Back to Practice—Resources & References



Associated Bodywork & Massage ProfessionalsBack to PracticeMoving Forward During Uncertainty—April 24 Update from ABMPDear Member:We hope this message finds you and your loved ones well. The past month has been perhaps the most trying we collectively have experienced in our lives. While challenging, it certainly underscores the passion and care of our community. Our staff has spoken with thousands of you over the past few weeks, and we remain focused on supporting you during these unprecedented times. We are committed to you, and we are committed to getting through this?together.Apart from the tragedy of illness and death associated with COVID-19, one of the most difficult things we are dealing with is the uncertainty of the situation—uncertainty because the virus is new and much is unknown about it, because we don’t have sufficient testing—and the questions stemming from that uncertainty that do not have clear answers. How long will it last? How can we stay safe? When will we return to practice?When we strongly recommended our members close their practice on March 16, it was out of recognition that our collective goal was to slow the spread of the virus to support health-care workers facing a crisis of ability to provide care, and that there was no uncertainty that the best action we could all take was to stay home.If you are like me, uncertainty drives fear; gaining knowledge and understanding gives me a greater sense of calm. If you have not read?this article from?The New York Times?and/or listened to the associated podcast attached to the article, I encourage you to do so. While not uplifting, it is an extremely well-considered characterization of what life is likely to look like for the next year, or perhaps beyond. I can’t say it is calming, but it is extremely thorough and provides a clear-eyed look at what our country faces going forward.As you have likely heard or read, there are stirrings in some states and communities to “reopen our country”; the referenced article explains how that is fraught with risk. Nevertheless, our elected officials understandably feel some responsibility to enable economic activity in their state. Our country has added more than 20 million citizens to its unemployment rolls in just over three weeks—a number that dwarfs any historical reference. Beyond proclamations that we “weren’t designed for this,” balancing our collective safety with the psychological and economic needs of Americans is a reality that must be considered.As the country explores reopening businesses, we are fully in the midst of this uncertainty. Our members are articulating a wide range of views—from wanting us to take a firm stand that massage therapists, bodyworkers, estheticians, and cosmetologists should go back to work?before?other businesses because a one-on-one setting is safer than other businesses, to believing they should go back to work?after?other businesses because their work is incompatible with social distancing measures and, therefore, less safe.The reality is that whenever stay-at-home orders are lifted in your area—earlier or later—many of you are still going to be faced with the question, “Should I go back to work?”That is not a question we can answer for you.With the possibility of asymptomatic transmission of COVID-19, every choice we make in the foreseeable future has a real level of risk attached. Even with stringent sanitation protocols and enhanced client screening, there still exists a risk that you will get sick, or your client, or a family member, or more people down the line in your community at large.It is highly likely that at least tentative steps to begin getting people back to work will occur before epidemiologists fully concur it is smart to take that step.We urge you to make government permission to work only one element of your decision about whether and when to reopen. If your state is allowing you to reopen, you must then examine all the variables and ask yourself these questions on a personal level: How has your community and state been affected? What is the level of testing in your community? Who is at home, and how vulnerable are they should they become infected? What is the physical and psychological cost of reopening your practice?Of course, practitioners will make different decisions. While some will dive back in as soon as state permissions are in hand, others likely will pause until certain medical milestones are in place in their community. You will have to find your own comfort zones. Your clients will be making similar assessments, likely arriving at diverse conclusions. Your decisions may vary for different clients; ultimately, your safety—physical, mental, and financial—is your responsibility. No one can decide that for you.For those members planning to get back to work or seriously contemplating doing so, what follows is a hierarchy of ideas and precautions we strongly encourage you to consider for