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PROTOCOLS FOR RETURNING TO PRACTICE

 

This is a living document that will change if/when our governing body or Provincial Health guidelines change. This has been created based on the current guidelines forwarded by the Registered Massage Therapists Association of BC, the College of Massage Therapists of BC and the BC Provincial Health Officer. All patients must read, understand and agree to the current protocols as outlined here, prior to every appointment.

 

Returning to Safe Practice

The aim of these protocols is to reduce potential coronavirus transmission by:

  1. Required ongoing self assessment for symptoms of Covid-19 related illness in both the patient and the practitioner

  2. Reducing all non-treatment related interactions within the clinic environment

  3. Specifying Hand Hygiene requirements for practitioners and patients

  4. Avoidance of face touching, covering face when sneezing etc

  5. Enhanced cleaning protocols

  6. Appropriate use of personal protective equipment (PPE)

  7. Meeting professional obligations, particularly related to informed consent

 

1. Pre-Screening / Prior to Arrival

Patients will be informed of their responsibility to perform a self-assessment prior to their arrival for the appointment upon booking. Screening will take place two times prior to the appointment.

1. The day before the appointment
2. In the treatment room at your appointment time

  • -  The first screening will be communicated either verbally by a phone call from your practitioner and/or by an automatic screening survey via email ent 36 hours prior to your appointment time. 

  • -  If either party exhibits symptoms related to Covid-19, they are responsible for immediately cancelling all appointments.

Symptoms include: Fever , cough, chills , shortness of breath, sore throat or pain with swallowing, stuffy or runny nose, loss of sense of smell or taste, headache, muscle aches, fatigue, loss of appetite

***Covid-19 symptoms may range from mild to severe. Patients and practitioners MUST cancel appointments, regardless of the severity of any symptoms***

  • -  In order for treatment to commence, the practitioner and patient must agree that the therapeutic benefit of therapy outweighs any potential consequence of treatment, including the possibility of viral transmission.

  • -  Patients with higher risk profiles and/or weakened immune systems should consider alternative care and postpone treatments.

  • -  CANCELLATION FEE WILL BE WAIVED if canceled due to illness.

     

  • Practitioners will:

  • -  Take their temperature every day before work.

  • -  Complete a the self-screening tool and notify you of the results at the time of your appointment.

  • -  Be aware of the number of places visited or stopped at outside of work.

  • -  Disclose their number of contacts (places visited) to their patients with full transparency.

  • -  They will not use medicines that reduce fever e.g. acetaminophen or ibuprofen. If they have taken a fever reducing medicine they will wait at least 4 hours after their last dose to take their temperature.

    Practitioner not feeling well

    Practitioners will not go to work if they are not feeling well – even if their symptoms are mild and they are uncertain of whether it is COVID-19 or not. Practitioners are committed to protecting their colleagues and their patients and will stay home if there is any doubt in their mind. Practitioners expect to miss more work than usual to make sure that they are taking care of their self, their colleagues, and their community.

    Practitioners commit to:

  • -  (If they feel mildly ill) staying home, not going to work, not going to public places, not using public transit, taxis, or ride shares. Not having visitors to their home.

  • -  Calling their family physician, a walk-in clinic, local public health unit, complete the COVID-19 self- assessment by visiting https://bc.thrive.health/ or calling 811 and following their instructions.

  • -  If they live with others they will stay and sleep in a separate room and use a separate bathroom if possible.

  • -  If they test negative but still aren’t well they will stay home until they are better to protect their patients and colleagues from falling ill.

  • -  If they test positive for COVID-19 they will contact patients to inform them to monitor for symptoms. For instructions on how to isolate follow the instructions of public health officials. For more information see http://www.bccdc.ca/Health- Info-Site/Documents/Self-isolation.pdf

  • -  If they become ill with COVID-19 they will stay away from work for at least 10 days beyond the onset of symptoms, AND until the fever is gone without medication, AND they are feeling better AND they have been cleared by a public health official.

    Illness among close contacts

    If a close contact, a spouse, those they live with or their child becomes ill practitioners will stay home and self-isolate with their family. They will follow the instructions from the BC Centre for Disease Control: http:// www.bccdc.ca/Health-Info-Site/Documents/Self-isolation_caregivers.pdf

    Practitioners will only return to work when:

  • -  Their close contact has been tested and the results for COVID-19 come back negative and they are well.

  • -  OR after self-isolating for 14 days and having no symptoms or fever develop.

  • -  OR being cleared by a public health official.

    If a patient alleges they were exposed to coronavirus at an appointment OR in the same timeframe they were at an appointment with the practitioner, and the practitioner has had an appointment with that patient within the past 14 days, the practitioner will immediately self-isolate and cancel all appointments. Regardless of when the last appointment was, the practitioner will call public health at 8-1-1 and report the alleged transmission, providing both the practitioner’s name and the name and contact information of the patient.

