06/09/2020
The time has come for the clinic to REOPEN!
I will be back in the clinic starting on Tuesday June 23rd!
Important information about the clinic!
To ensure your safety and mine, a few changes will be effective immediately. Please note that if I or you fail to meet any of the new standards it will result in your treatment being cancelled.
I would also like to make sure that you know that at any time before or during your Massage Therapy Treatment if you feel unsafe or unsure if having/continuing your treatment is in your best interest, you many cancel/stop the treatment. I do still ask that you give as much notice as possible as my treatment times are now more limited. I will also have on hand a handbook made up of all the directives, precautions, logs and certificates that I need to have/ am implementing if you should want to take a look or have a copy.
This notice will state the new procedures that I, and Heather Rivers RMT will be implementing. Know that we have worked as a team though all of this and we aim to bring you cohesive, thorough, safe health care that you can trust. I know it will feel like a lot to read over at first, but I ask that you PLEASE READ IT ALL.
If you fail to comply with any of the new standards your appointment will be cancelled. No excuses or exceptions will be made. If you have any concerns or questions please email me and I will happily answer the best I can. I will do my best to remind you of any documents you need to sign before your treatment and of any procedures you need to do when you arrive, but it is your responsibility to make sure it is done to avoid your treatment being cancelled.
Below is a more in depth explanation of our new procedures. If you wish to read and have a physical copy of the document we will have one on hand at the clinic.
COVID-19 Procedure Document
Registered Massage Therapy Clinic
RMTs will only provide healthcare services in accordance Ontario Chief Medical Officer of Health’s Directive #2. Under the guidance of:
⦁ Ontario’s Chief Medical Officer of Health (CMOH),
⦁ Ontario Ministry of Health (MOH)’s guidance for the health sector,
⦁ MOH’s COVID-19 Operational Requirements: Health Sector Restart, and,
⦁ Sector-specific workplace safety guidelines.
Registered Massage Therapists (RMTs) should not return to practice if they cannot meet the requirements set by the above.
Guiding Principles
⦁ RMTs must follow all directions provided by the CMOH’s Directive #2, MOH’s COVID- 19 Operational Requirements: Health Sector Restart (May 26, 2020 or as current), MOH’s guidance for their health sector, and sector-specific workplace safety guidelines.
⦁ The procedures in this document pertains to the delivery of care at Nicole M. Andrews Registered Massage Therapy, Medical Acupuncturist clinic at 58 Rossland Rd W. Oshawa, ON Suite 214.
⦁ In-person Massage therapy treatment should only be provided when the anticipated benefits of treatment outweigh the risks to the client and the RMT.
⦁ RMTs should not return to practice if they cannot meet the requirements set by the above.
This document will provide procedures in accordance with the policies set by the CMTO’s COVID-19 Pandemic – Practice Guidance for Massage Therapists. Which has been prepared based on Ministry of Health and Public Health Ontario information and resources, in collaboration with other healthcare regulators.
Environmental Protocols
Prior to clinic progressive reopening
⦁ RMTs have made changes prior to reopening the clinic for service to limit any risk of exposure via direct or indirect contact
⦁ Removed table heating pad
⦁ Removed office decor, not pertinent to treatment delivery, from high touch areas (ie. reception desk, tables in treatment room).
⦁ Removed client “help yourself” items that were previously offered
⦁ Removed all linen stored in the treatment room to cabinet/fully closing drawers. Which will remain closed at all times, unless RMT is redressing the treatment room.
⦁ Suspension hot stone treatment services for the time being.
⦁ RMT will close the treatment room door once the room is redressed while they wait for the next client's arrival and screening to be passed and complete.
⦁ Vinyl table & Stool coverings have been acquired and implemented to provide another barrier to reduce risk of transmission
⦁ Vinyl pillows will only be used in the clinic, and with a linen barrier when needed
⦁ No pillow case if under bottom sheet
⦁ With pillow case if no sheet is used as a barrier
⦁ Additional linens including sheets, face cradle covers, blankets, pillow cases have been acquired to ensure more than adequate supply is available.
⦁ Seating in clinic is 2 meters apart in the event a client is unable to arrive alone
⦁ All screening signs have been printed, and inserted into protective plastic to allow for cleaning and disinfection.
⦁ Streamlined treatment room & reception area environment to aid in effective cleaning and disinfection
⦁ RMTs have provided guidance including a map as to instruct clinics to park in the west parking lot, and walk around the building and enter through the east parking lot doors (if possible).
Ongoing Once the Clinic has Reopened
⦁ Hand Sanitation station has been set up upon entry into the clinic for client use or they will be provided the opportunity to wash their hands in the washroom.