yourself, your practice, and your clients. I understand that our members’ practices differ: not every idea may fit for you. For every member, I do emphasize the reality that while these may be ways to make your practice safer, there is no known way to eliminate the risk of transmission and infection. There simply is no risk-free environment in which to conduct business today.That news does not feel good for us to give. We would love nothing more than to be able to share guidelines on what it means to go back to work in perfect safety and health, and hopefully someday not too far down the road we will be able to do that, but this reflects our new uncertain reality. Choose your restart date carefully, adopt new practice protocols, recognize that we may face the possibility of another pause, and understand that future practice will be different from past work.What we have developed is a very thorough look at the issues and challenges you will face when you resume your practice; our team has been tirelessly developing it over the past several weeks. I encourage you to start with the summary, which provides a good synopsis; should you want to dig in deeper, there are seven other sections of valuable information.We will continue working on your behalf and will update you as we learn more. Again, know that we are still right here. We are committed to getting through this with our amazing community intact. We wish you and your family safety, health, and well-being.Warmest regards,Les SweeneyPresidentAssociated Bodywork & Massage ProfessionalsAssociated Skin Care ProfessionalsAssociated Hair ProfessionalsAssociated Nail ProfessionalsBack to Practice—SummaryUsing COVID-19 best practice recommendations from the?Centers for Disease Control and Prevention (CDC)?and the?World Health Organization (WHO), guidance from other health-care sectors, findings from the limited and?preliminary research?on the virus, and the most accurate updates we could gather from the?quickly evolving science, we’ve compiled this document of practice protocols that seem most appropriate for practitioners who are choosing to move forward with reopening their businesses.This document does not represent a recommendation from ABMP for reopening your practice, but rather gives our best guidance for when that time comes.There Are No GuaranteesIn lieu of a?cure, vaccine, antibody tests, or other intervention for COVID-19, there is no way right now to venture back into practice without revised protocols to protect you and your clients. Even so, there is no guarantee that you or your clients will come away from your interactions unscathed.Important Reopening ConsiderationsYou must be abiding by the guidelines and recommendations of your state and/or local governments, as well as your massage regulatory agencies regarding reopening your practice. If you live in a state that has ordered you to shut down your business and you are still seeing clients, you will not be covered by your professional liability insurance in case of an accident or claim. If you are working as an employee, consult with your employer to understand the precautions they are taking on behalf of you and your clients.Following CDC guidelines is imperative to offering the safest experience for your clients. Much of the information that follows draws from CDC guidelines, which are available for your personal reference at?coronavirus/2019-ncov/index.html.A likely requirement in any regulations or reopening plan will be the use of personal protective equipment (PPE), specifically face masks. We understand that PPE is scarce and any available supplies are being redirected—rightly so—to frontline workers and health assistance staff who are still operating without the proper supply of equipment they need to work safely. Diverting supplies for non-emergency equipment requests at this time would be dangerous and unethical. Consider other options for face coverings for you and your clients in the interim. We have an overview of PPE options at?updates/blog-posts/use-personal-protective-equipment-ppe-massage-therapists.What Your New Business Might Look Like When You ReopenTemper your expectations—it may be a while before you’re fully up and running again. Use this time to update cancellation policies, waiting room layouts, booking programs, and language changes for your website and e back slowly—see what challenges you encounter with the new working protocols and what areas to improve. Staggered appointment times and greater time necessary for cleaning protocols might mean you’ll need to rethink your daily schedule and the number of clients you can see. Think about your hours of operation.In accordance with extended shelter-in-place recommendations to protect our more vulnerable populations you may only be able to work with clients who are in lower risk categories for COVID-19 complications.We understand there is a fine line between getting back to work and earning an income, and protecting the safety