State boards have requirements to protect client privacy, confidentiality, documentation and record retention. Codes of Ethics address these issues as well. Even if the practice is not a covered entity under HIPAA, it is important to keep
client information private and confidential. Records should be secured in a locked cabinet and electronic files should follow encryption and password security protocols and accessed only by appropriate staff.
HEALTH AND SAFETY
Therapists are solely responsible for any injury sustained by the client during or after therapy, and any resulting medical and/or legal liability. The therapist is responsible for the health, safety, and welfare of the patient, even if a physician prescribed the massage or bodywork treatment. ● Therapists must be aware of health concerns outside of their scope of practice and must suggest the client visit a healthcare professional if necessary. It is important to document this information with specific details regarding the health concern(s). ● Never give medical advice or make statements that could be taken as a diagnosis as this could be construed as practicing medicine without a license, which can be subject to legal action. ● Never discuss a client’s medical or health status with anyone without written, explicit consent from the client, including the client’s doctor, even if serious injury or illness is suspected. Medical preparedness ● Learn to administer first aid, including CPR. ● Keep your first aid kit easily accessible. ● Remind clients to dispose of candy or gum before they get on the massage table. ● Practice universal precautions as standard procedure. ● Take a thorough intake before performing a massage. Personal security ● Screen first-time clients to verify that they clearly understand the nature of massage. ● Ask clients to read and sign an information form, which explains what to expect during the massage. ● Set office policies regarding personal property, loss, restricted access and personal privacy. ● Install an emergency buzzer in case you need to call for assistance. ● Have a plan for handling inappropriate comments or behavior by clients (AMTA, 2016e). Creating a safety and security plan is not a one-time event. With periodic review and ongoing attention to security concerns, your clients can relax and enjoy the full benefits of massage. ● 50 percent take two prescribed drugs. ● 20 percent take more than five prescribed drugs. (Centers for Disease Control and Prevention, 2016) The massage and bodywork professional must realize that many clients are taking prescribed medications that may impact the type of modalities, procedures, positions, duration and frequency of care they plan. The professional must have information on drug administration routes, drug interactions, dosages, adverse reactions and allergies, safety considerations, medical conditions being treated and other health care providers to contact for further information. Treatment planning guidelines related to client drug information include the following:
The following general guidelines should be followed to ensure the health and safety of clients and practitioners while upholding ethical standards: ● Review Occupational Safety and Health Administration (OSHA) and industry standards of health, safety and hygiene (Occupational Safety and Health Administration, 2016). ● Draping, towels, the massage table surface, and all items or materials must be cleaned according to accepted standards of sanitation, and must meet all legal health and safety requirements, including universal precautions relating to communicable diseases. ● Carefully assess a client’s condition before beginning professionally approved and appropriate therapy. ● Never apply techniques that are outside of accepted practice in the field. ● Continually assess verbal and non-verbal client feedback during the massage to ensure the technique is appropriate, effective, and tolerated by the client ● Never allow the client or anyone, even the client’s doctor, to dictate the therapeutic plan of treatment. Safety, security and risk management In order to provide the critical and ethical element of safety to ensure client welfare, the practitioner must address safety and security precautions in all phases of the practice. According to the AMTA, the best safety measure is prevention (AMTA, 2016e). Awareness of the potential hazards is fundamental to creating a plan to address safety risks. One of the first steps should be to assess what areas of your business could provide potential safety hazards. The AMTA provides the following guidelines: Physical safety features ● Check the sidewalk and entrance to your office for obstacles and toe catches. ● Assure that all ice and snow is cleared prior to your first appointment. ● Review and approve your building’s maintenance and cleaning plan. ● Keep stairways and hallways free of clutter. ● Check the stability of railings along stairways and hallways. ● Keep throw rugs to a minimum, and make sure they do not pose a safety risk ● Assure that your massage table is in good repair. ● Create a standard protocol for collecting an incident report from a client that does have an accident due to the physical feature of your building. Treatment planning and pharmacology An important element of safety, informed consent, and client welfare is the consideration of medical conditions and pharmacology when determining the plan for massage and bodywork care. The increasing demand for massage and bodywork for a variety of physical and medical conditions through integrated, multi-disciplinary approaches to health care requires competency in the area of pharmacology. The following Centers for Disease Control and Prevention statistics outline the prevalence of prescribed drug use in the U.S. today: ● 70 percent take a prescribed drug every day. ● 81 percent of those over 57 years old take a prescribed drug every day.
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