COVID-19 & Therapy Best Practice

It’s no surprise that therapists are raising concerns with their relevant industry bodies. In such a high contact industry, not only are therapists at risk – so too are clients. On Friday 13 March 2020, the Physiotherapy Board of Australia issued an email addressing COVID-19 concerns of members and the appropriate actions for therapists. In the memo, Kim Gibson (Chair, Physiotherapy Board of Australia outlined the crucial role health professionals play in reducing the spread of COVID-19 stressing the need “to adjust established procedures to provide appropriate care to patients and clients.”

The memorandum states:

“If a concern is raised about your decisions and actions, as always, the specific facts will be considered, including the factors relevant to your working environment. We would also take account of any relevant information about resources, guidelines or protocols in place at the time.”

Here are key practices to keep your clinic hygienic and reduce your risk as much as possible:

1 – Ill clientele. Reducing exposure has been found to be one of the most effective ways in reducing the spread COVID-19. Therefore, as per usual protocol, ill or symptomatic clients should be asked to postpone their sessions until they are well. Not only does this reduce the likelihood of bringing illness into the practice and putting staff at risk, it will also mitigate the risk of other customers and give the reassurance that you are placing their health as a top priority. Whilst it is understandable there may be some emergency cases, recommendation derives from the Australian Health Sector advice to ‘isolate’ these clients by using (where possible) an alternate treatment room which is thoroughly cleaned and disinfected after treatment.

2 – Whilst handwashing is a necessary part of therapist hygiene protocol, particular diligence should be practiced in the current climate directly before and after a client, especially after skin to skin contact. The Centre for Disease Control and Prevention recommend humming ‘Happy Birthday’ twice, i.e. scrubbing for 20 seconds, to ensure proper cleanliness. Replacing towels more frequently is another measure that can be taken, should any residue pathogens linger.

3 – A common practice amongst clinics is the use of towels for modesty and supportive purposes. Whilst there is much to still be learned about COVID-19, it has been well established that repeated use of towels in healthcare settings can contribute to outbreaks in other microorganisms, such as Staphyloccocus Aureus (Sifuenets et al, 2013). It was shown that Staph can survive up to three weeks in cotton towels – which are commonly used in therapy clinics and hospitals – despite regular laundering, with normal laundering determined to be “not enough” to remove all viable microorganisms [Sifuentes et al, 2013].

Where possible, we strongly recommend the use of disposable products as there is clear evidence that they are more hygienic. This would include using a protective barrier for all shared patient contact surfaces such as the therapy bed and face hole.

4 – Education and Understanding. It has been shown that education alone can improve both clinician and consumer hygiene practices. Given this information, we recommend having in-services with staff members using information provided by your governing body to better their understanding of the COVID-19 virus and the necessary precautions that are to be implemented. It is suggested that you offer your clientele the necessary equipment to ensure they maintain the hygiene practices recommended to them such as hand sanitizers or an area to wash their hands correctly.