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Distance Education -> Prevention of Medical Errors for the Massage Therapist -> Chapter: 06
Recomendations for Sanitary Practices
Identify Specific Recommendations for Sanitary Practices for Massage Businesses
Massage therapists should know the importance of washing hands between sessions. But how many of us forget to clean our massage oil or lotion bottles? Maintaining good sanitary practices is the first step to reducing medical errors of execution or planning at our massage therapy establishments.
Sanitation Guidelines for the Massage Therapy Professional 13
1. Hands and forearms must be clean and washed thoroughly with an antibacterial/ antiviral soap before touching each client. This step will reduce the spread of any communicable disease or infection from therapist to client, and vice versa. Any infected wound or open lesion on any exposed portions of the body should be contraindicated for massage until the condition has healed.
2. Clean clothing must be worn daily. The massage therapy professional should wear fresh
clean work clothes on a daily basis. This step would to reduce the risk of spreading any communicable disease or virus that may have come in contact with the clothing either at work, or from home. For example, a therapist my have dressed in their work clothes prior to assisting a family member with the flu, then left to start their work day. The possibility exists that the flu virus may travel to work not only on the therapist's hands but also on their clothing. The same goes for a therapist coming home from work after working with clients who may have a cold, or some communicable disease; it would put their family at risk of infection.
3. The massage therapy establishment must be maintained, and in good repair, and be free from all insects, rodents, or other vermin. All massage rooms should be well lit, well ventilated, and maintained with adequate heat and air conditioning (temperature at around 75 ° F).
4. All sewage and liquid waste must be disposed of in a municipal sewage system or approved septic system. The water supply must be adequate, conform to the state plumbing code, and deemed safe and sanitary by the health department.
5. The massage therapy establishment must have a sanitary toilet facility with an adequate supply of hot and cold running water, and must be conveniently located for use by employees and clients. Soap in a covered dispenser, and single-use sanitary towels in a dispenser, and a covered waste receptacle, must be provided at each lavatory installation. A supply of toilet paper on a dispenser must be available for every toilet.
6. The lavatory and toilet rooms must be equipped with fly-tight containers for garbage and refuse. These garbage cans must be easily cleanable, well maintained, and in good repair.
7. Massage lubricants, including but not limited to oil, lotions, powders, and alcohol, should be dispensed from suitable containers, to be used and stored in such a manner as to prevent contamination. The bulk lubricant should be stored separately from the container you use for application. The bulk lubricant should be poured, squeezed, or shaken into a separate container. Any unused lubricant that comes into contact with the client or massage professional must be discarded. The container used for application should be cleaned with alcohol before or after each session.
8. Only freshly laundered sheets and linens should be used for each massage. Do not reuse soiled or unclean linens. All clean linens should be stored in compartments, shelves, or cabinets, at least 4 inches off the floor. All soiled linens must be placed in a covered receptacle immediately after use, and should remain there until washing. All soiled linens should be washed in a machine at a hot water temperature of at least 140 ° F, with detergent and an antiviral cleaning agent (at least 10% bleach solution, or 9 parts water to 1 part bleach).
9. Massage tables must be covered with an impervious material that is cleanable and must be kept clean and in good repair. The table must be cleaned thoroughly with soap or other suitable detergent and water, followed by adequate sanitation (at least 10% bleach solution, again) procedure before use with each individual client.
10. Observe the following rules when cleaning the massage area:
a. Clean from the cleanest area to the dirtiest. This prevents soiling of a clean area.
b. Clean away from your body and uniform. If you dust, brush or wipe toward yourself, microorganisms will be transmitted to your skin, hair, and uniform.
c. Do not shake linen, and dust with a damp cloth to minimize the movement of dust.
d. Used linens must be stored in a closed bag or container while in the massage room or during transport.
e. Floors should be considered dirty. Any object that falls on the floor should not be used for a client.
The ten guidelines as noted above are consistent with The Florida Administrative Code, Chapter 64B7-26.003 Massage Establishment Operations 14 , which reads:
(1) Facilities, Each establishment shall meet the following facility requirements:
(a) Comply with all local building code requirements.
(b) Provide for the use of clients a bathroom with at least one toilet and one sink with running water. Such facilities shall be equipped with toilet tissue, soap dispenser with soap or other hand cleaning materials, sanitary towels or other hand-drying device such as a wall-mounted electric blow dryer, and waste receptacle.
(c) Maintain toilet facilities in a common area of the establishment. Establishments located in buildings housing multiple businesses under one roof such as arcades, shopping malls, terminals, hotels, etc., may substitute centralized toilet facilities. Such central facilities shall be within three hundred (300) feet of the massage establishment.
(d) If equipped with a whirlpool bath, sauna, steam cabinet and/or steam room, maintain clean shower facilities on the premises.
(2) Personnel. A licensed massage therapist must be on the premises of the establishment if a client is in a treatment room for the purpose of receiving massage therapy.
(3) Safety and sanitary requirements. Each establishment shall:
(a) Provide for safe and unobstructed human passage in the public areas of the premises; provide for removal of garbage and refuse; and provide for safe storage or removal of flammable materials.
(b) Maintain a fire extinguisher in good working condition on the premises. As used herein "good working condition" means meeting the standards for approval by the State Fire Marshal. Such standards are presently contained in Chapter 4A-21, F.A.C.
(c) Exterminate all vermin, insects, termites, and rodents on the premises.
(d) Maintain all equipment used to perform massage services on the premises in a safe and sanitary conditions, including the regular application of cleansers and bactericidal agents to the massage table. Unless clean sheets, towels, or other coverings are used to cover the massage table for each client, "regular application," shall mean at least one time a day and also whenever oils or other substances visibly accumulate on the massage table surface.
(e) Maintain a sufficient supply of clean drapes for the purpose of draping each client while the client is being massaged, and launder before reuse all materials furnished for the personal use of the client, such as drapes, towels and linens. As used herein "drapes," means towels, gowns, or sheets.
(f) Maintain lavatories for hand cleansing and/or a chemical germicidal designed to disinfect and cleanse hands without the use of a lavatory in the treatment room itself or within 20 feet of the treatment area.
(g) Maintain all bathroom and shower facilities and fixtures in good repair, well lighted and ventilated.
(4) Financial responsibility and insurance coverage. Each establishment shall maintain property damage and bodily injury liability insurance coverage. The original or a copy of such policy shall be available on the premises of the establishment.
PRACTICE QUESTIONS FOR CHAPTERS 6.
Please answer the following questions:
1. Which choice is the first step to reducing medical errors at massage therapy establishments?
a. Having a current massage establishment license.
b. Maintaining good sanitary practices.
c. Providing continuing education.
2. Identify the correct statement:
a. Massage lubricants should be dispensed from suitable containers, to be used and stored as to prevent contamination.
b. Massage lubricant containers should be refilled without prior cleaning.
c. There is no need to clean your massage lubricant bottles between clients.
3. The Florida Administrative Code, Massage Establishment Operations, defines a drape as:
a. A towel
b. A sheet
c. A gown
d. All of the above
13 Fritz, Sandra, Mosby's Fundamentals of Therapeutic Massage, 2 nd Ed ., St. Louis, MI, Mosby's Inc. 2000, pg. 236.
14 Board of Massage Therapy, Law and Rules . Florida Department of Health: Division of Medical Quality Assurance. January 2002 Edition.
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