⦁ Soiled linen bags will be stored outside of the treatment room, in the reception area and away from high traffic/touch areas
⦁ Tea service for clients will not be offered at this time.
⦁ Water bottles will be available. For those who need one it will be upon request only
⦁ Clients are asked to wait in their car prior to their treatment. Your RMT will call/text you when it is time to come up to the clinic. This is to limit persons in the hallways waiting and to limit client cross over.
⦁ Client is asked to be wearing a mask upon arrival to clinic. If you do not have one please inform your RMT at the time of the call or text so they can have one ready for you.We will be charging a small fee for any disposable mask we provide.
Cleaning & Disinfecting
⦁ RMTs will clean and disinfect all necessary equipment and environment based on the “Two Wipe” method. 1st to clean from visibly soiled surfaces, and 2nd to disinfect.
⦁ RMTs will use only products approved by Health Canada by cross-referencing the Drug Identification Number (DIN) on the product container.
⦁ RMTs will clean and disinfect the treatment room before and after every client
⦁ Removal soiled linens into a closed bag or container, following the POH handling of soiled linen protocol.
⦁ Clean and disinfect the treatment room including but not limited to, the treatment table, face cradle, chair, stool, pillows, tables, oil/cream bottles, treatment room door handle.
⦁ RMT will sanitize their hands between un******ng and redressing the treatment room.
⦁ RMT will redress the treatment room with fresh, cleaned linens that were laundered on the highest heat setting available.
⦁ RMTs will clean and disinfect all high touch areas at MINIMUM twice per day, or when visibly soiled. Including by not limited to
⦁ Doork***s / Light switches
⦁ Chairs and arm rests
⦁ counters/desks/tables
⦁ Pens/stylus
⦁ Tablets, phones and POS systems
⦁ RMTs will ensure all equipment is in good working condition inorder to reduce the risk of injury or transmission of infectious diseases.
Hand Hygiene
⦁ RMTs must thoroughly wash their hands (including forearms and elbows) with soap and water for at least 20 seconds between every client.
⦁ RMTs & the Client will sanitize hands upon arrival of the client into clinical space and during assessment intake.
⦁ RMT will wash hands with soap and water in the bathroom while the client is preparing for treatment within the treatment room.
⦁ RMT will follow Hand Washing protocol as directed by Public Health Ontario, and use paper towel to open all doors between washroom and clinical space
⦁ Once within clinic space, RMT will dispose of paper towels and sanitize hands prior to entry to the treatment room if necessary.
⦁ Post treatment, RMTs will use paper towel barriers when exiting the clinic space when touching door k***s between clinic and bathroom. Disposing of paper towel in garbage
⦁ RMTs will wash hands with soap and water in bathroom while the client is redressing post treatment
⦁ RMTs will use NEW paper towel barrier post hand washing protocol when touching door k***s between bathroom and clinic. Disposing of paper towels in garbage.
⦁ Anyone who enters the clinic space will be required to wash their hands upon arrival, including but not limited to staff, clients and visitors.
⦁ Clients will be given the option of:
⦁ using hand sanitizer or
⦁ using the washroom to wash hands with water and soap.
⦁ Clients will be directed to use the paper towel to open all door handles between the washroom and clinic space
⦁ Signage will be posted on proper hand washing & sanitization techniques
⦁ Hand sanitizer approved by Health Canada (alcohol-based sanitizer at 60%-90% alcohol) will be provided in the clinic if soap and water is not an option.Administrative Protocols⦁ RMTs will maintain a roster of clients who enter the clinic via their appointment schedule
⦁ RMTs will maintain a contact trace log that will include the names and phone numbers of anyone who enters the clinic space that is not a client. This information will be kept for 10 years.
⦁ Visitors must be made aware of this via signage and verbal communication, if they wish to not be on the contact trace records, they will not be able to enter the premises.
⦁ RMTs will maintain a Cleaning and Disinfection log, that will include but not limited to the following
⦁ Log date, time of treatment cleaning and disinfection before and after each client
⦁ Log date, time of each high contact surface cleaning, at minimum twice per day
⦁ This log will be completed digitally on Google Drive, and printed periodically to be stored in files.
⦁ This log will be kept for 10 years
⦁ For EVERY appointment scheduled, clients will be required to virtually complete the COVID-19 Screening Agreement prior to their scheduled appointment.
⦁ Screening will be sent 24 hours prior to or at time of booking the appointment via email
⦁ If clients do not sign and return the agreement by 7pm the day before their treatment, their appointment will be automatically cancelled.
⦁ RMTs will document the reason for cancelling treatment within the client’s file
⦁ It is the RMTs discretion whether or not to reschedule the appointment.