    Practitioners will only return to work when:

  • -  The case has been investigated and proven false, AND the practitioner has not had any symptoms.

  • -  OR after self-isolating for 14 days and having no symptoms or fever develop.

  • -  OR being cleared by a public health official.

    If the patient has tested positive for COVID-19, OR the case is investigated and proven true, the practitioner will immediately call and notify all patients seen since the last appointment, OR in the past 14 days, whichever is longer.

 

2. Physical Distancing Upon arrival at the clinic:

  • -  Patients will be required to arrive on time to their appointments, unaccompanied unless previously arranged with treating therapist and wait outside the clinic. Your therapist will bring you in at your appointment time. 

  • -  The clinic will remain locked at all times to ensure physical distancing inside the reception area and hallways as much as possible.

  • -  We ask that you check in via the Jane Online Self Check-In if possible when you arrive at the clinic. This is not mandatory but will notify us when you have arrived. There is signage with instructions on how to do this at the front door or you can copy this link into your phone browser for checking in: 

westshoremassagetherapy.janeapp.com/checkin

  • -  Practitioners are responsible for greeting patients at the door, and holding the door/escorting patients through doorways to reduce patient-environment contact. They are also responsible for encouraging patients to move effectively within the clinic by educating them of revised practices and maintaining 2 metres distance between while in common areas.

  • -  Patients and Practitioners will advise each other of their current Self-Assessment results upon arrival to the clinic.

  • -  Patients will also receive a Covid-19 screening questionnaire upon arrival inside the treatment room which may include a fever screening with a contact-less forehead infrared thermometer.

  • -  The appointment will be cancelled if the patient or provider do not meet the pre-screening criteria upon physical presentation at the clinic.

    ***All practitioners are responsible to screen as we go, erring on the side of caution***

     

  • Reception Area:

  • -  To maintain social distancing, the reception area is closed at this time.Tea and water will not be available to patients at this time.

  • -  Appointment start times will be staggered as much as possible, and a minimum of 20 minutes will be added to the booking time to allow for enhanced sanitization between patients.

  • -  To reduce traffic in the reception area, payment and booking future appointments will need to be done after your treatment in the room with your RMT or via the online booking program or over the phone. Though we are required to accept cash for payment we strongly urge you to keep a credit card in our system to expedite the payment process and reduce handling of cash or cards. Receipts will be issued via email only.

  • -  Patients will receive any documents they need prior to their appointment, and have them filled out online. If you do not have access to a computer to complete the required forms prior to their appointment time please let us know so we can make arrangements with you to complete the forms electronically at the clinic BEFORE your appointment time. Ensure you arrive 15 minutes prior to your appointment time to do this and call the clinic to let us know you have arrived.

  • -  Practitioners will greet patients and end the session by opening and closing the door for them. Practitioners are required to prevent anyone else entering common spaces.

  • -  Practitioners will repeat the above step for their individual treatment rooms.

     

  • Within the Treatment Room:

    Practitioners are required to obtain written consent from each patient to confirm understanding that physical distancing is not possible during treatment, and of the risks related to Covid-19. Obtaining verbal consent is required for every subsequent visit.

 

3. Hand Hygiene

In the reception area:

  • -  Immediately upon entering the clinic and prior to leaving you will be asked to sanitize your hands at the reception sanitizing station.

  • -  Practitioners will wash their hands with soap and water as per the posted guidelines before and after disinfecting spaces, before donning or doffing PPE (i.e. masks, glasses, etc.), before and after greeting patients.

  • -  Hand washing guidelines are visibly posted at the wash stations.

    Within the treatment room:

  • -  Practitioners will open and close doors, as required, to reduce patient contact.

  • -  Tissues are provided within the treatment room that the patient may use as a barrier to touching surfaces.

  • -  Doors, doorknobs, and any other surfaces will be disinfected between patients.

 

4. Face Touching and Covering Coughs and Sneezes

Tissues or paper towels are available throughout the clinic for staff and patients to use as a barrier for touching their faces (i.e. to scratch and itch)

Practitioners will:

  • -  Always cover their mouth and nose with a tissue when they cough or sneeze, even while wearing a mask.

  • -  Throw used tissues in the trash.

  • -  Immediately wash hands with soap and water for at least 20 seconds. If soap and water are not readily available, they will clean their hands with hand sanitizer that contains at least 60% alcohol.

 

5. Enhanced Cleaning Protocols

Additional time (minimum 20 minutes) has been scheduled between patients to allow for thorough cleaning of the treatment room. Practitioners will be trained in the sanitization processes.

