webpage.

Clear communication is essential in audiology because it ensures that patients fully understand their hearing health, diagnostic evaluations, treatment recommendations, and further care. The audiologist is responsible for conveying complex medical and technical information in ways that are accessible and tailored to each patient’s needs—particularly because many patients are struggling with hearing-related challenges.

Health Literacy—or the ability to access, understand, and apply health information—plays an important role in patient safety. For individuals with hearing loss, communication barriers can further complicate health literacy. Examples of such barriers can include the following:

• increased risk of misunderstandings
• improper device use
• lack of proper accommodations

It is imperative that audiologists take the necessary steps such as those listed below to ensure that patients and their care partners understand their diagnoses, management plans, and follow-up care.

• Use plain language and avoid technical jargon.
• Confirm patient understanding through teach-back techniques.
• Provide written or visual instructions.

Unclear communication between audiologists and the patient (or care partner) can lead to any of these situations:

• misunderstood instructions on how to insert, clean, or store hearing devices—leading to device damage or improper use
• missed appointments or discontinued care
• delays in seeking care or reluctance to attend appointments due to difficulty understanding the information provided
• difficulty using communication strategies, which may lead to avoidance of social engagements and reduce overall quality of life.

For more information on clear communication and health literacy, consult these resources:

• The Value of Health Literacy in Communication Sciences and Disorders (ASHA)
• Tips to Better Communicate With Patients (ASHA)
• What Is Health Literacy? (CDC)
• Health Literacy Fact Sheets (Center for Healthcare Strategies)
• Communicating Clearly and Effectively With Patients (The Joint Commission)

In the profession of audiology, ensuring communication access and practicing culturally sensitive communication are not just ethical imperatives—they’re foundational to delivering equitable, effective care that honors every patient’s diverse backgrounds and communication needs.

Communication access means that people with communication disabilities have the same opportunities to take part in—and fully benefit from—high-quality services and programs as everyone else does. This access includes using necessary communication supports such as

• interpreter services,
• communication aides, and/or
• assistive listening devices.

Cultural responsiveness involves thoughtfully engaging with and addressing the unique blend of cultural factors and diverse identities that each person brings to any interaction. Culturally sensitive approaches

• help minimize misunderstandings,
• increase patient comfort, and
• promote greater engagement between the audiologist and the patient and their care partners.

Recognizing and respecting cultural differences in health care approaches and communication styles supports access to care, trust building with patients, and better health outcomes for all individuals—regardless of cultural or linguistic background.

For additional information related to communication access and cultural responsiveness, see the following ASHA resources:

• Collaborating With Interpreters, Transliterators, and Translators
• Cultural Responsiveness
• Communication Access
• Communication Access in Health Services

Social determinants of health (SDOH) are nonmedical factors that may impact patient safety by influencing individuals’ access to care, understanding of health information, ability to follow medical recommendations, and overall health outcomes.

These nonmedical factors include the following:

• Social and Community Context
• Education Access and Quality
• Neighborhood and Built Environment
• Health Care Access and Quality
• Economic Stability

Here are some examples related to SDOH in the audiology profession.

Health Care Access and Quality

• Example: An individual is having trouble hearing at his job; this difficulty is significantly impacting his career. He lives in an area where the closest audiologist is 75 miles away.
• Impact: This situation results in undiagnosed and untreated hearing loss. This individual becomes more withdrawn from family members and friends. He feels that he can no longer perform his duties at work.

Economic Stability

• Example: A patient with limited income may delay hearing evaluations or may be unable to afford hearing aids, even when hearing loss significantly impacts their communication and quality of life.
• Impact: This delay leads to prolonged untreated hearing loss, reduced social engagement, and poor health outcomes.

For additional information on SDOH, see ASHA’s Social Determinants of Health (SDOH) webpage.

Infection control is critical for patient safety in the practice of audiology. Audiologists routinely encounter patients’ ears and bodily fluids; our equipment and supplies can serve as vectors for the spread of disease. Audiologists utilize materials and equipment that are either disposable or reusable.

Disposable items (single- use) in audiology can include ear tips, headphone covers, probe tubes, foam tips, and disposable gloves. Proper disposal is crucial to prevent cross-contamination.

• Identify single-use items: Always check manufacturer instructions for items labeled “single-use” or “disposable.”
• Use appropriate waste containers:
• Standard disposables may be put into regular trash.
• Biohazardous items contaminated with blood or body fluids must be disposed of in biohazard bags.

• Avoid reprocessing: Never attempt to sterilize or reuse disposable items.
• Gloves: Remove gloves immediately after contact with bodily fluids and dispose of them in the appropriate container. Always wash hands afterward.
• Documentation: Some facilities log disposal of biohazardous materials for compliance.

Reusable audiology materials and equipment should be maintained in a clean and safe condition to support patient safety and equipment longevity. Without proper cleaning, disinfection, and sterilization protocols, items can harbor and transmit bacteria, fungi, or viruses. Reusable audiology materials and equipment include, but are not limited to

• otoscopes,
• earmold impression materials,
• stainless steel cerumen removal tools,
• audiometers and other test equipment, and
• test equipment attachments, such as
• supra-aural headphones,
• bone conduction oscillators,
• reusable electrodes, and
• VNG goggles.

Adherence to infection control standards protects everyone from exposure—not only to our patients, but also clinicians and staff. Implementing consistent, evidence-based infection prevention practices support patient safety.

For additional information on infection control, see the following resources:

• Infection Prevention and Control for Audiology Equipment (ASHA)
• Infection Control Resources for Audiologists and Speech-Language Pathologists (ASHA)
• Infection Control for Healthcare Providers (CDC)
• About Handwashing (CDC)

The Joint Commission—a health care accreditation organization—establishes national patient safety goals (NPSGs) to improve patient care. NPSGs are updated annually and may differ depending on the health care setting. To view the most recent safety goals by setting, see the Joint Commission’s National Patient Safety Goals webpage.

Patient safety in audiology isn’t just about maintenance of hearing devices—it also includes

• proper infection control,
• environmental awareness, and
• attention to individual patient needs.

Below are clinical considerations and examples related to patient safety that align with The Joint Commission’s NPSGs.