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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:

  1. anatomy, physiology and pathology appropriate to the massage methods and contexts covered by the unit
  2. the importance of applying the underpinning knowledge of anatomy, physiology and pathology to the practice of massage
  3. the accepted standards of practice and recognition of client’s presenting with pre-existing conditions and problems
  4. the importance of accurate client assessment, reassessment and record keeping
  5. the physiological and neurological effects of the massage methods covered by the unit
  6. the content of massage mediums in relation to allergic reaction and contraindication
  7. the psychology of injury as it applies to massage methods
  8. the relevance of nutrition– hydration, food fuels, chemical fuels
  9. the importance of physiology in understanding client needs
  10. how to conform to protocols for all forms of communication
  11. the importance of cleanliness and hygiene and the standards that should be applied when applying massage in a variety of situations and environments
  12. the importance of maintaining the dignity and comfort of the client throughout the massage process
  13. the importance of ensuring the client is correctly positioned
  14. 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
  15. 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
  16. the importance of working within the boundaries of informed consent
  17. the importance of obtaining information on the possible cautions and contraindications to massage before commencing any treatment and how to obtain this information
  18. the indications for massage
  19. 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
  20. the agreed standards of personal hygiene, dress and appearance and why they are important
  21. current safety legislation for the types of equipment used in massage
  22. the importance of making sure the equipment and the area provide for the comfort and dignity of the client
  23. the correct materials to use for the range of massage methods covered by the unit
  24. the importance of explaining the aims and objectives of massage to the client
  25. how to obtain relevant information
  26. how to observe, palpate, assess and move the area to be massaged in advance and why
  27. the importance of referral to relevant professionals when necessary and of working within your scope of practice
  28. how to prepare the body area for the range of methods listed and why
  29. why the client should understand the nature and purpose of the massage and the equipment being used
  30. 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
  31. the application of the range of methods to the range of conditions/situations listed
  32. situations in which you should and should not remove the massage medium
  33. the importance of evaluating the effectiveness of massage
  34. how to obtain feedback from the client on the effects of massage
  35. the  possible adverse reactions to massage and how to identify these
  36. why it is important to provide reassurance and opportunities for further feedback and how to do so
  37. 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
  38. the details of the massage and its effects that should be recorded
  39. the importance of accurate and confidential  record keeping and safely storing records
  40. 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:

  1. ensure there is adequate public liability and professional indemnity insurance
  2. apply agreed standards of personal hygiene, dress and appearance
  3. make sure equipment meets current health and safety requirements
  4. make sure equipment and area provide for the comfort and dignity of the client
  5. identify, assess and manage risks in the area
  6. make sure equipment and area are clean and hygienic
  7. select materials that are appropriate for the planned massage method
  8. where necessary, follow approved guidelines for the presence of a chaperone
  9. prepare and store records according to legal requirements
  10. obtain information on the client and their context
  11. obtain information relevant to the cautions and contraindications to massage methods and respond appropriately
  12. observe, palpate, assess and move the area in a way that is consistent with the client and their context
  13. refer when necessary to a relevant professional
  14. agree the aims and objectives of the massage method
  15. devise a massage strategy appropriate to the client, their context and your scope of practice
  16. identify objective and subjective markers to measure the effect of massage method
  17. follow the correct procedures to obtain informed consent
  18. make sure the client understands the nature and purpose of the massage method and the equipment to be used
  19. adapt your working practices to the area in which you are working
  20. where necessary, follow approved guidelines for the presence of a chaperone
  21. prepare the relevant body area with due respect to the client’s dignity and their informed consent
  22. make sure the client is correctly positioned, safe and comfortable throughout the massage method
  23. select and apply massage methods that are within your scope of practice and the client’s informed consent
  24. apply the massage method correctly and consistently to meet the client’s presentation and needs in the context
  25. observe and take account of the cautions and contraindications to massage methods
  26. record and respond appropriately to visual and oral feedback during the delivery of massage methods
  27. provide the client with appropriate materials and assistance to remove the massage medium when appropriate
  28. respond appropriately to pre-existing conditions and disease processes
  29. obtain and record feedback on the effects of massage methods from the client
  30. measure client feedback against the aims and objectives of your massage strategy
  31. identify any adverse reactions
  32. make reassessments
  33. provide the client with appropriate advice and additional opportunities for feedback
  34. make clear records in an acceptable format
  35. where necessary refer and/or report on progress to the relevant health care professional and follow their directions
  36. store records safely and securely according to legal requirements
  37. evaluate the massage strategy
  38. 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
CNH21 Plan, apply and evaluate massage to prevent and manage injury
Final version approved June 2010 © copyright Skills For Health,
For competence management tools visit tools.skillsforhealth.org.uk