Plan for Return to Clinical Practice in Respect of Covid-19

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This plan was developed based on the recommendations by the The College of Massage Therapists of British Columbia (CMTBC) and The Registered Massage Therapists Association of British Columbia (RMTBC). The goal is to reduce the risk of exposure to the virus that causes Covid-19 for both patients and the practitioner within our clinical setting. Here, we identify the actions that the therapist at Spruce Massage Therapy commits to, and that all visiting patients must commit to, in order to resume massage therapy services. 

“Coronavirus 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 coronavirus 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 amongst 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 
     

Pre-Screening / Prior to Arrival

  • Prior to every appointment, patient’s will need to fill out the online BC Covid-19 Symptom Self Assessment form. Patient’s should stay home if they experience any symptoms of Covid-19. 

  • The therapist will use the BC Covid-19 Self Assessment tool on themselves daily and commits 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: Fever, cough, chills, shortness of breath, sore throat or pain with swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches, fatigue or 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. 

  • Patient’s 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.

  • The treatment will be cancelled immediately if the patient does not meet the pre-screening criteria upon physical presentation at the clinic. 
     

Physical Distancing / Reception Area / Entry into Clinic Space

  • If you happen to arrive early for your appointment please wait outside on the covered porch and come up at your scheduled appointment time.

  • Patients must arrive unaccompanied. 

  • 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. 

  • Patients are not permitted to lounge in the clinic reception area before or after the treatment. 

  • There is additional time in between appointments for enhanced cleaning and to avoid patient’s crossing paths. 

  • Patients are asked to arrive on time and not early for appointments. 
     

Within the Treatment Room

  • During the treatment the therapist will be wearing a mask at all times. It is still recommended that patient's wear a mask. However, if you are fully vaccinated you may chose not to wear one.

  • It is not possible to maintain physical distancing while in the treatment room. 

  • Patients will be asked to keep all personal belongings on the guest chair which will be sanitized between patients. 


Hand Hygiene

  • Patient’s are asked to use the provided hand sanitizer before and after their treatment. 

  • The therapist will wash their hands thoroughly for at least 20 seconds before starting the treatment and when the treatment ends. 


Payment

  • Cash will not be accepted at this time. A wireless Point of Sale system with Tap is available for card use. 

  • The POS machine will be sanitized between each patient. 

  • Receipts will be emailed, not printed. 


In the Treatment Room

  • The therapist will open the door to the treatment room and allow the patient to enter. The therapist will open/close the door before, during and after the treatment as required – reducing the need for the patient to touch the door. 

  • Patients will be permitted to open the door for themselves after the treatment to let themselves out of the treatment room. 

  • Tissue is available inside the treatment room for the patient to use as a barrier when opening the door. 

  • Hand sanitizer is available within the treatment room; patients will be asked to sanitize their hands before and after the treatment.

  • The door and doorknobs will be disinfected between each patient. 
     

Avoid Face Touching

  • Tissue will be available throughout the clinic: in the reception area, treatment room and washroom in order that patients and the therapist may use tissue to address an itch and/or touch the face for any other reason. 

  • Inter-oral and face massage will not be conducted at this time. 
     

Enhanced Cleaning

  • Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room.

  • Common space and high touch surfaces will be cleaned and disinfected between patients, regardless of appearances. 

  • High touch surfaces include (but are not limited to): Light switches, door knobs, POS machine, electronic devices, table surfaces, chairs, stools, window coverings, faucets, etc. 

  • The treatment table, table levers, face cradle, heating pad switch and oil bottles will be immediately sanitized after each treatment. 

  • All linens, including blankets and pillow cases are single use only and will be laundered using high heat and detergent.

  • A GermGuardian Air Purifier with HEPA Filter has been placed in the treatment room and will be utilized in between each patient and/or during the treatment.

  • A disinfected single-use plastic bin has been placed in the treatment room. The patient will be asked to keep all of their personal belongings in this bin during the treatment. Bins will be disinfected between each patient.
     

Personal Protective Equipment

  • The therapist will wear a face mask in the clinic and during the treatment. It is recommended that patient's wear a face mask during the treatment. Patient's can bring their own mask or one will be provided for you.
     

Professional Obligations Liability Insurance

  • The therapist carries professional liability insurance through the Registered Massage Therapist Association of BC. 
     

In the Event That a Patient Alleges they Caught COVID-19 from the Therapist

  • The therapist will immediately call public health at 8-1-1 to report the alleged transmission, providing both the name of the RMT and the name and contact details of the patient. 

  • All massage therapy appointments will be cancelled and the therapist will cease to provide services until Public Health has investigated and provided direction. 

  • The therapist will immediately self-isolate until Public Health has investigated and provided direction. 
     

Asymptomatic Spreaders

  • Asymptomatic transmission of the coronavirus is an unavoidable risk of practice, until there is an effective treatment or vaccine against Covid-19. 

  • We have put into place protocols to help mitigate that risk as outlined in this document.
     

Informed Consent

  • In the current environment of Covid-19 risk, informed consent requires that the patient be informed and understands that: Any massage therapy treatment involves some risk of Covid-19 transmission; 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.