1、BSI Standards PublicationBS EN 16686:2015Osteopathic healthcareprovisionBS EN 16686:2015 BRITISH STANDARDNational forewordThis British Standard is the UK implementation of EN 16686:2015.The UK participation in its preparation was entrusted to TechnicalCommittee SVS/18/2, Osteopathic services.A list
2、of organizations represented on this committee can beobtained on request to its secretary.This publication does not purport to include all the necessaryprovisions of a contract. Users are responsible for its correctapplication. The British Standards Institution 2015. Published by BSI StandardsLimite
3、d 2015ISBN 978 0 580 84110 1ICS 11.020Compliance with a British Standard cannot confer immunity fromlegal obligations.This British Standard was published under the authority of theStandards Policy and Strategy Committee on 31 July 2015.Amendments issued since publicationDate Text affectedBS EN 16686
4、:2015EUROPEAN STANDARD NORME EUROPENNE EUROPISCHE NORM EN 16686 July 2015 ICS 11.020 English Version Osteopathic healthcare provision Prestations de soins dostopathie Osteopathische Gesundheitsversorgung This European Standard was approved by CEN on 30 April 2015. CEN members are bound to comply wit
5、h the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN-CENELEC Manag
6、ement Centre or to any CEN member. This European Standard exists in three official versions (English, French, German). A version in any other language made by translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management Centre has the same sta
7、tus as the official versions. CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malt
8、a, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and United Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMIT EUROPEN DE NORMALISATION EUROPISCHES KOMITEE FR NORMUNG CEN-CENELEC Management Centre: Avenue Marnix 17, B-1000 Brussels 2015 CEN
9、 All rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. EN 16686:2015 EBS EN 16686:2015EN 16686:2015 (E) 2 Contents Page European foreword . 4 Introduction . 5 1 Scope 6 2 Terms and definitions . 6 3 Description of Osteopathy 8 4 Clinical practi
10、ce . 9 4.1 General 9 4.2 Essential competencies for osteopathic practice 9 4.3 Case History, examination and interpretation of the findings 10 4.4 Osteopathic treatment . 10 4.5 The osteopathic profession 11 4.5.1 General 11 4.5.2 Continuing professional development 11 4.5.3 Quality management . 11
11、5 Ethics 12 6 Education and Training . 12 6.1 General 12 6.2 Forms and/or categories of education 12 6.2.1 General 12 6.2.2 Common features of both Type I and Type II programmes . 12 6.2.3 Type I programmes 13 6.2.4 Type II programmes . 13 6.3 Core competencies: the context of osteopathic education
12、14 6.4 Osteopathic teaching, learning and assessment . 15 6.4.1 Teaching and learning . 15 6.4.2 Practical skills 15 6.4.3 Clinical education 16 6.4.4 Assessment 17 6.5 General management requirements 18 Annex A (informative) Osteopathic models 19 A.1 General 19 A.2 Biomechanical Model 19 A.3 The re
13、spiratory/circulatory model . 19 A.4 The neurological model 19 A.5 The biopsychosocial model 20 A.6 The bioenergetic model 20 Annex B (normative) Ethics for osteopaths 21 B.1 General 21 B.2 Acting in the patient interest 21 B.3 Working in partnership with the patient 21 BS EN 16686:2015EN 16686:2015
14、 (E) 3 B.4 Maintaining public trust and confidence in the osteopathic profession . 22 B.5 Maintaining, respecting and protecting patient information 22 B.6 Working in partnership with healthcare providers 23 Annex C (informative) Types of techniques used in osteopathic treatment . 24 C.1 General . 2
15、4 C.2 Direct techniques 24 C.3 Indirect techniques 24 C.4 Balancing techniques . 24 C.5 Combined techniques . 24 C.6 Reflex-based techniques 24 C.7 Fluid techniques 24 Annex D (informative) A-deviations 25 Bibliography 35 BS EN 16686:2015EN 16686:2015 (E) 4 European foreword This document (EN 16686:
16、2015) has been prepared by Technical Committee CEN/TC 414 “Project Committee - Services in osteopathy”, the secretariat of which is held by ASI. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by Jan
17、uary 2016, and conflicting national standards shall be withdrawn at the latest by January 2016. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. CEN and/or CENELEC shall not be held responsible for identifying any or all such paten
18、t rights. Attention is drawn to the fact that in certain countries specific national regulations apply and take precedence over this European Standard. Users of this European Standard are advised to inform themselves of the applicability or non-applicability for this European Standard by their natio
