CNH21 Plan, apply and evaluate massage to prevent and manage injury

Overview

This standard is about preparing for and applying the following massage methods: - effleurage - petrissage - tapôtement - vibration - compressions - friction - passive stretching Massage may be applied in the following contexts: - injury management – post acute phase - injury prevention - pre-existing conditions/disease processes (therapeutic and remedial). Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

anatomy, physiology and pathology appropriate to the massage methods and contexts covered by the unit
the importance of applying the underpinning knowledge of anatomy, physiology and pathology to the practice of massage
the accepted standards of practice and recognition of client’s presenting with pre-existing conditions and problems
the importance of accurate client assessment, reassessment and record keeping
the physiological and neurological effects of the massage methods covered by the unit
the content of massage mediums in relation to allergic reaction and contraindication
the psychology of injury as it applies to massage methods
the relevance of nutrition– hydration, food fuels, chemical fuels
the importance of physiology in understanding client needs
how to conform to protocols for all forms of communication
the importance of cleanliness and hygiene and the standards that should be applied when applying massage in a variety of situations and environments
the importance of maintaining the dignity and comfort of the client throughout the massage process
the importance of ensuring the client is correctly positioned
the importance of having a suitable chaperone present when working with clients and the principles to observe in relation to the protection of children and vulnerable adults and child protection legislation
the importance of obtaining informed consent prior to assessment and any application or course of massage – practitioners are required to tell the client anything that would substantially affect the client’s decision; such information typically includes the nature and purpose of the massage, its risks and consequences and any alternative courses of treatment
the importance of working within the boundaries of informed consent
the importance of obtaining information on the possible cautions and contraindications to massage before commencing any treatment and how to obtain this information
the indications for massage
what the cautions and contraindications to massage are, for example: acute trauma, tumour, open wounds, frostbite, acute soft tissue injury, circulatory disorders, fractures, thrombosis, bursitis, periostitis, myositis ossificans, infections, skin disorders, allergic conditions, risk of haemorrhage, areas of altered skin sensation, mental incapacity
the agreed standards of personal hygiene, dress and appearance and why they are important
current safety legislation for the types of equipment used in massage
the importance of making sure the equipment and the area provide for the comfort and dignity of the client
the correct materials to use for the range of massage methods covered by the unit
the importance of explaining the aims and objectives of massage to the client
how to obtain relevant information
how to observe, palpate, assess and move the area to be massaged in advance and why
the importance of referral to relevant professionals when necessary and of working within your scope of practice
how to prepare the body area for the range of methods listed and why
why the client should understand the nature and purpose of the massage and the equipment being used
how to apply the range of methods listed in the unit with particular reference to: contour of hands, position (stance/posture), depth of pressure, direction of movement, the medium used, speed and rhythm of movement
the application of the range of methods to the range of conditions/situations listed
situations in which you should and should not remove the massage medium
the importance of evaluating the effectiveness of massage
how to obtain feedback from the client on the effects of massage
the possible adverse reactions to massage and how to identify these
why it is important to provide reassurance and opportunities for further feedback and how to do so
how to report/refer to relevant health care professionals, why it is important to follow their directions and to recognise working within scope of practice
the details of the massage and its effects that should be recorded
the importance of accurate and confidential record keeping and safely storing records
legal requirements for the storage of information on clients and the methods you have applied

Performance Criteria

You must be able to do the following:

ensure there is adequate public liability and professional indemnity insurance
apply agreed standards of personal hygiene, dress and appearance
make sure equipment meets current health and safety requirements
make sure equipment and area provide for the comfort and dignity of the client
identify, assess and manage risks in the area
make sure equipment and area are clean and hygienic
select materials that are appropriate for the planned massage method
where necessary, follow approved guidelines for the presence of a chaperone
prepare and store records according to legal requirements
obtain information on the client and their context
obtain information relevant to the cautions and contraindications to massage methods and respond appropriately
observe, palpate, assess and move the area in a way that is consistent with the client and their context
refer when necessary to a relevant professional
agree the aims and objectives of the massage method
devise a massage strategy appropriate to the client, their context and your scope of practice
identify objective and subjective markers to measure the effect of massage method
follow the correct procedures to obtain informed consent
make sure the client understands the nature and purpose of the massage method and the equipment to be used
adapt your working practices to the area in which you are working
where necessary, follow approved guidelines for the presence of a chaperone
prepare the relevant body area with due respect to the client’s dignity and their informed consent
make sure the client is correctly positioned, safe and comfortable throughout the massage method
select and apply massage methods that are within your scope of practice and the client’s informed consent
apply the massage method correctly and consistently to meet the client’s presentation and needs in the context
observe and take account of the cautions and contraindications to massage methods
record and respond appropriately to visual and oral feedback during the delivery of massage methods
provide the client with appropriate materials and assistance to remove the massage medium when appropriate
respond appropriately to pre-existing conditions and disease processes
obtain and record feedback on the effects of massage methods from the client
measure client feedback against the aims and objectives of your massage strategy
identify any adverse reactions
make reassessments
provide the client with appropriate advice and additional opportunities for feedback
make clear records in an acceptable format
where necessary refer and/or report on progress to the relevant health care professional and follow their directions
store records safely and securely according to legal requirements
evaluate the massage strategy
destroy records as legally required

Additional Information

This National Occupational Standard was developed by Skills Active and was transferred over to Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments