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COVID 19 SAFE PRACTICE

I am a passionate physiotherapist - and physio is what I do very well.
 

I have been enjoying the virtual appointments and see that this is a medium of treatment we will be continuing with, as it benefits many people.
 

However - I am aware that I can’t use all of my skills, especially hands-on treatment, to help those who really need it for their progress and quality of life.

 

Your safety and health is my top priority.

 

So I can help you, and you can help me, here is some information about how face-to-face appointment will be carried out, and the measures I have taken to keep your safety at the highest priority:
 

I am following the guidance from Public Health England (PHE), The Chartered Society of Physiotherapy (CSP), the Health and Care Professionals Council (HCPC), and accommodating my work to their guidance. 
 

Essentially, we both need to justify that the benefits of seeing a patient face-to-face are demonstrably greater than the risks of infection transmission, and to demonstrate we understand the risks.

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Image by Anton

Therefore, a health screening/risk assessment of each patient, prior to each appointment will be carried out - in writing (email)  24 hours prior to the appointment, and verbally at the beginning of each appointment - to be able to confirm no changes to your health have occurred since you booked. This will also establish you understand the risks involved to you and I, due to being in close contact, and that you are aware of the measures below, undertaken to keep the treatment environment safe. This informed consent shows that you understand and agree with the measures and processes and you are free of COVID 19 symptoms. 
 

Your initial appointment will be a Telehealth one (virtual), so only necessary face to face appointments are carried out. This in-depth assessment will help us both to justify and agree on the need for a face-to-face appointment.

Aim:

  • To give guidance to Deborah Thomas, any physiotherapists or other staff, working within Deborah Thomas Physiotherapy, during the Covid-19 pandemic.

  • This SOP defines Deborah Thomas Physiotherapy’s procedures to be followed during the Covid 19 pandemic, when triaging patients to establish the suitability for face-to-face appointments.

  • This SOP outlines the procedures to be taken to ensure the safety of staff and patients when in clinic.

  • Based on GOV.uk and PHE guidelines issues to date.

 

Key elements:

  • Follow CSP COVID-19 triage pathway to establish face to face or virtual assessment & treatment.

  • All initial appointments will be virtual / telehealth ones. Face to face appointments can only be booked in person in clinic, or via phone or email communication, the online diary will not be open to Face-to-face bookings.

  • No walk-in appointments, all appointments must be pre-booked.

  • No waiting area facilities.

  • The patient and therapist must agree it is necessary to carry out a face-to-face treatment session, the decision is a joint decision, and the clinical reasoning for this is documented in the patient’s notes.

  • Examples of reasons for treating face to face may include but are not exclusive to:

  • The patient is off work due to this condition, and once improved will be able to return to work.

  • The patient would otherwise contact another health care provider, GP or A&E

  • The patient is not improving with virtual treatment and self-management and the impact on their quality of life is severe.

  • There is a deterioration in the patients’ symptoms or condition.

  • Where serious pathology is suspected

 

The 3-point F2F check:

  • Only if a 3-point F2F check has been passed, should patients be booked in for F2F Physiotherapy

    • ✓ Clinically indicated

    • ✓ Risk assessment passed

    • ✓ Consent of Patient

 

If face to face treatment appropriate:

  • Premises risk assessment must be carried out before F2F consultations are allowed.

  • Covid 19 Pre assessment screening questions emailed to patient and chaperone

  • Covid 19 Pre assessment informed consent form emailed to patient and chaperone

  • Above info documented in patients’ records

  • Patient advised to attend ONLY at their specified treatment time (patients arriving early will be asked to wait in their car)

  • The therapist will call the patient 5 minutes prior to the appointment to arrange meeting at the clinic entrance.

  • Patients are asked not to bring anyone with them to their appointment unless they are under 18 years old or require a chaperone/translator

  • Patients and chaperone informed about the risk of infection during the clinical triage (virtual assessment and on arrival). If the risk is accepted and the patient consents to comply with ICP’s – this is clearly documented in patients’ notes.

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I know that having all of this information can be confusing and overwhelming. If you would like to talk about the measures I have in place to ensure your safety then please call me on 07976977247 or send an email to dthomasphysio@gmail.com.