⦁ Upon arrival for EVERY scheduled appointment (and after hand sanitization protocol), RMT will verbally review the COVID-19 Screening Agreement with the client and themselves If BOTH client and practitioner pass screening, they may proceed with the appointment.
⦁ Documentation of both client and practitioner screening results will be made in the client’s file.
⦁ If, either practitioner or client are unable to pass screening, either or must follow the screening fail protocols set out on the COVID-19 Screening agreement
⦁ NOTE if at any time the RMT's feels they are exhibiting any symptoms and feel it is unsafe to treat clients at any time they will be cancelling clients immediately and reschedule when it is fit to do so.
⦁ Signage will be posted outside and within the clinic to provide clientele information on, but not limited to, the following:
⦁ COVID-19 Patient & Visitor information posters
⦁ General COVID-19 Information poster
⦁ Physical Distancing Poster
⦁ RMT’s will complete the suggested eLearning Health & Safety, Risk Assessment and Hand Hygiene from the CMTO & PHO
⦁ IPAC Core Competencies for Community Clinic
⦁ Hand Hygiene eLearning Tool
⦁ Public Health Ontario YouTube videos on Hand Hygiene – IPAC Full Personal Protective Equipment (PPE) PPE – Gown and Gloves (PPE) PPE – Facial Protection – IPAC PPE – Respirators - IPAC
⦁ Payment in the form of visa or debit is preferred over cash or chq for sanitary reasons.
⦁ Any impersonal written consent required for additional treatment protocols will be completed digitally on tablet and with client’s finger or stylus
⦁ Stylus & tablet will be disinfected before and after every client.
⦁ RMTs have increased time in between appointments to allow for proper cleaning & sanitization of treatment room and clinic * This may result in the need to shorten your current precooked appointments.
⦁ RMTs have updated their email notifications of scheduled and upcoming appointments to remind clients:
⦁ Complete the virtual COVID-19 Screening Agreement no later than 7pm the day prior to their scheduled appointment
⦁ They will be required to complete a verbal COVID-19 screening upon arrival to the clinic, and if they are unable to pass their appointment will be cancelled.
⦁ If they feel any symptoms relating to COVID-19 to cancel their appointment, self-isolate for 14 days and complete the online screening prior to contacting their primary health care physician.
⦁ They will be required to wear a mask at all times during their appointment. If a clients does not bring a mask , we will provide you with a disposable surgical one.Note a small fee will be charged to the client to cover the cost of the mask.Health Care Practitioner & Clientele
Personal Risk Protocols
⦁ RMTs will thoroughly wash their hands (including forearms and elbows) with soap and water before & after each treatment.
⦁ RMTs will use barriers to protect freshly cleaned and disinfected hands during transition between washroom and clinics space. Disposing of barriers appropriately.
⦁ RMTs will thoroughly wash their hands (including forearms and elbows) with soap and water before & after clean and disinfection of clinic and treatment space.
⦁ RMTs will use barriers to protect freshly cleaned and disinfected hands during transition between washroom and clinics space. Disposing of barriers appropriately.
⦁ RMTs will wear a surgical/procedure mask (not cloth) during treatment and whenever within two (2) metres of clients.
⦁ Masks will be changed after each client (if available)
⦁ Masks will be changed whenever wet, damaged or soiled.
⦁ Clients must come to the appointment wearing a clean disposable or reusable mask to be worn throughout the treatment.
⦁ If the client cannot wear a mask (e.g. due to a health condition or difficulty breathing), the client may be required to postpone any appointments until they are able to wear a mask or a mask is no longer required. It is up to the RMT's discretion if to continue the treatment if a client is unable to wear a mask.
⦁ Clients will be responsible for informing their practitioner if they are unable to wear a mask for the entirety of their appointment within the clinic (including reception room and treatment room) and possibly need to reschedule all treatments until a later date. (Cancellation policy will be in effect at this time but will be up to the RMT's discretion to enforce it on a per case basis)
⦁ RMTs may also (if PPE supplies permit), provide a surgical/procedure mask to be used by the client during treatment at a small fee.
⦁ RMT will advise the client how to properly put on and take off the mask to limit possible transmission of COVID-19 if they should need proper guidance.
⦁ RMTs will reserve the right to thoroughly assess the possible risk vs benefit of proceeding with treatment, and will cancel and reschedule any appointments where the risk will outweigh the benefit.
⦁ RMTs will keep clear open communication with clientele through this process.
Please note as the Covid-19 situation evolves some procedures may be changed or added. We will update our guidelines document of any changes. We will also inform clients as needed of any changed begin made.
Thank you for taking the time to go over this email. If you have any questions please contact me!
I look forward to seeing you soon!!!
Nicole M. Andrews RMT, CMAG
