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Standards of Practice > Standards of Practice > Flashcards

Standards of Practice Flashcards

1
Q

What is the purpose of the Standards of Practice

A
  • Outline what is expected of every RMT in Ontario
  • Informs other stakeholders of the expectations and requirements, including clients, employers, other healthcare professionals, educators, students, exam candidates
  • help guide decision making when there is a complaint
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2
Q

Contravening or failing to maintain a SofP?

A

Professional misconduct under the CMTO

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3
Q

What is required to practice Acupuncture?

A
  • RMT must have successfully completed a confirmed acupuncture education program (or have been grand parented in CMTO)
  • have the required insurance
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4
Q

What are Sensitive Areas?

A
  • upper/ inner thighs
  • chest wall muscles
  • breasts
  • buttocks (gluteal muscles)
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5
Q

What is required for informed consent?

A

Must include a discussion with the client about the:

  • nature of treatment
  • the expected benefits
  • risks and side effects
  • alternative courses of action
  • likely consequences of not receiving treatment
  • the right to ask questions about the information provided and that assessment or treatment will be stopped or modified at any time at their request
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6
Q

What is required for discharge of care?

A
  • Must work with the client and others, as required, to plan and implement discharge from care
  • only discontinue care if the discharge process has been documented in the clients file and
  • treatment is no longer needed
  • client requests discontinuation
  • alternate services are arranged
  • the client is abusive or a threat
  • the client is given reasonable opportunity to arrange alternative services
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7
Q

What is conflict of interest?

A

RMT must avoid:

  • providing or receiving monetary or other benefit for referring a client to or from any other business (for example, a referral fee)
  • recommending a product or service that the RMT has a personal or financial interest without first disclosing it and advising the client that they may obtain a suitable alternative product elsewhere (document discussion)
  • sharing revenue, fees, or income with someone associated with their practice who is not a regulated health professional in Ontario, unless the RMT has a written agreement in place that ensures RMT is still held responsible
  • renting premises to or from any person when rent is determined by number of client referrals to the landlord
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8
Q

What is required for a person to consent

A
  • Must be capable

- Must be voluntary and not obtained through misrepresentation or fraud

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9
Q

How long do you have to document consent conversations?

A

24 hours

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10
Q

What is required for draping?

A
  • always drape the client (unless client wants to be clothed)
  • engage in a discussion about draping/ how to position themselves
  • explain what areas will be treated
  • protect client from exposure of genital area and gluteal cleft
  • never reach under the draping or clothing
  • drape using material that provides an effective visual barrier
  • drape to prevent visual exposure of any areas that are not being treated
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11
Q

Fees must be..

A
  • communicated prior to providing services
  • be itemized on a receipt, if requested
  • be posted in a visible location
  • not differ from the posted fee without noting the rationale and difference in the clients health record, and without prior acceptance by the patient
  • not be excessive
  • not be reduced for prompt payment
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12
Q

What must receipts include?

A
  • date of appointment
  • name of client
  • name of RMT
  • amount of transaction
  • signature and registration number of RMT
  • HST number if applicable
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13
Q

What would a receipt for a gift certificate look like?

A

When a gift certificate is redeemed, the receipt would say “gift certificate redeemed” with no dollar amount given

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14
Q

What percentage of alcohol must a hand rub be?

A

70% alcohol

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15
Q

When can you treat sensitive areas?

A
  • Treatment is clinically indicated
  • RMT obtains written informed consent
  • RMT discussed draping prior to treatment and drapes effectively
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16
Q

What does the Regulated Health Professionals Act cover?

A

Covers the following:

  • Prohibitions (controlled acts such as treatment when there is risk of harm, restriction of the term Doctor, or prescribing drugs)
  • misc items like exception of aboriginal healers and midwives
  • names the professions and colleges covered by the act
  • includes provisions for sexual abuse, complaints, discipline, incapacity, appeals, investigation..
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17
Q

What does the RHPA say is a controlled act?

A

Potentially hazardous health care activities which ought to be performed only by a health care professional that is properly trained and accountable for their actions

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18
Q

Examples of Controlled Acts under the RHPA?

A
  • Diagnosis
  • procedures below the dermis, mucous membrane, in or below the cornea, in or below the teeth (including scaling of teeth)
  • setting or casting a bone or joint dislocation
  • moving the joints of the spine beyond the individuals usual physiological range using fast, high amplitude thrust
  • administering a substance through injection or inhalation
  • putting an instrument or finger: beyond the external ear canal or beyond the point in the nasal passages where they normally narrow, beyond the larynx, beyond the opening of the urethra, beyond the labia majora, beyond the anal verge, into an artificial opening
  • prescribing drugs, vision devises, hearing aids
  • fitting dental prosthesis
  • managing labor or delivering a baby
  • allergy testing
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19
Q

Advertisements must have the following…

A
  • General info about the practice (location, accessibility, hours of operation, address, telephone #)
  • identification of the educational qualifications of the staff
  • information on the types of services available
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20
Q

Advertisements may NOT contain..

A
  • a testimonial by a client, former client, friend or relative of a client
  • claims or guarantees about treatment that cannot be verified
  • an endorsement of a product or line of products
  • anything that is false or misleading
  • any sexual innuendo or language that is sexual
  • any statements that discriminate under the basis of protected status
  • any wording that would imply that staff are members of the college when they are not
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21
Q

Example of an ad

A 
Name of Clinic
Name of Massage Therapist 
Indication of College membership
services offered
Clinic phone #
hours of operation
Wheelchair accessibility
Free parking available
Clinic Address
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22
Q

Why is maintaining client records important?

A
  1. Assists MT in recalling details of client history, condition, treatment
  2. Assists with continuity of care if colleges or a locum are called upon to treat client
  3. Provides record for medical legal purposes when the client requires a report relating to the illness or injury treated
  4. Provides record of events for the MT in the event of inquires relating to treatment by insurers or a complaint against MT
23
Q

With regards to Maintenance of Records, RMTS are required to…

A
  1. Make and maintain client records
  2. Maintain client records for 10 years from the date of the last entry, or if the client is less than 18, 10 years from the date that the client turns 18. RMTs may retain personal possession of the records or make arrangements with a custodian
  3. Ensure the confidentiality of the patient is maintained
  4. Release information contained in the clients record at the clients request
24
Q

What principles must be adhered to with maintenance of records?

A
  1. All info relating to MT services provided is confidential
  2. The health info contained in the file belongs to the client and can be released only with his/her consent or as required by law
  3. The client has the right to access the info in their health record
25
Q

When do receipts have to be issued?

A

At the time of service

26
Q

What needs to be on a receipt for MT?

A
  • Date of the financial transaction
  • description of the service
  • duration of the treatment
  • Name of the payer
  • Name of RMT
  • Registration number and signature
  • If applicable, HST number
27
Q

How is a receipt for products or services that are outside the massage therapy scope of practice different?

A

For products and services that are outside the MT scope of practice, receipt cannot have the RMT registration number, and the description cannot say “massage therapy treatment”. It must indicate the product or service provided. Receipts for missed or cancelled appointments must be clearly marked

28
Q

If a third party is paying for the massage treatment, who would the receipt be issued to?

A

The receipt must read “massage therapy treatment for ____ (name of recipient). The receipt is still issued to the payee

29
Q

How would a receipt for a gift certificate look?

A

when a gift certificate is purchased, the description of services is “Gift certificate” and the dollar amount paid is listed. When the gift certificate is redeemed, a receipt for the dollar amount is NOT issued… instead it says “gift certificate redeemed”

30
Q

Duplicate receipts must have…

A

must reflect the date that the duplicate receipt was issued. The description must read “ massage therapy treatment on (date of treatment) and must be clearly marked “duplicate”

31
Q

When commencing employment, or entering into a group practice, massage therapists should..

A

develop an agreement that explicitly covers procedures for record storage, covering both termination of the employment or partnership, and closing, relocation, or selling the practice

32
Q

What are the options for record retention when a MT terminates a relationship with a facility?

A

records can be stored by facility or MT.

  • If the facility is storing the originals- a copy should be kept by the MT, or an agreement that the MT can have access to them if required.
  • If the MT is keeping the records, facility should be provided the MT new practice location so that clients who wish to access to their records can contact the MT to do so.
33
Q

Can the massage therapist contact clients before they leave a practice?

A

Yes, it is professional misconduct to abandon a client. MT’s have a responsibility to contact clients and let them know they are leaving a practice. This may be done in person, telephone, or letter.

34
Q

What should a MT do when closing a practice?

A
  1. Give clients as much notice as possible that the practice is closing
  2. Assist clients with the transfer of their care to another provider
  3. Advise them that the therapist is required to keep their records for 10 years, or if they are under 18, for 10 years after they turn 18.
  4. Provide info on how they can assess their records in the future (MT may store the records or appoint a custodian. if the member has died, the estate may elect to store the records and respond to client requests, or choose to transfer the records to a custodian)
35
Q

What should a MT do when selling the practice?

A
  1. Give clients as much notice as possible
  2. Facilitate the transfer of care to a new practitioner or respects clients choice if they wish to choose a new practitioner not associated with the clinic
  3. Advise the client of the arrangements that have been made for storage/ access to their records and respect the clients wishes if they want their records transferred to another practitioner
36
Q

Where can information on client record policies be found?

A

Massage Therapy Act

37
Q

What must a MT do when a request is made for information from a clients file?

A

Ensure the following procedures are followed:

  1. a signed consent (from the client or clients representative) authorizing release of the information to the particular individual, is in the clients file. The consent form should be dated within the last 6 months
  2. if no consent form exists or if it is older than 6 months, the requesting party should be contacted and notified a new consent will be required
  3. Once consent has been obtained, the requested copy, summary, report or medical/legal report should be prepared
  4. A fee that reflects the cost of the materials used, time required, and cost of sending it to the requester should be established. MT can request payment prior to sending it
38
Q

What is involved with removing your business contact information from the registrar?

A

As per the Health Professionals Procedural Code (HPPC), the college maintains a public registrar with every business contact. In rare cases, a registrant may request to have their contact info removed due to a safety concern. Registrant must submit request in writing

39
Q

What act specifies rules about Ancillary and Related Activities?

A

Massage Therapy Act

40
Q

What does the Massage Therapy Act say about Ancillary and Related Activities?

A

Basically Massage Therapy has to be the main business (ancillary can’t be the main business).
The act specifies the Scope of Practice:
“The practice of Massage Therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissues and joints by manipulation to develop, maintain rehabilitate or augment physical function or relieve pain. “ Ancillary isn’t directly in the scope of practice but it’s related
-Can’t be billed as massage therapy treatment

41
Q

What is the policy regarding ancillary/ related activities?

A

Activities carried out by MT which do not strictly fit the definition of the scope of practice in the Massage Therapy Act must be closely related to MT and must be carried out within the context of an active massage therapy practice.

42
Q

What would be examples of Ancillary or related activities?

A
  • selling massage related supplies for home use
  • teaching massage related courses
  • publication of books
  • the temporary investment of surplus funds earned by the corporation
43
Q

What is the HCCA?

A

Health care consent act, 1996
-sets out specific requirements for obtaining consent for treatment, and in particular addresses specific situations where the client is incapable of providing consent, and a substitute decision maker is required

44
Q

The HCCA sets out the following…

A
  1. What constitutes the elements required for consent
  2. in what situations consent is required
  3. how to determine the clients capacity to provide it, and what to do if the client is incapable
45
Q

According to the HCCA, consent must…

A
  • relate to the treatment being proposed
  • be informed
  • be voluntary
  • must not be obtained through misrepresentation or fraud
46
Q

According to the HCCA, the Massage Therapist, when explaining the proposed treatment to a client, must explain…

A
  • the nature of the treatment
  • the risks and side effects, or any alternative options
  • the expected benefits
  • the likely consequences of not having treatment
47
Q

Consent is informed if…

A
  • information about the treatment is given

- responses to additional requests for information is given

48
Q

How does the HCCA define treatment?

A

anything done for therapeutic, preventative, palliative, diagnostic, cosmetic, or other health related purpose, including a course of treatment or plan of treatment. A practitioner may only administer treatment without consent in emergency situations

49
Q

What is NOT considered treatment by the HCCA?

A
  • The assessment of capacity or the general assessment of the clients condition
  • the taking of health history
  • the communication of the assessment findings
  • the admission of the person to a hospital or facility
  • a personal assistance service or a treatment that poses little or no risk to the client

However, the COLLEGE says MT have to get Informed consent for any client interaction, specifically for assessment and treatment

50
Q

In what situations might capacity be questioned?

A
  • evidence of confused or delusional thinking
  • alcohol or drug impairment
  • clients inability to make a clear treatment choice
  • lack of ability to communicate
51
Q

At what age is someone deemed capable of providing consent?

A

There is no specific age. The ability to provide consent will depend on the cognitive and maturity level of the person, the risks associated with the treatment proposed, and the complexity of the issues.

52
Q

If someone disagrees with the need for their substitute decision maker, what are their options?

A
  • Finding another decision maker of the same or senior rank that is more acceptable to the client
  • Exercise their right to apply to the Consent and Capacity Review Board
53
Q

What is a Substitute Decision Maker?

A

Individuals who make treatment decisions for individuals who are not capable of making them independently. In most cases, the individual will be a family member

54
Q

How does the HCCA set out the hierarchy of substitute decision makers?

A
  1. An official guardian appointed by the court
  2. an attorney for personal care
  3. A representative appointed by the Consent and Capacity Review Board
  4. A spouse, partner or relative in the following order:
    a) spouse or partner
    b) Child if 16 years or older or the custodial parent
    c) parent who only has right of access
    d) brother or sister
    e) any other relative

Standards of Practice (3 decks)

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