of you and your clients. For those thinking about going back to work we recommend the following to states and our members:Face masks be utilized in treatment rooms to help prevent the spread of COVID-19; we encourage that both the therapist and the client wear a face covering.Following stringent sanitation protocols between each client is critical. Use EPA-certified disinfectants on all surfaces, doorknobs, chairs, etc., that a client might have touched.Change all linens, fleece blankets, and perhaps your clothes between each client. Use gloves where practical.Stagger client appointments or text them when they can come in so there is no more than one client at a time in common areas. Make sure you have ample time to prepare for, and take care of, each client and your work area.Be transparent—in your reminder phone call, on your intake form, even when clients arrive for their appointment. Ask them: Have you had a fever in the last 24 hours of 100°F or above? Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath? Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms? If they answer yes, then ask them to reschedule, without penalty.Live your words—do the same that you ask of your clients. Let them know how you are feeling, and err on the side of caution. They are just as concerned as you are.Set expectations for your client; let them know there is a “new” normal in your practice (e.g., limiting your “table talk”). Let them know safety is an important element of your therapy.For more ideas and specific protocols, choose one of the seven other sections in the menu above.Back to Practice—Treatment Room & Office ReadinessStart by looking at your office and treatment rooms with a fresh eye. Think about having bare, easy-to-clean surfaces; you will be doing a lot of cleaning going forward. Give your space a deep clean, and consider what you might need to add or remove to make your space safer.RemoveRemove clutter, knick-knacks, and unnecessary items that don’t serve a purpose to your practice. Consider removing items (e.g., soft, comfy armchair) with surfaces that can’t be cleaned properly. There may be a time for these things to return to your treatment room, but for now, think about every surface a client interacts with in your space and how you can keep those surfaces clean for the health of all your clients.Remove all product testers and samples from your shelves and counters. Create client signage: “Let me know if you want to sample this product.”Rethink seating in any waiting areas, both in regards to their cleanability and their spacing so that clients are 3–6 feet apart, per the CDC; stagger client appointment start and end times so there is no client overlap in the waiting area. Remove unnecessary and communal items, including pillows and magazines.Eliminate self-serve items and treat jars, and move water dispensers to a place where the practitioner controls their use.CleanDo a deep clean of all spaces. Use?EPA-approved cleaning products?and protocols on all surfaces in your space, top to bottom. Follow the disinfectant contact time, per the product manufacturer. Establish a cleaning schedule for a bathroom in a clinic setting (for example, every 20–30 minutes) and in a sole practitioner setting (wipe down bathroom surfaces after every client visit).Wash all linens, rugs, blankets, and curtains thoroughly and clean any holding receptacles for dirty laundry. Consider whether a laundry service would be helpful to you at this time. As customary, ensure you have a secure and covered way to store fresh linens and a separate lidded and lined receptacle for dirty linens.Clean bolsters, tables, chairs, and stools as directed by the CDC and product manufacturer. Certain porous materials can start to break down with repeated chemical disinfectant use. Barrier protections might be in order for tables, chairs, and bolsters.Clean light fixtures and switches; doorknobs, doors, and door frames. Clean floors thoroughly.AddHave hand sanitizer, cleaning wipes, and facial tissues available in all spaces. Have disposable paper towels or a standing wipe dispenser available to use when handling doorknobs.Have a hard-surfaced, nonporous chair or large hard-surfaced/plastic basket for clients to put their clothes on/in. You do not want client clothing to be laid over soft furniture that the next client will then sit on as they remove their shoes or disrobe.Lidded trashcans that are operated by a foot pedal will keep facial tissues and other waste products from remaining exposed to the treatment room air.If you have a restroom within your space, install no-touch soap and paper towel dispensers. Add a lidded, foot-pedal trashcan. Place?CDC handwashing guidance posters?inside your restroom.If you don’t have windows you can open in your client treatment spaces, consider adding a high-efficiency particulate air (HEPA) purifier. Although there is no direct evidence yet that these types of air purifiers can reduce the transmission