Five tips and tricks

It may not be the first thing you think about when starting or running a physiotherapy practice, but hygiene is crucial.

Working hygienically is good for health while also giving patients confidence in the therapist and the practice, but it does take extra time. Especially for physiotherapy and osteopathy practices, which usually don’t have an assistant and where one treatment follows another in quick succession. So, how can you ensure your practice is hygienic quickly and easily? To answer this question, we not only looked at the hygiene protocols of the WHO and the Dutch Association of Physiotherapy, but also at the treatment materials available on the market. And we came up with these five tips:

• Tip 1: Use a fast-acting disinfectant on the table after each treatment.
• Tip 2: Protect the treatment table with an antibacterial cover that can be disinfected.
• Tip 3: Use an Ergomax face cushion.
• Tip 4: Only wash your hands with soap and water if absolutely necessary. Use hand sanitiser at all other times.
• Tip 5: Follow the general hygiene recommendations.

Tip 1: Use a fast-acting disinfectant on the table after each treatment.

The problem:

Every physiotherapist is familiar with, and probably has, the same terry cloth treatment table cover. Created to protect the table while also being comfortable for patients. However, it needs to be replaced and washed after each patient for hygiene reasons. The disadvantage is that this not only takes time but also money. In reality, these covers often languish away in a cupboard and other solutions have to be found so you can work hygienically.

The solution:

Instead of a terry cloth cover, disinfect the (uncovered) treatment table with a disinfectant after each treatment. But watch out: not all products kill viruses and are not all fast-acting. There’s no point using a product that fails to kill viruses while one that takes five minutes to be effective will put paid to your efficiency gains. That is why you should choose a disinfectant carefully. The advantage is clear: no need to change covers every half hour and you can forget about mountains of laundry.

Tip 2: Protect the treatment table with an antibacterial cover that can be disinfected.

The problem:

Unfortunately, there are also disadvantages to disinfecting the treatment table with a disinfectant. Because while you’ll save time, it remains to be seen if you’ll also save money. You may spend less money on water and energy consumption, but you will have to buy a good, fast-acting disinfectant. Also, a treatment table without a cover is not protected and may suffer wear and tear more quickly from frequent disinfectant use. Possible solutions that do not create extra work and laundry include using a roll of paper or having the patient bring their own towel. But… a roll of paper is less comfortable, feels cold, shifts during transfers, and gives microorganisms the chance and space to spread across the table. In the end, you’ll still need a disinfectant. The same applies to using a towel, where you cannot even be sure how clean it was in the first place.

The solution:

These problems melt away like snow in spring if you swap the fabric cover for a protective cover you can disinfect. For example, Gymna offers bi-elastic protective cover that can be disinfected. This waterproof cover is made from a durable, breathable material and is hypoallergenic, hydrostatic, flame-retardant, and antibacterial, meaning it is mould and bacteria-resistant. Microorganisms cannot survive on the cover because its material does not provide them with a breeding ground. And if you still wish to disinfect the cover, this can be done easily and quickly because it also covers the narrow gaps between the treatment table cushions. You can disinfect using liquids, sprays, or wet wipes. It can also be washed at 95°C. And, of course, it also protects the table cushions.

Tip 3: Use an Ergomax face cushion.

The problem:

No matter how you decide to keep your treatment table hygienic while protecting it from wear and tear, the facial recess in the table is and always will be unhygienic. This area not only comes into contact with sweat, but also with saliva, which often contains germs. Furthermore, exhaled aerosols condense on the treatment table. Careful disinfection is therefore very important, but at the same time, practically impossible because of all the nooks and crannies in the cushion around the recess. Moreover, experience has taught us that the leather around the recess in the table wears out the fastest anyway. Increased and more frequent disinfection is therefore not desirable. A face cover (a single-use protective membrane) is not a solution because it can slide off easily and is not particularly hygienic.

The solution:

The waterproof Ergomax face cushion is an efficient and hygienic solution that is both washable and disinfectable. It is quick to replace, easy to clean, and resistant to aggressive agents. And it is also much more comfortable for your patients.

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Tip 4: Only wash your hands with soap and water if absolutely necessary. Use hand sanitiser at all other times.

The problem:

The golden rule is wash, wash, wash your hands. But hand washing takes time, time, and more time. Not just the washing itself, but also doing all the laundry because cloth towels can only be used once (a problem you can avoid by using paper towels).

Hand hygiene according to the WHO:

Hand hygiene is the collective term for hand cleansing and hand disinfection and reduces the risk of transmission of microorganisms. Hand cleansing is washing the hands with running water and soap and tackles microorganisms and dirt. Hand disinfection is the disinfection of the hands with hand sanitiser (from 70% alcohol) and only tackles microorganisms. The latter is less damaging to the skin, faster, and does not require a sink. The WHO recommends five moments for hand hygiene:

• Before hand contact with the patient
• Before clean and aseptic operations
• After hand contact with bodily fluids
• After hand contact with the patient
• After hand contact with the patient’s environment

The solution:

Only use soap and water if absolutely necessary. According to the WHO, this is when the hands are visibly dirty, sticky, or wet, or after using the toilet. Washing with soap and water is also recommended after coughing, sneezing, or blowing your nose because, even though disinfection is enough, theoretically, the patient feels more comfortable if water is used in these cases. Disinfection alone is sufficient at all other times. In fact, it has been scientifically proven that hand sanitiser disinfects better than disinfectant soap. Due to unnecessary skin stress, you shouldn’t disinfect after washing with soap and water.

Hand washing refresher:

Wet your hands, get some soap and rub it on your thumbs, fingertips, wrists, and between your fingers for at least 10 seconds. Rinse off the soap and dry your hands with paper towel or kitchen roll.

Hand disinfection refresher:

Fill the well in the palm of your dry hand with hand sanitiser (moisture reduces the effectiveness of the disinfectant). Rub over your hands and keep rubbing until the alcohol has dried. Only then are the pathogens dead.

Extra tip 1:

Station hand gels every few metres and disinfect your hands from time to time, especially in the presence of patients. This gives confidence and is also easy to do on the way from the waiting room to the treatment room.

Extra tip 2:

Also disinfect your soap dispenser as some microorganisms can thrive in that environment. Because bacterial growth can occur in leftover refillable containers, a non-refillable container is preferred.

Tip 5: Follow the general hygiene recommendations.

These last few tips and recommendations won’t make you more efficient on their own, but they are hygienic and necessary:

• Wear short sleeves and do not wear jewellery on hands or forearms.
• Keep fingernails short and clean and do not use artificial nails, nail polish, or decorations.
• Tie back your hair or put it up, keep your beard or moustache short, and don’t touch your face or hair.
• Wear clean clothes daily and wash contaminated clothes immediately at 60°C (or at 40°C and then dry in the drying cabinet or press at setting 3). The same goes for a headscarf.
• Do not eat or drink in areas where patient-related work takes place.
• Keep the windows open as much as possible. Position any air conditioner to ensure that the airflow does not go from one person to another.
• Disinfect patient and staff areas two to three times a day, focusing on areas that are touched frequently (don’t forget the door handles).

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