Treatment Room:

  • -  Every surface that the therapist or the patient touches is to be cleaned and sanitized between every treatment. This includes oil bottles, treatment tools, linens, the treatment table (surface and table legs near the face rest), desks, chairs, doorknobs, light switches, etc.

  • -  Bench to be used as a cleanable space for patients to store their clothing and personal items during treatment. Hanging clothes on hooks will be discouraged, and if used will also be disinfected.

  • -  There will be tissues available for practitioners and patients to use when opening doors.

  •  The practitioner will:

A. Between every appointment use approved disinfectant in a spray bottle to spray clockwise from the door around the entire treatment room all touch surfaces, including:

  • -  Door handle inside and out

  • -  Cabinet handles/touch open areas

  • -  Desk, devices/pens used

  • -  Stool

  • -  Massage table with special attention to the head rest cradle, headrest cushion, and table legs near the headrest

  • -  Bench

  • -  Any other surfaces touched by the patient or their belongings

  • -  Walls touched in self-care demonstrations

B. Disinfecting of high touch areas in the common spaces between appointments as well as on a schedule that will be posted in our staff room, including:

  • -  Door handles

  • -  Faucet/sink

  • -  Toilet handle and seat

  • -  Washing machine

  • -  Laundry basket

  • -  Cabinet open areas

  • -  Frontdesk

  • -  Stool/bench/chairs

  • -  Closethandles

C. Launder all linens, blankets, and hand towels after every use. Contaminated linens can transmit disease via direct contact or by aerosols of contaminated lint generated during sorting, and handling of contaminated items.

Practitioners will:

  • -  Avoid shaking out laundry before placing into the washing machine – it may create aerosolized particles.

  • -  Avoid contact between used linens and practitioner clothing

  • -  Use proper hand washing after touching and processing dirty laundry, as well as cleaning and disinfecting of the buttons, knobs, and doors of the laundry area.

  • -  Linens will be washed using regular laundry soap and hydrogen peroxide to disinfect and put through a dryer cycle until completely dried.

 

6. Personal Protective Equipment (PPE)

  • -  Required: Practitioners will wear procedural/surgical or cloth masks worn in common areas and changed between treatments. Patients are asked to bring your own well-fitted clean face mask with no exhalation valve and wear it at all times in the clinic except when face down on the treatment table. If you have your own fabric mask we request that it be cleaned prior to use at the clinic and needs to meet CDC requirements  http://www.bccdc.ca/health-info/diseases-conditions/covid-19/prevention-risks/masks?fbclid=IwAR0ANvdAhREMscPtvZV5kLVmP6bTaG9dkaJ56ajgZgxTwObqBZaAqP87rRc.

  • - If you arrive for your appointment with a cloth mask that does not meet CDC requirements we will provide a disposable mask at a $2 fee.

  • - If you are bringing a disposable mask it must be brand new and never used before.

  • - If you do not have a mask we have a limited number of disposable masks available for $2.

  • -  Wash hands with soap and water prior to putting on a mask, prior to taking off a mask, and after disposing of a mask in the laundry or garbage (cloth or paper/disposable)

  • -  Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Safety glasses/goggles or shield

  • -  Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Aprons, clothing covers, scrubs, or changes of clothes to be changed between treatments

  • -  Depending on comfort (practitioner will have this available for use as needed for the comfort of the patient OR the practitioner): Gloves

    ***Note Gloves do not offer any protection over the regular and rigorous handwashing that is typical of massage therapy practice. Gloves are recommended during cleaning, intra-oral work (as per normal practice), and in the case of cuts or open injuries on the patient or the therapist (as per normal practice). Gloves are always discarded after every use. If the patient is comforted by the use of gloves, they can be used.***

7.  Professional Obligations

         -  All practitioners carry professional liability insurance.

         -  All practitioners follow the health and safety requirements as outlined by the        College of Massage Therapists of B.C. and the B.C. Public Health Officer and sterilize all touched surfaces within the treatment room between appointments.

Informed Consent:

  • -  Practitioners will inform each patient of our standard protocols to mitigate risk where possible, but ultimately risk is never reduced to zero.

  • -  The patient must consent to treatment while acknowledging the risks involved. Practitioners will document patients consent in advance and at every treatment.

  • -  Asymptomatic transmission is an unavoidable risk of practice. We have put into place these protocols to help mitigate risk as outlined. Documents will be provided to practitioners and patients as required to maintain adherences to protocols set by Westshore Massage Therapy.

    Other details to note at this time:

    - Intra-oral TMJ and external face/TMJ treatments will not be conducted.

    - We will not be using thermaphores or heating pads during treatments as their covers cannot be disinfected.

    - We are not taking appointments for minors.

 
PH: 250-478-1120 ~ 110-751 Goldstream Avenue ~ Langford, B.C. ~ V9B 2X4