Osteopathy practice in Henley-on-Thames, Oxfordshire, and Prestwood, Buckinghamshire.

Mobile 07799 25 8883

Covid-19

Covid-19 Risk Assessment

28th June 2020

Hazards:

Spread of Covid-19 Corona Virus

Who might be harmed:

The patient and anyone accompanying the patient, and those they come into contact with after an Osteopathy consultation. The Osteopath and those he comes into contact with. (There is only one osteopath in the practice and no other staff).

How the virus is thought to be transmitted: 

The virus is transmitted in bodily fluid droplets. The main means of transmission is via a cough or a sneeze but can also be via blood or bodily waste. The droplets travel in the air and fall to any surface beneath them. Our current understanding is that the virus remains alive for up to 72 hours on hard surfaces, such as glass, metal, plastic and for shorter amounts of time on more porous materials such as paper or wood. The virus enters the body via the mucous membranes of the mouth, nose and eyes and via any open wound in the skin. The risk to a person of transmitting or receiving the virus increases with proximity to another person. A person who has contracted the virus will shed it at the highest rate in the days before they show symptoms if they show symptoms at all. Any of us could be pre-symptomatic or asymptomatic at any one time unless we have isolated for at least 14 days. The Government considers that the risk of passing the virus by droplets reduces considerably if two people are 2m or more apart. The risk is further reduced if the people are in an open outdoor space.

Main hazards in the practice for transmission to happen:

Proximity: An osteopathy consultation involves close proximity and touch. The practice is a small room with 2 windows and door opening to the outside. It is a small space so it is assumed that the droplets could easily transmit through the air to the other person even if doors and windows are open. The treatment part of the consultation increases this close proximity.

Surfaces: Droplets could be on door handles of treatment room, house front door and loo. Chairs, cushions and table. Treatment couch, covering and pillows. Loo, sink and towel. Clothes, skin, hair - treatment involves touch so droplets can transmit that way.

Actions to control risk: The proximity during treatment cannot be changed, nor can the surface of the treatment table. However other variables can be reduced. If the osteopath drove to the patients house and conducted the consultation there, a) in terms of surfaces only the table would be a risk as the patient would provide their own pillows and the couch could be kept without a cover and sanitized before and after the treatment, and the osteopath could avoid touching any surfaces other than the treatment table, stool and paper work, b) for the rest of the summer to reduce risk further the patient’s garden would be used if they have one, or if raining a covered outdoor space like a veranda or room/conservatory that can be aired well. If an indoor room has to be used then it should be aired beforehand and as many windows and doors as possible are to be kept open during the treatment.

Further actions to control risk during a home visit:

At the car: The osteopath unloads table, stool and bag. Then sanitizes hands and puts mask on. The patient will be asked in advance to wear a mask, or one can be provided.

Set up: The osteopath walks to treatment area not touching anything. If the consultation is to take place in the garden then if possible he will be let straight into the garden bypassing the house. He puts the previously alchohol-wiped treatment table up.

Consultation: Paper work – consent form and case history – is completed (patient will be sent consent form by email so they are able print it out to reduce passing of paper). Treatment table top alchohol wiped and hands sanitized. Patient puts pillows on table and has blanket ready if needed. Standing exam and movements. Patient lies down or sits. Minimum time will be spent at the head during exam and treatment to reduce the proximity between patient and osteopath faces – it is often possible to treat head and neck from elsewhere on the body.

Finish: Patient sits up and gets off table and takes blanket and pillows off. Hands sanitized. Table top alchohol-wiped. Patient will be asked to pay later with bank transfer. Osteopath walks to car not touching anything.

At car: Sanitize hands and forearms. Take mask off. Sanitize hands. Change shirts between visits.

A maximum of six home visits in a day to allow time for PPE and sanitizing.

 

This risk assessment was written with the help of the Institute of Osteopathy and government websites.