19、nal responsible authorities. According to the CEN/CENELEC Internal Regulations, the national standards organisations of the following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Repub
20、lic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and the United Kingdom. BS EN 16686:2015EN 16686:2015 (E) 5 Introduction Osteopath
21、y is a primary contact and patient-centred healthcare discipline, that emphasizes the interrelationship of structure and function of the body, facilitates the bodys innate ability to heal itself, and supports a whole-person approach to all aspects of health and healthy development, principally by th
22、e practice of manual treatment. Patients who choose osteopathic treatment have to be assured of the quality and the standard of care that they will receive. This standard is concerned with the provision of osteopathic diagnosis, treatment and care. It aspires to set a standard that provides for high
23、 quality clinical practice, education, safety and ethics for the benefit of patients. This European Standard does not supersede national legislation. BS EN 16686:2015EN 16686:2015 (E) 6 1 Scope This European Standard specifies the requirements and recommendations regarding the healthcare provision,
24、facilities and equipment, education, and ethical framework for the good practice of osteopathy. 2 Terms and definitions For the purposes of this document, the following terms and definitions apply. 2.1 care interventions that are designed to maintain and improve health 2.2 case history detailed acco
25、unt of a patients health and disease status and other information provided by them 2.3 clinical record document which relates to the case history, examination, assessment, evaluation, diagnosis, treatment or care provided to a patient, and any necessary administrative information 2.4 co-morbidities
26、concomitant but unrelated pathological or disease processes 2.5 consent acceptance by a patient of a proposed course of action to be taken by an osteopath after having been informed of relevant factors relating to it 2.6 continuing professional development CPD means by which members of a profession
27、maintain, improve and broaden their knowledge and skills relating to that profession 2.7 diagnosis the development by an osteopath of working hypotheses of dysfunction(s), and recognition of signs and symptoms of illness or disease using diagnostic processes of examination, assessment and evaluation
28、 Note 1 to entry: This definition is being used in this European Standard, whether or not the legislation of an individual state prevents such a term being used by an osteopath. 2.8 dysfunction area of the body with impeded biomechanical, neuroelectrical, vascular, biophysical, biochemical or cellul
29、ar function which is causing a decrease in health 2.9 health state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity BS EN 16686:2015EN 16686:2015 (E) 7 2.10 healthcare activity carried out by a professional in the field of the health and/or well-be
30、ing of the person Note 1 to entry: This definition is being used in this European Standard, whether or not the legislation of an individual state prevents such a term being used by an osteopath. 2.11 osteopath osteopath (in some circumstances and some countries referred to as an osteopathic physicia
31、n or osteopathic practitioner) is an individual who has completed an appropriate education in osteopathy and continues to demonstrate the required standards 2.12 osteopathy primary contact and patient-centred healthcare discipline, that emphasizes the interrelationship of structure and function of t
32、he body, facilitates the bodys innate ability to heal itself, and supports a whole-person approach to all aspects of health and healthy development, principally by the practice of manual treatment Note 1 to entry: The terms osteopathy and osteopathic medicine are sometimes, and in some countries, us
33、ed interchangeably. 2.13 patient confidentiality right of an individual to have information about them kept private 2.14 primary contact profession profession that a patient may consult directly but does not imply managing the multidisciplinary care of the patient Note 1 to entry: This definition is
34、 being used in this European Standard, whether or not the legislation of an individual state prevents such a term being used by an osteopath. 2.15 referral transfer of responsibility for care to a third-party for a particular purpose, such as additional investigation, care or treatment that is outsi
