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There is a huge void of any clear and direct hygiene standards for therapy professionals who have a duty of care to their customers, such as those in the allied health, massage and beauty sectors.
Purifas has developed the following five essential steps that constitute best practice for therapy professionals, which are based on all current research and evidence.
1. Clients with symptoms of illness should be strongly advised not to attend therapy.
It is well established1, 1a, 1b by virologists and medical experts that the infectious period after contraction of an infectious pathogen begins before the carrier becomes symptomatic (if at all). While the overlap may vary between diseases, the incubation period is usually between 7–10 days, with a carrier typically becoming infectious within the latter 5 days.
While it is near impossible to monitor infection without symptoms, it should be made explicitly clear that a client with any significant symptoms should not attend for therapy, regardless of how mild they may think their condition is, as they have the potential to be a carrier of an infectious pathogen. Extra caution may also be established by asking clients who have been exposed to people who are ill to also reconsider their attendance.
You can communicate this to your clientele by displaying signs in high traffic areas of your clinic, including a hygiene requirement section on your website, promoting your policies on social media and explicitly asking your clients either at the time of booking or when confirming their appointment.
2. Clients and therapists should wash their hands before and after therapy.
The primary focus of hygiene research has largely been on hand hygiene and its effectiveness in diminishing the transmission of disease via contact2, 3. Hand washing is accepted as essential, especially in healthcare. However, the issue is compliance by healthcare personnel and attendants. Studies show the compliance rate to be as low as 10%4, 5!
Therapy professionals must observe frequent and stringent hand washing at three critical points:
Clientele should be given access to facilities to wash their hands upon entry to the clinic and at the completion of their treatment.
While thoroughly washing their hands, they must also limit the use of reusable towels, which have been shown to harbour bacteria despite repeated washing6.
Healthcare associated infections (HAIs) are a substantial contributor to the healthcare burden and preventable disease figures. It is therefore imperative that the heightened hygiene practices implemented to mitigate the COVID-19 viral pandemic remain in place and become the new standard.
3. Within the therapy room, only apply single-use, fit-for-purpose hygiene products to all shared surfaces and items.
Single-use protective materials are known to be more hygienic, quickly eliminating the trace of contact of the previous patient or potential infectious pathogens.
The main points of entry and exit of a pathogen are through the nasomucosal openings7. Prone therapies use a shared face hole, which can significantly increase a client’s risk of cross-transmission via contact, droplet and potentially even airborne microbes shed from the nose, mouth and even eyes. Through single-use solutions, like the Purifas® FaceShield™ or Purifas® PillowGuard Recyclable, the risk of cross contamination of any bacteria/flora/microbes is dramatically reduced.
Research6 has shown that reusable materials — such as towels, pillowcases and bed linen — can harbour bacteria despite hospital-grade washing. In particular, 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 laundering6. It was concluded that normal washing or laundering of towels, whether done in-house or externally, was not enough to remove all viable microorganisms6.
4. Sanitise all shared surfaces after each therapy session.
All shared surfaces should be sanitised between each client to ensure the risk of cross transmission is minimised. To effectively sanitise a surface, research indicates it must first be cleaned with a detergent and then disinfected with an appropriate TGA-approved antibacterial or sanitising agent8, 9. (Remember to ensure that these agents are safe for use in a clinical setting.)
5. All high-traffic areas and contact points should be cleaned regularly.
High-traffic contact points, such as door handles, arm chairs, waiting room areas and reception desks, are cross-transmission risks, especially in facilities with a high turnover of clients. All areas that customers come into contact with upon entry and exit of the clinic, such as bathroom areas, should be cleaned and sanitised regularly. There is evidence to show a significant reduction in HAIs when a staff member is added who has a dedicated role specifically for this task10. Depending on the size of your clinic, this may not be feasible. In this case, you should have these hygiene and safety tasks clearly assigned to the appropriate personnel, including clear outlines on what is needed to be done and the frequency. The Australian Commission on Safety and Quality in Health Care has provided some resources to assist business owners and health-related professionals develop an environmental cleaning program.
Making these five steps standard practice in your clinic will help maintain a safe and hygienic environment for your clients, and contribute to a reduction in community transmission of illness.
REFERENCES
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