Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to observe the condition of the client and gather information relevant to the case to enable correct assessment, planning and provision of a remedial massage

Application 

This unit may apply to work in massage in a range of settings and contexts

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Determine the scope of the assessment and the client's needs

1.1 Establish the client's purpose for consultation and identify the symptoms experienced

1.2 Determine the client's eligibility for using clinic/personal policies

1.3 Explain the services able to be provided and the limits of available services clearly

1.4 Explore and clarify the client's expectation of the service/clinic

1.5 Identify factors likely to have a negative impact on assessment  in consultation with the client and implement strategies to minimise the effects of these factors wherever possible

1.6 Ensure personal abilities, level of professional competence and parameters of role are defined to the client and determine practice and at all times

1.7 Refer client to other health care professionals  where the needs of the client are identified as beyond the scope of the services able to be provided, or if in the opinion of the practitioner the needs of the client are best met by doing so

1.8 Identify and promote the legal rights of the client

2. Obtain and record an accurate history of the client

2.1 Seek information from the client for the client's history  in a respectful way with all enquiries asked in a purposeful, systematic and diplomatic manner

2.2 Collect and record accurate, relevant and well organised information in a form which can be interpreted readily by other professionals

2.3 Manage information in a confidential and secure way

3. Manage the health assessment

3.1 Ensure informed client consent is obtained prior to conducting tests, in accordance with relevant legislation and regulations

3.2 Allow adequate time during consultation to gather critical information

3.3 Identify and minimise factors that may interfere with the information gathering process

3.4 Identify, establish and routinely observe essential requirements for the maintenance of clinical and practitioner hygiene

3.5 Anticipate potential sensitivities  of the client, adapt approach accordingly to take these into account and take steps to ensure the client's dignity is maintained at all times

3.6 Pursue and investigate abnormal findings in a deliberate, logical and appropriate manner

3.7 Assess reliability of data obtained and establish appropriate clinical correlation with the client's complaint as soon as possible

3.8 Record all information accurately in a systematic manner in accordance with clinic guidelines

4. Prepare the client for assessment

4.1 Ensure the client's body is not unnecessarily exposed during assessment/treatment

4.2 Respect client boundaries at all times

4.3 Seek client feedback on comfort levels

5. Make a comprehensive assessment of the client

5.1 Identify signs of condition according to remedial massage therapy framework

5.2 Elicit specific details of signs and symptoms of the presenting complaint/s

5.3 Assess client through palpation, observation and sensory information gathering techniques

5.4 Conduct physical assessment

5.5 Use other appropriate assessment techniques

5.6 Use questions to clarify results and gain further information in a manner relevant to the client's needs and test results

5.7 Identify contra-indications to treatment

5.8 Conduct functional and special tests and make differential assessment

5.9 Observe and analyse static and dynamic variables of posture

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Advanced assessment procedures and options allowing complex regional assessments
• Atheroma formation and oedema and their effects within the human body
• Awareness of critical information required for assessment and treatment according to massage therapy framework
• Best practice massage therapy principles
• Bioenergetic concepts and the cardio-respiratory concepts in relation to exercise
• Digestive, integumentary, nervous, urinary, endocrine and reproductive systems
• Disease causation, acute and chronic inflammatory processes, wound healing and haemorrhage processes
• Environmental physiology and the effects of drugs on the individual
• Ethical and legal implications of enquiry
• Further testing procedures
• History, philosophy and beliefs of massage therapy within a health framework
• Indications, possible reactions and contra-indications to treatment
• Infectious and immunity process
• Main paths of the human respiratory and cardiovascular systems and their physiology
• Neoplasms and pathological skin conditions
• Normotensive and hypertensive characteristics
• Pain and chronic pain syndromes
• Physical signs and symptoms of disease
• Structure and function of anatomical systems appropriate to massage therapy and the scope of practice
• Structure and function of cells, tissues, blood and organs
• Structure and function of skeletal, muscular, cardiovascular and lymphatic systems
• Symptomatology and pathology
• Technical and practical knowledge of treatment
• Temperature control, homeostasis, feedback mechanisms, neurological, psychological and psychogenic foundations and issues
• Terminology correct to epidemiology and massage practice
• The pathological process of thrombosis and embolism

continued  ...

Essential knowledge Cont :

• The effects of hormones on the body
• The processes of ageing
• The processes of biological maturation
• The situation and referral patterns of trigger points
• The structure and function of the articular system ie classification of joints and types and ranges of motion
• The structure and function of the immune system
• Understanding of physiology and anatomy according to massage therapy
• Understanding of the fundamental principles of biomechanics and functional anatomy

Essential skills :

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Communicate effectively with client/other health practitioners
• Comprehend common medical terminology
• Demonstrate communication skills
• Demonstrate observation skills
• Demonstrate record keeping skills
• Demonstrate skills in applying advanced assessment techniques
• Discuss and observe treatment protocols
• Gather and interpret information through the tactile senses
• Identify prominent bones/structure and phasic and postural muscles
• Manage time throughout consultation and treatment
• Observe and identify variations of posture
• Palpate prominent bones/structure and phasic and postural muscles
• Perform testing and assessment procedures
• Read medical reports
• Read medical test results or documents
• Recognise and adjust to contra-indications for treatment
• Transcribe assessment findings and treatment in a client history using accepted medical terminology
• Use equipment and resources competently and safely
• Use terminology correct to epidemiology and massage practice
• Write referrals, appraisal letters for insurance companies and other documentation

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of performance in the workplace or a simulated workplace (defined as a supervised clinic)
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
• Assessment may contain both theoretical and practical components and examples covering a range of clinical situations
• Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender
• Assessment of sole practitioners must consider their unique workplace context, including:

• interaction with others in the broader professional community as part of the sole practitioner's workplace
• scope of practice as detailed in the qualification and component competency units
• holistic/integrated assessment including:

• working within the practice framework
• performing a health assessment
• assessing the client
• planning treatment
• providing treatment

Context of and specific resources for assessment :

• An appropriately stocked and equipped clinic or simulated clinic environment
• Relevant assessment instruments
• Appropriate assessment environment
• Skilled assessors

Method of assessment 

• Observation in the workplace
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
• Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory)
  If successful, a second assessment is to be conducted during workplace application under direct supervision
• Examples of assessment notes
• Oral questioning on technique or assessment strategy

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Related units :

This unit should be assessed in conjunction with the following related units:

• HLTCOM404C Communicate effectively with clients
• HLTHIR301B Communicate and work effectively in health
• HLTIN301C Comply with infection control policies and procedures

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Factors likely to have a negative impact on assessment may include :

• Language difficulties
• Disabilities
• Emotional trauma
• Lack of privacy or focus due to additional parties being present
• Cultural or gender factors

Other health care professional may include :

• Podiatrists
• Osteopaths
• Energy therapists
• Physiotherapists
• Chiropractors
• Medical practitioners
• Registered nurses
• Social workers
• Alternative health practitioners
• Counsellors
• Other allied health care professionals

Client history may include :

• Date of presentation
• Identifying personal details
• Source of referral (if applicable)
• Main presenting complaint or reason for massage
• Presenting symptom picture
• General state of health

• physical
• emotional
• allergies
• dietary picture
• sleep pattern
• exercise
• leisure activities

• Childhood and adult illness
• Accidents, injuries, operations
• Hospitalisations
• Occupational history and environment
• Other current medical/alternative health care treatment
• Medication, supplements and natural prescriptions - current and previous
• Previous occurrence of presenting complaint
• Social lifestyle including social drug usage
• Family history

Potential sensitivities may include :

• Gender
• Ethnicity
• Language
• Religious beliefs
• Cultural heritage
• Sexuality
• Ability
• Presenting disease state and personal history

Physical assessment will include attention to :

• Active movements
• Passive movements
• Resisted movements
• Functional movements
• Palpatory findings
• Swelling
• Instability
• Parasthesia
• Characteristics of pain

Established assessment procedures may include :

• Observation
• Discussion
• Temperature
• Pulse
• Palpation
• Percussion
• Range of motion tests
• Muscle strength tests
• Orthopaedic tests
• Observation of variations of posture
• Any other method in which the practitioner has been trained to a competent standard
• Procedure which is conducted according to legislative and regulatory requirements

Contra -indications to treatment may include :

• Remedial massage therapists are not expected to diagnose any conditions but must be able to recognise the indications and contra-indications of conditions
• Massage is contra-indicated in all infectious diseases suggested by fever, nausea and lethargy until a diagnosis is received and recommended by a medical practitioner
• referral for diagnosis when symptoms do not have a logical explanation. Indications for referral include:

• pain-local, sharp, dull, achy, deep, surface
• fatigue
• inflammation
• lumps and tissue changes
• rashes and changes in the skin
• oedema
• mood alterations, eg depression, anxiety
• infection
• changes in habits such as appetite elimination or sleep
• bleeding and bruising
• nausea, vomiting or diarrhoea
• temperature - hot or cold

• Endangerment sites are areas where nerves and blood vessels lie close to the skin and are not well protected

• anterior triangle of the neck
• posterior triangle of the neck
• axillary area
• medial epicondyle
• lateral epicondyle
• area of the sternal notch and anterior throat
• umbilicus area
• twelfth rib dorsal body
• sciatic notch
• inguinal triangle
• popliteal fossa