PLAN FOR RETURN TO CLINICAL PRACTICE DURING COVID-19
This plan was developed with the goal of reducing the risk of exposure to the virus that causes Covid-19 for both patients and the therapist within my clinical setting. Here, I identify the actions that I will commit to, and that all visiting patients must commit to, in order to resume massage therapy services.
“Corona virus is transmitted via liquid droplets when a person coughs or sneezes. The virus can enter through these droplets through the eyes, nose or throat if you are in close contact. The virus is not known to be airborne (e.g. transmitted through the particles floating in the air) and it is not something that comes in through the skin. It can be spread by touch if a person has used their hands to cover their mouth or nose when they cough. That’s why we recommend you cough or sneeze into your arm and wash your hands regularly.” Source: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/how-it-spreads
The overall aim of these protocols is to reduce potential corona virus transmission by:
• Required ongoing self-assessment for signs of Covid-19 related illness in both the patient and the therapist
• Reducing all physical, non-treatment related interactions among all people within the practice environment
• Hand hygiene requirements
• Avoiding face touching
• Enhanced cleaning protocols
• Appropriate use of personal protective equipment (PPE)
• Meeting professional obligations, particularly related to informed consent and liability insurance
Self-Assessment for Symptoms of Covid-19: For Patients & Therapists Pre-Screening / Prior to Arrival
• Patients will be informed about their responsibilities at the time of booking. A notice will be placed on the website, and the online booking software will send them protocols as part of a Covid-19 specific consent form they will be required to sign electronically, prior to arriving at their appointment.
• One day prior to their booked appointment, the patient will be strongly encouraged to complete the online BC COVID-19 Symptom Self-Assessment tool and to stay home if they experience any symptoms of Covid-19. The tool can be found here: https://bc.thrive.health/covid19/en
• The therapist will use the BC COVID-19 Self-Assessment tool herself, and commit to canceling all appointments if symptoms appear.
• Symptoms of Covid-19 are similar to other respiratory illnesses and seasonal allergies. An appointment must be cancelled immediately if either the patient or the therapist presents with even mild symptoms that may be signs of Covid-19 including:
o Shortness of breath
o Sore throat or pain with swallowing
o Stuffy or runny nose
o Loss of sense of smell
o Muscle aches
o Loss of appetite
• Covid-19 Symptoms may range from mild to severe. Patients are required to cancel appointments if they experience what they determine to be ‘just the sniffles,’ ‘seasonal allergies’ or ‘just feeling under the weather,’ on the day of their appointment.
• As a part of this consent form, patients must commit to understanding that while we’ve taken all possible measures to minimize risk of viral transmission, the nature of massage therapy means that physical distancing is not possible in the treatment room.
• In order for massage therapy treatment to commence the therapist and patient must agree that the therapeutic benefit of massage therapy outweighs any potential consequence of treatment, including the possibility of viral transmission.
• Patients must confirm that they have not been in contact with anyone displaying illness, or signs and symptoms of Covid-19 within 14 days prior to their treatment.
• Patients with higher risk profiles and/or weakened immune systems should consider alternatives for care and postpone treatment.
• Patients who develop even mild illness or symptoms should cancel booked appointments, even without notice. They will not be charged a late cancellation fee if they cancel due to illness.
• Upon arrival patients must confirm that they have done a pre-screening and have no signs of Covid-19 as outlined here: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/symptoms
• Masks MANDATORY within the clinic space. If the patient has a mask, they are asked to bring it with them and wear it when they arrive. If the patient does not have a mask, a clean cloth mask can be provided if requested.
• Patient must confirm that they have not traveled outside of Canada within 14 days prior to their appointment.
• The treatment will be cancelled immediately if the patient does not meet the pre-screening criteria upon physical presentation at the clinic.
Physical Distancing / Entry into Clinic Space
• Masks are MANDATORY within the clinic space. If the patient has a mask, they are asked to bring it with them and wear it when they arrive. If the patient does not have a mask, a clean cloth mask can be provided if requested. If you are uncomfortable wearing one throughout the duration of the treatment, exceptions can be discussed and made a head of time.
• The therapist will wear a new clean face mask for each patient, and be worn at all times in the clinic.
• The therapist will wear non-latex gloves if/when appropriate, or at the patient’s request.
• Only 1 patient/person is permitted in the clinic space at any given time, unless the patient is a minor and must be accompanied by an adult.
• The therapist and the patient will both maintain a space of 2 meters (6 feet) distance between each other in all clinic areas outside the treatment room.
• Appointment times are spaced a minimum of 30 minutes apart to reduce the potential of patients crossing paths, and to allow for time in between appointments for enhanced cleaning.
• Patients are asked to arrive on time. If early, patients must wait in their vehicles until their appointment time.
• The clinic door will be locked behind them to prevent anyone else from entering the space during the course of their treatment.
Restroom for Patient Use
• The restroom has been equipped with soap, single use hand towels and proper hand washing guidelines.
Hand Hygiene Reception Area / Entry into Clinic Space
• Immediately upon entering the clinic space the patient must go directly to the hand washing sink without touching anything inside the clinic and wash their hands with soap and water for at least 20 seconds and then dry thoroughly.
• The therapist will wash hands thoroughly for at least 20 seconds between patients, before and after disinfecting spaces
• Hand washing protocols will be posted visibly at the sink.
• Receipts will be emailed, not printed, unless otherwise requested.
In the Treatment Room
• It is not possible to maintain physical distancing while in the treatment room and receiving treatment.
• The therapist will communicate with the patient that corona virus can be transmitted by touch if droplets are on the hand when it touches the face, as it can transfer those infected droplets to the mouth, nose or eyes.
• The therapist will wear a mask at all times.
• Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room and high contact surfaces.
• All linens, including blankets and pillow cases are single use only and will be laundered between each use.
Professional Obligations in the Case of Illness, or Suspected Illness
• All massage therapy appointments will be cancelled and the Therapist will cease to provide services if directed by health authorities.
•All Patients up to 2 weeks prior to the Therapist’s symptoms beginning will be informed.
• Asymptomatic transmission of the Corona Virus is an unavoidable risk of practice until we’ve acquired herd immunity, there is an effective treatment, or a vaccine has been developed against Covid-19.
• The therapist is following protocol to help reduce or mitigate risk where possible, but that risk cannot be reduced to zero;
• The patient consents to the treatment despite some risk, and the RMT will document the patient’s consent in advance and at every treatment.