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On arrival at clinic:

  • The therapist will open and close all doors

  • The patient will be required to put on a surgical IIR face mask provided to them by the therapist

  • On entering the clinic, the patient is required to clean their hands with alcohol gel

  • The patient will be asked the COVID 19 symptoms screening questions again

  • Provided the patient passes these questions, treatment will proceed

 

In the treatment room:

  • The therapist will open and close all doors

  • The patient will place their personal items in the designated area

  • The patient will either sit on the available chair or treatment couch

  • The therapist will seek & gain consent for hands-on assessment & treatment

  • The therapist will conduct the subjective and objective assessment as clinically appropriate – minimising patient contact where possible and maintaining SD according to guidelines

  • The therapist will treat as clinically appropriate

  • Pillowcases will not be in use, only wipe clean pillows

  • A disposable paper towel will cover the treatment couch, no blankets or soft treatment couch covers will be used.

  • A pen will be provided for patients use – this pen will be cleaned after each use and in between patients

On exiting the treatment room / at the end of a treatment session:

  • The therapist will open and close all doors

  • Payment – in advance via BACS, or by contactless card transaction. No cash or cheques.

  • The patient will keep the surgical face mask on until they have left the clinic.

  • The patient will again be asked to clean their hands with alcohol gel.

  • The patient will leave via the exit - the door is opened by the therapist

  • Once the patient has left the premises, the therapist will remove PPE and dispose of it in the bin provided in the treatment room.

 

In between Patients:

  • A 15 minute gap will be left between patients to ensure no patient crossover.

  • Doors will be kept open to ventilate the treatment room – where possible.

  • All contact surfaces and equipment used will be cleaned as per PHE guidelines.

  • Cleaning will be performed first with a detergent solution, followed by a clean with a disinfectant solution as per PHE guidelines

  • The therapist will, Don and Doff PPE, wash their hands- as per PHE guidelines

Toilet Facilities:

  • Toilet facilities, including door handles, will be cleaned after each treatment session if they have been used by a patient. This is to avoid the physiotherapist entering the toilet facilities and then re-entering the treatment room. These are also cleaned every evening as part of a whole clinic clean – provided by CW Therapy Rooms.

  • There is signage in place to educate on proper handwashing technique, located next to the sink, closing the toilet lid prior to flushing.

  • Paper hand towels are provided for users to dry their hands and these should be disposed of in the bin provided.

  • Electronic, contactless taps and soap dispensers are provided in each toilet cubicle,

  • Alcohol gel will be provided in the bathroom, should patients wish to use this in addition to liquid hand-soap.

  • Automatic, contactless hand-gel dispensers are located throughout the clinic.

 

PPE:

  • The therapist will wear a face mask appropriate for the therapy performed, a plastic apron, and gloves during each consultation. This is single-use and will be changed after every appointment.

  • The therapist will use a face shield/visor when clinically required. This will be cleaned at the end of each clinic session, and not re-used for 72 hours.

  • The patient will be provided with a surgical IIR face mask on arrival. They will keep this on until they have left the clinic. This is explained on booking and in the email reminders.

  • MSK Physiotherapy is deemed as non-aerosol generating, therefore, the use of FFP3 masks and full-length gowns is not indicated.

  • PPE will be disposed of appropriately by CW Therapy Rooms as clinical waste.

  • PPE will be worn as per PHE guidance and following donning and doffing procedures for non AGPs.


At the end of a clinic/shift

  • A thorough clean of the room to be implemented to include all surfaces, floor, door handles, hooks, sink & taps, bin lid. The correct cleaning materials, equipment & procedures to be provided by Deborah Thomas.

  • If a patient has used the toilet facilities – These will be cleaned after the treatment room has been vacated and cleaned.

  • The bin bags emptied and replaced (double bag), disposed of as clinical waste

  • Uniform/work clothes to be washed at the hottest temperature suitable for the fabric, separate from other clothing, in a load no more than half the machine capacity

  • The whole clinic is cleaned every evening – organised by CW therapy rooms. The treatment room is thoroughly cleaned at the end of every therapists’ shift and documented as per cleaning lists in the room.

Last Updated: 19.04.2021

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