of COVID-19, their use with similar viruses indicates they might help in some situations, and it would be logical that these filters could reduce concentrations of COVID-19 particles that remain airborne.Back to Practice—Business Practices & Marketing ReadinessPreparing?your clients for the realities of your new practice will help keep you both safe by setting expectations up front. Use?the time you are closed to update cancellation policies, waiting room layouts, booking programs, and language changes for your website and materials. Inform clients of all new policies and changes to existing municating with ClientsConsider how you will put clients at ease when you reopen, explaining any reopening plans, new protocols, and new policies. Once finalized, add it to your website, prepare client emails, and create social media posts with similar messaging.Share an overview of your sanitation protocols with clients.Create a client education document about personal responsibility and mitigation efforts.Cancellation policies and booking language should be adapted and updated on forms, website pages, and booking platforms. Here is some sample language:New Cancellation Policy sample language:Amid the ongoing uncertainty of COVID-19, we have?modified?our cancellation policy to offer greater?flexibility?to all our clients. We hope this will alleviate any stress and hesitation you have about an upcoming appointment.?If you need to reschedule for whatever reason, and especially if you are not feeling well, we understand and request for you to please contact us as soon as possible to reschedule.?To further support you, there will be no penalties for cancellations.New Booking Policy sample language:?Due to COVID-19, we are temporarily limiting the number of daily appointments. The health and safety of our clients and staff is very important to us. For this reason, walk-in appointments will not be accepted and clients who are not currently receiving a service will be asked to step out in order to control the number of people within the salon/spa/clinic. If you are experiencing a fever, cough, or sore throat, please reschedule your appointment for when you are no longer symptomatic. If you have been to a COVID-19-impacted area or have been in close contact with a person infected with COVID-19, we ask that you please reschedule your appointment for 14 days past the date of contact. Please note, we are requesting that clients wear face coverings when they arrive for their appointments.Watch this ABMP video with pathology expert?Ruth Werner on how to do effective intake interviews.Business ChangesRevise your hours as appropriate to accommodate changes to your pre- and post-session protocols, as well as to eliminate the overlap of clients in your space. Leave 30 minutes between clients for hygiene and room sanitation protocols as well as personal re-set time, and stagger start times so no client arrivals or departures overlap. That time could be reduced if a cleaning crew was employed to help turn rooms.Consider a touchless pay system. If not possible, clean touch pad after each transaction with vendor-approved cleaning solutions. Move away from accepting cash and check for payments; if your tips typically come in cash, leave discrete envelopes in the treatment room or at the front desk for clients to deposit tips into. Therapists should not touch their cash until the end of day, and only when gloved and able to handle properly.Revise Health Intake and other related client forms as necessary. (See additional information in the “Pre-Session Interaction” section.)Populations that are especially vulnerable to COVID-19 may have stricter and extended shelter-in-place recommendations. This includes clients who are 65 years and older, and those with conditions such as heart disease, lung disease, diabetes, and suppressed immune systems.Here is sample language if you have clients in these at-risk categories that need to wait a little longer before returning to see you:?In accordance with extended shelter-in-place recommendations to protect our more vulnerable populations, I am not working with clients with compromised immune systems, clients aged 65 or above, or clients in other elevated at-risk categories at this time.Back to Practice—Pre-Session InteractionMore than ever, protecting yourself and your clients starts before they arrive for an appointment. Add information to your health intake forms, review your pre-screening call process, and put a hold on accepting walk-in clients.Health-Intake UpdatesInclude COVID-19-related questions on your Health Intake form:Have you had a fever in the last 24 hours of 100°F or above?Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?Include informed client consent language about the risk of infection on your Health Intake form.Sample language:?I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive massage and bodywork from this practitioner.Consider an online health intake process. Have clients fill out their forms and return them to you before the appointment; use the pre-screening call to remind the client if forms have not been returned.Prescreening CallQuestions to ask a client in your day-before reminder/screening call:Have you had a fever in the last 24 hours of 100°F or above?Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?If yes on any, reschedule without penalty.Explain your revised Cancellation Policy and that there is no penalty if they wake up with cold or flu symptoms and need to cancel on day of, but to still notify you as soon as possible.Take a minute to explain any new protocols as necessary, including the client’s wearing of masks as they arrive for their appointments. Does the client have a mask they can wear? Let them know you can provide a mask and describe to them how you want them to use it during their visit: have the mask on when entering the premises; together, you will evaluate their breathing comfort during the prone positioning portion of their massage session. The mask protocol is consistent with the CDC’s recommendation to the general public advising them to wear a cloth face covering whenever they must leave their home.Back to Practice—In-Session ProtocolsMuch of what you know about sanitation and hygiene will remain in place, but there are several new considerations to navigate, including taking a client’s temperature, working with a mask, and making sure a client is comfortable while wearing a mask.Practitioner PreparednessHygiene protocols remain standard and customary. The CDC recommends you take steps to ensure everyone adheres to respiratory hygiene, cough etiquette, and hand hygiene. Provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%–95% alcohol, tissues, and no-touch receptacles for trash disposal.Have your mask on and adjusted before your client arrives. To further protect yourself and clients, consider wearing clothing that can be changed out between clients. Keep hair up and away from your face. All other practitioner hygienic protocols apply—no long nails, jewelry, open-toe shoes, flip flops, or sandals.Practitioners should take their own temperature before each work day begins to ensure they are not presenting with any coronavirus symptoms.Avoid shaking hands with clients or hugging. Consider sharing with clients that you'll eliminate casual conversation?and remain in minimal necessary in-session conversation mode through the duration of the session.Treatment table setup will look largely the same, but linens/bedding will be turned over completely for each client. Use products with nonpermeable barriers, like mattress pads, to cover your table, table warmers, etc. On top of that barrier you can layer your washable fleece pads, sheet sets, blankets, etc. Put similar nonpermeable coverings on bolsters and pillows. Apply a ready-made disposable face-cradle cover to your face cradle, and top it with a pillowcase, leaving a large hammock-type pocket underneath that could catch client aerosols when they are prone. Each client will receive a completely new table setup.Consider opening treatment room windows if feasible. If using a high-efficiency particulate air (HEPA) purifier, make sure it is on before your client arrives.Client Arrival and IntakeAssume Standard Precautions for all client care:?coronavirus/2019-ncov/hcp/infection-control-recommendations.html.Use a no-contact thermometer to take the client’s temperature upon arrival; ask the client to reschedule if their temperature is 100°F or higher. If the client is not wearing a mask as you requested during the reminder phone call, offer them a cloth mask at this time before continuing.Initiate doorway screening checklist questions:Have you had a fever in the last 24 hours of 100°F or above?Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?Leave time for proper health history overview with new clients and updates with existing clients. Watch this?ABMP video with pathology expert Ruth Werner on how to do effective Intake Interviews.After the health history overview, discuss with the client their comfort in wearing a face covering during the session. Remember that face masks, including the homemade variety, protect other people from getting sick from you; but unless the client is also wearing a face mask, the practitioner is not protected. If the client is unable to wear a mask for health or comfort reasons, consider using an N95 medical mask for yourself once they return to the marketplace in sufficient supplies.Ask clients to use hand sanitizer (per CDC, at least 60% alcohol) before going to the treatment room and ensure that it’s applied liberally and properly, Give instruction on how to proceed with the session, including new direction on where to place clothing, the availability of hand sanitizer in the room, and the cleaning protocols you want to share to put clients at ease. Explain to clients that the room has been fully sanitized, but to put them fully at ease, they are