35、de the referring practitioners competence 2.16 treatment interventions that are designed to improve, maintain and support health, relieve symptoms, or reduce dysfunction and disease BS EN 16686:2015EN 16686:2015 (E) 8 3 Description of Osteopathy The practice of osteopathy uses osteopathic, medical a
36、nd scientific knowledge to apply the principles of osteopathy to patient diagnosis and treatment. The aim of osteopathy is to improve and support all aspects of health and healthy development. Osteopathic treatment may be preventive, curative, palliative or adjuvant. Osteopaths analyse and evaluate
37、the structural and functional integrity of the body using critical reasoning of osteopathic principles to inform individual diagnosis and treatment of the patient. These principles are: the human being is a dynamic functional unit, whose state of health is influenced by the body, mind and spirit; if
38、 one part is changed in the system, the balance of the whole pattern will be affected; the body possesses self-regulatory mechanisms and is naturally self healing; the human being always tries to regain its own dynamic balance and establish homeostasis; and structure and function are interrelated at
39、 all levels of the human being. The osteopathic approach to healthcare is patient-centred and focused on the patients health rather than disease-centred. Scientific rigour and evidence-informed practice are an important part of patient treatment and case management. Osteopaths use manual contact to
40、identify and evaluate movement in all structural and functional aspects of the patient, identifying alterations of function and movement that impede health and addressing these. The highly developed sense of touch and attention to complex systems as a unit is typical of an osteopathic approach. Oste
41、opathy is an independent healthcare discipline. Osteopaths should also cooperate with practitioners of other disciplines. Osteopathy is based on principles drawn from human physiology, anatomy, embryology and other bio-medical sciences. In consequence of the complexity of the human organism there ar
42、e a number of different models that are used in osteopathy. The models set out in Annex A articulate how an osteopath seeks to influence a patients physiological responses. These models influence the gathering of diagnostic information and the interpretation of the significance of structural finding
43、s in the overall health of the patient. Typically a combination of models will be appropriate for an individual patient and adapted to the patients diagnosis, co-morbidities, other therapeutic regimens, and response to treatment. The terms osteopathy and osteopathic medicine are sometimes, and in so
44、me countries, used interchangeably. BS EN 16686:2015EN 16686:2015 (E) 9 4 Clinical practice 4.1 General Osteopathy is focused on the patients health rather than being disease-centred. Osteopaths shall have an understanding of osteopathic and non-osteopathic models of health and disease and how these
45、 inform a critical consideration of practical patient care and management. They shall have a critical awareness of relevant research and of principles and practice of relevant healthcare approaches for adequate referral, cooperation and adjuvant treatment. 4.2 Essential competencies for osteopathic
46、practice Osteopaths share a set of core competencies that guide them in the diagnosis, management and treatment of their patients and form the foundation for the osteopathic approach to healthcare. The following are essential competencies for osteopathic practice which sould be included in all train
47、ing programmes (see 6.3 below): a) osteopathic history, principles, and approach to healthcare; b) basic sciences relevant to osteopathic practice; c) diagnosis and treatment planning; d) knowledge of the mechanisms of action of manual therapeutic interventions and the biochemical, cellular and gros
48、s anatomical response to treatment; e) ability to appraise medical and scientific literature critically and incorporate relevant and contemporary information into practice; f) competency in the palpatory and clinical skills necessary to diagnose dysfunctions of the body, with an emphasis on osteopat
49、hic diagnosis (see Annex A); g) competency in a broad range of osteopathic skills; h) proficiency in physical examination and the understanding of relevant tests and data, including diagnostic imaging and laboratory results; i) understanding and expertise in diagnosis and osteopathic treatment using the osteopathic models (see Annex A) and evaluation of the outcomes; j) thorough knowledge of the indications for osteopathic treatment, and contraindications to specific osteopathic techniques; k) ethical and legal aspects of healthcare; l) a basic knowledge of commonly
