‘Effective infection prevention and control is central to providing high quality healthcare for patients and a safe working environment for those who work in [a] healthcare setting.’1
In fact, therapy providers – including those in the allied health space – have a “legal responsibility to provide a safe work environment, safe systems of work and a safe environment for patients and visitors.’1
To help therapists understand their obligations and how to meet them, a fundamental document was released last year. The Australian Guidelines for the Prevention and Control on Infection in Healthcare (“The Guidelines”) was compiled by The National Health and Medical Research Council (NHMRC) in partnership with the Australian Commission on Safety and Quality in Healthcare.
Released in May 2019, The Guidelines provide ’evidence-based recommendations that outline critical aspects of infection prevention and control, focusing on core principles’1 that should be applied to a wide range of healthcare and clinical settings.
The Guidelines state that ‘to be effective, infection prevention and control must be a priority in every healthcare facility’1 and ’the person in charge of the organisation must have overall responsibility for and direct involvement in the organisation’s infection prevention and control program.’1
Often in hospital, clinical, massage and beauty settings a customer will be required to lie face down (prone) on a therapy/massage bed and place their face into a hole in the bed, an area that is provento harbour infectious agents, and therefore requiring high quality hygiene practice.
The three categories of bacterial transmission
The Guidelines categorise the modes of bacterial transmission as such:
The predominant modes of transmission in prone therapy are contact and droplet.
Contact is the most common mode of bacterial transmission. It involves transmission via touch which can be direct whereby infectious agents and microbes transfer directly through contact from one person to another. It can also be indirect, whereby infectious agents of microbes are transferred between people via an intermediate object (fomite) or person.
During prone therapy, there are multiple points for potential contact transmission. In simple terms, any part of the therapist or customer’s body that touches the bed may, and in most cases will, transfer bacteria whether it be harmful or non-harmful. This not only refers to the top of the bed but also includes areas in and around the face-hole of the bed. This is particularly worse when people are undressed as many people “carry staph bacteria on the surface of their skin”2. Surfaces have been shown to carry bacterial agents for weeks, and serve as the intermediary object as described above, particularly in therapy settings and high traffic areas.
Droplet transmission occurs when an infected person coughs, sneezes or talks. These respiratory droplets can then infect a person if transmitted directly to a susceptible mucosal surface (eyes, nose or mouth) of another person. As with contact transmission, it can also be spread indirectly by contaminating a shared intermediary object or fomite.
During therapy, while a customer is prone, the droplets of a cough, sneeze or even spit whilst speaking or breathing land on the bed’s surface – particularly the interior aspect of the face hole and it’s surrounds. Staph may be carried in people’s noses and has been found on the internal aspect of the face-hole during random swab testing on private clinics. This is even despite what some perceive, or may appear to be “hygienic practice.”
Agents such as saliva and other fluids act as vehicles which allow bacteria to travel from one area to another meaning the risk of infection in the face hole is greatly intensified for the next customer. Particularly without proven protection or hygiene practice as they will be exposing their mucosal surfaces to the resultant bacteria.
Airborne transmission can occur during breathing, talking, coughing or sneezing and by evaporation of larger droplets which can be dispersed over long distances by air currents and infect individuals by entering the small airways of the respiratory tract.
Learn About The Australian Guidelines & FaceShield™
After four years of extensive consultation with consumers, primary and community healthcare providers and other key stakeholders, The Australian Commission on Safety and Quality in Healthcare released the Primary and Community Healthcare Standards – the first nationally consistent safety and quality standards.