COVID-19 PROCEDURE FORM
Face-to-face consultations during the COVID-19 pandemic
COVID-19 has presented a unique challenge to all industries and healthcare is no different. As Mindfully Active Physio (from hereon referred to as MAP) resume face-to-face (from hereon referred to as F2F) consultations, there are a number of procedures that will be implemented to minimise risk of infection and adhere to all guidelines from relevant governing bodies.
What Mindfully Active Physio Will Do
MAP will put the following procedures into place to reduce the risk of COVID-19 transmission:
Prior to a F2F session, all clients will be triaged via telephone. This triage must be completed prior to every session, and not just the first time.
The MAP practitioner and the client will then make an informed decision as to whether or not a F2F session is deemed necessary. If so, you will be asked to attend the clinic at KORU Gym at an agreed time. If not, an online/video consultation can be performed as an alternative.
The treatment room at KORU will be exclusively used by MAP and no-one else will enter the room without strict adherence to cleaning strategies (as discussed below).
Access to the treatment room will be from the external door and so, even when the gym fully re-opens, there will only be access via the external door to reduce the infection risk.
MAP will ask that all clients arrive at their designated appointment time. Your physiotherapist will be waiting at the treatment room door entrance to reduce the need for you to touch door handles, etc.
Upon arrival your temperature will be taken via an infrared forehead thermometer, and if deemed to be too high (38 degrees celsius or above) you will be asked to return home and will not be treated - of note, is that this is never going to be 100% accurate, but helps to add to the clinical picture and safeguard everyone.
Hand sanitiser will be provided upon arrival.
For all F2F sessions, practitioners will wear appropriate Personal Protective Equipment (PPE) inclusive of disposable gloves, plastic apron and Type IIR face mask. All practitioners will be trained in how to effectively wear PPE.
Regular hand washing and hand sanitising will be performed between every client.
Practitioner clothing will be washed and/or changed at the end of each clinic session (day).
All contactable surfaces, inclusive of door handles, treatment couch, sink, chairs, etc, will be disinfected between every client.
Adequate time will be implemented to perform necessary cleaning procedures and to help ensure that clients do not arrive/leave at the same time.
Towels will not be used during this time and single use couch rolls will be used as an alternative should they be required.
The treatment room window will remain open during all clinic times to facilitate ‘fresh air’ circulation within the room.
As best possible, treatment will remain socially distanced (>1m), and time within this distance will be limited to 15mins or less if possible.
All waste such as paper towels and PPE will be placed in double waste bags. These bags will then be kept in isolation for 72 hours before being disposed of.
Parents or guardians of the client will have to follow the same guidelines as above.
Payments will be performed online to prevent the need for payment devices or cash in clinic.
If a client discovers that they later develop COVID-19 symptoms, they must inform MAP that they have done so. It is then MAP’s responsibility to inform all clients who have subsequently been to the clinic over the following week.
If any MAP practitioner becomes symptomatic, they will isolate immediately and inform any client who they have come into contact with over the prior week.
Strict patient records will be electronically written, and saved securely and confidentially to ensure all procedures are followed and documented. There will be no paper forms to complete.
Contact details will be clarified and securely saved for each individual that enters the clinic. This is due to the ‘Track and Trace’ system, which may require information to contact you should you have come into contact with anyone who is experiencing COVID-19 symptoms or has been confirmed with having COVID-19.
What You Must Do
As the client who will potentially be receiving face-to-face consultations with MAP, it is important to recognise that infection control measures are a shared responsibility. We ask that you adhere to the following procedures:
First and foremost, be honest. If you suspect any symptoms or have come into contact with anyone who has displayed/expressed such symptoms, you must report this to MAP prior to the F2F session.
You must complete the COVID-19 Triage & Consent form prior to every F2F session to the best of your ability.
If you develop symptoms following a physiotherapy session, you MUST inform MAP immediately so we can inform clients who we have subsequently seen and isolate.
Please come to the clinic on your own unless a parent/guardian is required.
Please bring your own face mask to wear throughout the duration of the session.
Upon arrival, you must scan the QR code and log-in with the NHS Test & Trace App.
If you have travelled abroad, please check the UK Government website to see if you are required to quarantine/self-isolate. You must inform MAP of this and be aware that we cannot treat you within this isolation period, even if you feel asymptomatic.
PLEASE NOTE, toilets will not be accessible during this period, so preparation prior to the session will be key
Carry paper or fabric tissues to cover your mouth or nose when coughing or sneezing. Dispose of paper tissues in a trash can immediately after use
Adhere to relevant COVID-19 signage within and around the MAP Clinic at KORU Gym
No walk-in appointments are available.
COVID 19 TRIAGE & DECLARATION FORM
IMPORTANT INFORMATION CONTAINED, PLEASE READ FULLY
Prior to every Face-to-Face consultation (from hereon referred to as F2F) at Mindfully Active Physio (from hereon referred to as MAP), you must read the MAP COVID-19 Procedure Document, complete the following questions honestly and to the best of your knowledge, and sign the below consent and declaration. This is put in place to help reduce the risk of COVID-19 infection spread. It should be noted that risk of infection spread can not be fully eradicated and so you must discuss whether a F2F is necessary for your needs with the MAP clinic/practitioner.
1. To the best of your knowledge, have you been confirmed to have COVID-19 or come into close contact with someone who has? ___________
2. Have you experienced a fever (temperature of 38 degrees celsius or more) within the last 14
3. Have you experienced a shortness of breath within the last 14 days? ___________
4. Have you experienced a severe or persistent cough within the last 14 days? ___________
5. Have you lost your sense of taste/smell within the last 14 days? _________
6. Have any of your immediate family (or those you live with) displayed any of the above symptoms within the last 14 days? ___________
7. Are you deemed to be in the clinically ‘extremely vulnerable’ group to COVID-19 and therefore advised to shield at home by the Government (e.g. pre-existing respiratory concerns such as severe asthma, COPD, cystic fibrosis; cancer or other immunosuppressive therapies), or do you live with anyone who is? ___________
8. Have you travelled outside of the UK within the last 14 days, to a country that requires you to self-isolate? __________
Consent & declaration to receive care at Mindfully Active Physio
Please read the following before providing consent and accepting the potential risks of attending a F2F consultation:
- I have answered all triage questions relating to my exposure to Coronavirus (COVID-19) to the best of my knowledge.
- I understand that Coronavirus may not cause symptoms in some people and is currently causing a pandemic.
- I understand that there is a potential risk of transmission of Coronavirus (COVID-19) as a result of attending the clinic and/or receiving treatment.
- I have read MAP’s Procedure Document fully.
- I have had the opportunity to ask all of the questions I wish to, and all of my questions have been answered to my satisfaction.
I have read, agreed and understood the statements above relating to Coronavirus (COVID-19) risk and consent to receive physiotherapeutic care at MAP.
Print Name _____________________