B

CNH22 Plan, evaluate and apply complex massage/soft tissue methods

Overview

This standard is about preparing for and applying the following massage/soft tissue methods:

- friction

- connective tissue massage

- proprioceptive neuromuscular facilitation

- positional release/strain counter strain techniques

- effleurage

- petrissage

- muscle energy techniques

- myofascial techniques

- neuromuscular techniques/trigger point therapy

- soft tissue release

- tap�tement

- vibration

- compressions

- passive stretching

Massage may be applied in the following contexts:

- injury management � post acute phase

- injury prevention

- problem solving (non-injury presentations)

- 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. the different types of data and information:
  2. Anatomy, physiology and pathology appropriate to the massage methods and contexts covered by the unit
  3. The importance of applying the underpinning knowledge of anatomy, physiology and pathology to the practice of massage
  4. The accepted standards of practice and recognition of client�s presenting with pre-existing conditions and problems
  5. The importance of accurate client assessment and record keeping
  6. The physiological and neurological effects of the massage/soft tissue methods covered by this unit
  7. The content of massage mediums in relation to allergic reaction and contraindication
  8. The psychology of injury as it applies to massage/soft tissue methods
  9. The relevance of nutrition � hydration, food fuels, chemical fuels
  10. The importance of physiology in understanding the client�s needs
  11. How to conform to protocols for all forms of communication
  12. The importance of cleanliness and hygiene and the standards that should be applied when applying massage in a variety of situations and environments
  13. The importance of maintaining the dignity and comfort of the client throughout the massage process
  14. The importance of ensuring the client is correctly positioned
  15. The importance of having a suitable chaperone present when working with clients and the principles to observe in relation to protection of children and vulnerable adults and child protection legislation
  16. The importance of obtaining informed consent prior to any assessment and  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
  17. The importance of working within the limits of informed consent
  18. The importance of obtaining information on the possible cautions and contraindications to massage before commencing any treatment and how to obtain this information
  19. The indications for massage
  20. 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
  21. The agreed standards of personal hygiene, dress and appearance and why they are important
  22. Current safety legislation for the types of equipment used in massage
  23. The importance of making sure the equipment and the area provide for the comfort and dignity of the client
  24. The correct materials to use for the range of massage methods covered by the unit
  25. The importance of explaining the aims and objectives of massage to the client
  26. How to obtain relevant information
  27. How to observe, palpate, assess and move the area to be massaged in advance and why
  28. The importance of referral to relevant professionals when necessary and of working within your scope of practice
  29. How to prepare the body area for the range of methods listed and why
  30. Why the client should understand the nature and purpose of the massage and the equipment being used
  31. 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
  32. The application of the range of methods to the range of conditions/situations listed
  33. Situations in which you should and should not remove the massage medium
  34. The importance of evaluating the effectiveness of massage
  35. How to obtain feedback from the client on the effects of massage
  36. The  possible adverse reactions to massage and how to identify these
  37. Why it is important to provide reassurance and opportunities for further feedback and how to do so
  38. How and when to report/refer to relevant health care professionals, why it is important to follow their directions and recognising working within scope of practice
  39. The details of the massage and its effects that should be recorded
  40. The importance of accurate and confidential  record keeping and safely storing records
  41. 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. the details of the massage and its effects that should be recorded
  2. the importance of accurate and confidential record keeping and safely storing records
  3. legal requirements for the storage of information on clients and the methods you have applied
  4. ensure there is adequate public liability and professional indemnity insurance
  5. apply agreed standards of personal hygiene, dress and appearance
  6. make sure equipment meets current health and safety requirements
  7. make sure equipment and area provide for the comfort and dignity of the client
  8. identify, assess and manage risks in the area
  9. make sure equipment and area are clean and hygienic
  10. select materials that are appropriate for the planned massage/soft tissue method
  11. where necessary, follow approved guidelines for the presence of a chaperone
  12. prepare and store records according to legal requirements
  13. obtain information on the client and context
  14. obtain information relevant to the cautions and contraindications to massage/soft tissue methods
  15. observe, palpate, assess and move the area in a way that is consistent with the context and the client�s condition
  16. agree the aims and objectives of the massage/soft tissue method
  17. devise a combined massage and soft tissue strategy appropriate to the client and the context within your scope of practice
  18. refer when necessary to a relevant professional
  19. identify objective and subjective markers to measure the effect of massage/soft tissue method
  20. follow the correct procedures to obtain informed consent
  21. make sure the client understands the nature and purpose of the massage/soft tissue method and the equipment to be used
  22. adapt your working practices to the area in which you are working
  23. where necessary, follow approved guidelines for the presence of a chaperone
  24. prepare the relevant body area with due respect to the client�s dignity and their informed consent
  25. make sure the client is correctly positioned, safe and comfortable throughout the massage/soft tissue method
  26. select and apply massage methods that are within your scope of practice and the client�s informed consent
  27. apply the massage/soft tissue method correctly and consistently to meet the client�s presentation and needs in the context
  28. observe and take account of the cautions and contraindications to massage/soft tissue methods
  29. record and respond appropriately to visual and oral feedback during the delivery of massage/soft tissue methods
  30. provide the client with appropriate materials and assistance to remove the massage medium when appropriate
  31. respond appropriately to pre-existing conditions and disease processes
  32. obtain and record feedback on the effects of massage/soft tissue methods from the client
  33. measure client feedback against the aims and objectives of your massage strategy
  34. identify any adverse reactions
  35. make reassessments if necessary
  36. provide the client with appropriate advice and additional opportunities for feedback
  37. make clear records in an acceptable format
  38. refer and/or report to the relevant health care professional and follow their directions
  39. store records safely and securely according to legal requirements
  40. evaluate the massage strategy
  41. destroy records as legally required

Additional Information

This National Occupational Standard was developed by Skills Active and were transferred 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
CNH22 Plan, evaluate and apply complex massage/soft tissue methods
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk
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