also welcome to wipe down any surfaces again.Facial massage—Confirm with the client that they are comfortable with you applying hands-on work to their face; working through their face covering as needed to address sinuses, muscles around the temporomandibular joints, or lymph nodes in this area (if doing lymphatic drainage work), consider using gloves for this part of the treatment. Or, prior to the session, include this type of massage among the work you will not conduct during this time.Deliver customary pre-massage instructions to clients before leaving them to disrobe to their level of comfort. Wash hands thoroughly, up to the elbows, using?WHO guidelines for best practices before returning.During the SessionProne positions could be uncomfortable for clients who are wearing face coverings. Consider topping your face cradle and face cradle cover with a cotton pillowcase. Drape it so that it creates a contained hammock under the face cradle that could semi-effectively capture aerosols expelled by a client who is unable to comfortably wear a face covering during face-down positioning. When switching from prone to supine position with this client, ask them to put their face covering on before they turn over into the supine position.Noting the potential discomfort clients may have wearing a mask in prone position, consider using side-lying positioning to address the lateral and posterior aspects of the body.Hand massage—Leave any hand work for the final part of your treatment protocol.Before leaving the treatment room, remove gloves (if applicable), apply a generous amount of hand sanitizer per CDC application guidelines (at least 60% alcohol), and use a previously readied paper towel to open and close the treatment room door while leaving the room.Back to Practice—Post-Session ProtocolsImmediately following a session, it is important to consider how you prepare for room sanitation. It is also imperative to have a follow-up plan in place for open communication regarding any COVID-19 symptoms displayed by you or your clients after the session.Practitioner Sanitation ProtocolsUpon leaving the treatment room, immediately undergo your handwashing protocol while the client dresses. Do not touch or adjust your face covering. Wash hands thoroughly, up to the elbows, using WHO?guidelines for best practices.?Do not remove your face mask until you’ve taken payment for services and the client has left. If you must handle cash, check, or credit cards, do so using a pair of disposable gloves. Once the client leaves, dispose of the gloves, and remove your uniform shirt or apron, folding it in on itself and keeping the soiled surfaces inside. Place in a lidded container for daily laundry removal and wash hands before next removing your face mask carefully for additional uses. Finally, redress in a clean shirt.Hand hygiene after removing PPE or clothing is particularly important to remove any pathogens that might have been transferred to bare hands during the removal process. If hands are visibly soiled, use soap and water before applying alcohol-based hand sanitizer. For the removal of masks, the CDC says you must wash your hands both before and after removal.?(See more PPE guidelines in blog post)Begin room sanitation.Post-Session Client InteractionHave a post-session check-in with client 2–3 days later to ask typical session-follow-up questions, but also to ask about their overall health. Create a protocol that a client will call you and you will call a client if either start showing any apparent COVID-19 symptoms.Back to Practice—Post-Session SanitationIt takes 10 minutes for some cleaning products to effectively kill pathogens. Given this fact, and the other protocols necessary, we believe it is prudent to allow 30 minutes before your next client.Room Turnover Sanitation ProtocolsIf you have windows, open them immediately after a client has left and while you turn over the room to get as much air circulation in the room as possible (if they are not already open). If you don’t have windows, consider adding a high-efficiency particulate air (HEPA) purifier to the space.Remove all table setup items; fold linens in on themselves and place in lined, lidded hampers positioned outside the treatment space to minimize the possibility of dispersing virus in the air.Use hospital grade,?EPA-approved disinfectants?to clean anything the client came in contact with, including your table, face cradle, stool, bolsters, door knobs, side tables, chairs, etc. Follow more stringent state or regulatory agency protocols as required. Follow the product manufacturer’s recommendations for contact time (or how long a surface must stay visibly wet before the disinfectant destroys the pathogen). For some products, this can be 10 minutes. Be mindful of porous surfaces on tables and chairs, which can start to be damaged with the use of disinfectants; consider using barrier methods.Per CDC recommendations, clean?all equipment, devices, and surfaces?between each client interaction, including oil or lotion dispensers. This process includes cleaning:Hard (Non-Porous) Surfaces: If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection. For disinfection,?use EPA-approved disinfectants?for use against the virus that causes COVID-19. Follow the manufacturer’s instructions for all cleaning and disinfection products for concentration, application method, and contact time, etc. Additionally, diluted household bleach solutions (at least 1000ppm sodium hypochlorite) can be used if appropriate for the surface. Follow manufacturer’s instructions for application, ensuring a contact time of at least 1 minute, and allowing proper ventilation during and after application. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleaner. Unexpired household bleach will be effective against coronaviruses when properly diluted. Prepare a bleach solution by mixing 5 tablespoons (1/3 cup) bleach per gallon of water or 4 teaspoons bleach per quart of waterSoft (Porous) Surfaces:?For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning, if the items can be laundered, launder items in accordance with the manufacturer’s instructions using the warmest appropriate water setting for the items, and then dry items completely. Otherwise, use products that are EPA-approved for COVID-19.Electronics:?For electronics such as tablets, touch screens, keyboards, remote controls, and ATM machines, remove visible contamination if present. Follow the manufacturer’s instructions for all cleaning and disinfection products. Consider the use of wipeable covers for electronics. If no manufacturer guidance is available, consider the use of alcohol-based wipes or sprays containing at least 70% alcohol to disinfect touch screens. Dry surfaces thoroughly to avoid pooling of liquids.Linens, Clothing, and Other Items That Go in the Laundry:?In order to minimize the possibility of dispersing virus through the air, do not shake dirty laundry. Remove all linens, blankets, and table setups; fold items in on themselves before putting in a closed bin or hamper. Wash items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely.Repeat your handwashing protocol and reset the table and treatment space for next client.Sanitation Between ClientsContinue to wipe down bathroom surfaces (doorknobs, toilet handles, sink areas, light switches, etc.), reception-area countertops, point-of-sale equipment, and chairs (arm rests).Sanitation at End of DayEmpty all trash cans (each trash can has a liner), then use cleaning cloths to wipe the inside and outside of the garbage can thoroughly.Do end of day post-client cleaning, including the phone, keyboard, thermometer, and all light switches and doorknobs, as well as the bathroom and any other surfaces clients came in contact with.Remove bagged laundry from the dirty bin for washing and replace the hamper with a new liner.Back to Practice—Resources & ReferencesThese helpful resources were used in developing our guidelines. Also of note, the Federation of State Massage Therapy Boards (FSMTB) released their own guidelines on May 19, and they are available at? Academy of Dermatology AssociationClinic Preparedness ChecklistAmerican Academy of Dermatology Association. “Clinic Preparedness Checklist: Checklist to Prepare Your Clinic for COVID-19.” Accessed April 23, 2020.COVID-19 Guidance from OSHAAmerican Academy of Dermatology Association. “COVID-19: Guidance from OSHA During the Pandemic.” Last modified March 24, 2020. Accessed April 23, 2020.Managing Your Dermatology PracticeAmerican Academy of Dermatology Association. “Managing Your Dermatology Practice During COVID-19.” Last modified April 3, 2020. Accessed April 23, 2020.Use of PPE and Disinfection of PPEAmerican Academy of Dermatology Association. “Personal Protective Equipment (PPE) Use and Conservation During the COVID-19 Pandemic.” Accessed April 23, 2020.Screening and Post-Treatment GuidanceAmerican Academy of Dermatology Association. “Everyday Health and Preparedness Steps in Clinic.” Last modified April 7, 2020. Accessed April 23, 2020.American Physical Therapy AssociationPractice GuidanceAmerican Physical Therapy Association. “Physical Therapist Management of Patients with Diagnosed or Suspected COVID-19.” Last modified April 8, 2020. Accessed April 23, 2020.American Physical Therapy Association. “Where Things Stand: COVID-19 and Practice Guidance.” Last modified March 31, 2020. Accessed April 23, 2020.Coronavirus Resources and Provider InformationAmerican Physical Therapy Association. “Coronavirus (COVID-19) Resources for the Physical Therapy Profession.” Last modified April 23, 2020. Accessed April 23, 2020.American Physical Therapy Association. “Coronavirus: Information for Providers.” Last modified April 21, 2020. Accessed April 23, 2020.American Physical Therapy Association. “Novel Coronavirus: A Wake-up Call for Best Practices in Preventing Pathogen Transmission.” Last modified March 10, 2020. Accessed