Standard of Practice: Safety and Risk Management and Infection Prevention and Control

Patient Outcome

The patient receives care that is delivered as safely as possible and is not placed at significant risk for transmission of infectious disease or illness.

Registered Massage Therapist Outcome

The Registered Massage Therapist/Massage Therapist (RMT/MT) takes preventative and risk management measures to provide safe care and follows safe Infection Prevention and Control (IPAC) procedures to protect the health and safety of patients, themselves and others in the practice environment.

Requirements:

An RMT/MT must:

1. Implement and follow an IPAC plan tailored to the practice setting that adheres to current health and safety and IPAC government orders and directives, legislation and CMTO guidance.
   1. In the case of differences in requirements, RMTs/MTs must adhere to the most restrictive or stringent requirements.
2. Ensure practice settings are appropriately lit and arranged to allow sufficient physical/personal privacy and safety for each patient.
3. Maintain the practice setting in a sanitary manner, and ensure all equipment is in good repair to allow effective cleaning and disinfection.
4. Document maintenance of equipment used to treat patients within the practice setting in an equipment service record or log.
5. Handle any hazardous materials safely and in compliance with established and documented protocols and practices, including the requirements of the Workplace Hazardous Materials Information System (WHMIS).
6. Participate in training and/or certification and support activities related to safety and risk management as required and/or appropriate for the practice setting.
7. Recognize and manage situations that place patients, themselves, other RMTs/MTs, clinic staff and other healthcare professionals at risk.
8. Respond effectively to safety incidents, document and disclose them to relevant authorities to prevent future adverse events.
9. Stay informed of current infectious disease risks, symptoms, routes of transmission and prevention strategies in their community and/or practice setting.
10. Follow Public Health Ontario’s (PHO’s) recommendations for cleaning and disinfecting the practice setting, at a minimum including:
    1. Cleaning and disinfecting massage tables, face cradles and other surfaces touched by the patient and/or RMT/MT after each patient.
    2. Using cleaned and disinfected linens and covers for each patient (including but not limited to sheets, pillow covers, blankets, face cradle covers).
    3. Handling soiled linens safely.
    4. Cleaning and disinfecting any equipment, supplies or other tools used in assessment or treatment after each patient (for example, hot stones, oil bottles, pumps, ultrasound equipment, myofascial cups, etc.).
    5. Apply additional IPAC practices when indicated by risk assessment or by government or CMTO, such as using personal protective equipment (PPE) (for example, gloves, masks, gowns, face shields).
11. Postpone or modify care if appropriate IPAC measures cannot be implemented or required PPE is not available.
12. Provide information to patients about infectious disease risk, IPAC and PPE when appropriate.
13. Document and notify patients of any incidents where IPAC practices could not be maintained and/or a patient was exposed to significant risk of infectious disease transmission.
14. Conduct risk assessments of:
    1. the practice environment and all equipment/supplies used for patient services;
    2. infection transmission; and
    3. intended or likely interactions between RMT/MT and patient (for example, treatment approach and modalities, areas of body being treated, length of treatment).
15. Perform hand hygiene by:
    1. Washing hands using products that meet Public Heath Ontario’s expectations such as soap and running water or an alcohol-based hand rub (at least 70% or equivalent);
    2. Washing hands before entering or leaving the practice setting, before and after each patient interaction, after removing soiled linens and prior to handling clean linens, putting on or taking off PPE, after using the bathroom/washroom, before or after/eating drinking, or when hands are otherwise soiled;
    3. Maintaining fingernails for effective hygiene;
    4. Removing jewelry that may impede hand hygiene; and
    5. Covering their own broken skin or open wounds with a protective barrier (for example, finger cot, gloves).

Bolded terms are found in the Glossary.