April 23, 2020.Centers for Disease Control and PreventionCleaningCenters for Disease Control and Prevention. “Cleaning and Disinfection for Community Facilities.” Last modified April 1, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Cleaning and Disinfecting Your Facility.” Last modified April 14, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.” Last modified April 13, 2020. Accessed April 23, 2020.Guidelines for Infection ControlCenters for Disease Control and Prevention. “Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.” Last modified April 13, 2020. Accessed April 23, 2020.Personal Protective EquipmentCenters for Disease Control and Prevention. “Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19).” Last modified April 15, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Personal Protective Equipment: Questions and Answers.” Last modified March 14, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission.” Last modified April 3, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Strategies for Optimizing the Supply of N95 Respirators.” Last modified April 2, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Strategies to Optimize the Supply of PPE and Equipment.” Last modified April 22, 2020. Accessed April 23, 2020.Centers for Disease Control and Prevention. “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.” Last modified April 13, 2020. Accessed April 23, 2020.Prepare Your PracticeCenters for Disease Control and Prevention. “Prepare Your Practice for COVID-19.” Last modified March 31, 2020. Accessed April 23, 2020.MiscellaneousNational Institute of Environmental Health Sciences. “Protect Yourself from COVID-19 in the Workplace.” Accessed April 23, 2020.Santanachote, Perry. “What You Need to Know About Air Purifiers and the Coronavirus.” Last modified April 9, 2020. Accessed April 23, 2020.Visual Capitalist. “The Front Line: Visualizing the Occupations with the Highest COVID-19 Risk.” Last modified April 15, 2020. Accessed April 23, 2020.Washington State Department of Health. “COVID-19 Health Alert for Massage Therapists.” Last modified April 6, 2020. Accessed April 23, 2020.World Economic Forum. “There are the Occupations with the Highest COVID-19 Risk.” Last modified April 20, 2020. Accessed April 23, 2020.World Health Organization. “Q&A on Coronavirus (COVID-19).” Last modified April 8, 2020. Accessed April 23, 2020.Occupational Safety and Health AdministrationOccupational Safety and Health Administration. “Additional Resources.” Accessed April 23, 2020.Occupational Safety and Health Administration. “Guidance on Preparing Workplaces for COVID-19.” Accessed April 23, 2020.Forms & PrintoutsThese forms and printouts are provided for your use, or to sample from and adapt as fits your practice.FormsOffice Policies: COVIDHealth Information: COVID-19 AddendumScreening Questionnaire: COVID-19Client Arrival: Check-In Screening Protocol (COVID-19)PrintoutsABMP Disinfection Table TentABMP Handwashing ReminderABMP Door HangerABMP Social Distancing ReminderABMP Face Mask ReminderABMP Temperature Check Waiting AreaABMP Hand-Sanitizer ReminderABMP Temperature Check StationCDC "Handwashing and Hand Sanitizer Use"WHO "How to handrub? / How to handwash?"WHO "How to Handrub?"Personal Protective EquipmentA Comprehensive Overview of PPE for Massage Therapists and Bodyworkers?The use of personal protective equipment (PPE) will be central to moving forward and reopening your massage or bodywork practice when the time comes. These resources give an overview of the types of PPE that you might use in your practice, along with helpful video demonstrations of how to use them properly, and resources for sourcing PPE for your practice.Please note that there is currently a shortage of PPE, with most supplies being redirected—rightly so—to frontline workers and health assistance staff (nursing homes, home health aides, etc.) who are still operating without the proper supply of equipment they need to work safely. ABMP believes it’s professionally unethical to divert supplies from this delicate supply chain for non-emergency equipment requests at this time. Consider other options for face coverings for you and your clients in the interim.Play VideoVideo overview: Types of PPE2:20 Gown/Uniform2:48 Facial Protection2:59?Cloth Face Coverings3:33?Face Masks4:10?Respirators (N95s)5:31 Eye Protection & Face Shields5:58 Gloves6:30 Donning and Doffing PPE7:01 Donning and Doffing a Face Covering8:11 Donning and Doffing a Face Mask8:56 Donning and Doffing a Respirator (N95)10:32 Donning and Doffing GlovesABMP ResourcesUse of Personal Protective Equipment (PPE) for Massage TherapistsABMP Discount Partners and Resources for Personal Protective Equipment (PPE)Making Masks and Gloves WorkCDC ResourcesCDC: Understanding the Difference (between Surgical Masks and N95 Respirators) - InfographicCDC PPE Sequencing InfographicAdditional Resources - ................
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