Transforming and Supporting Patient Care - Health Professions ...

154Chapter 6 – Scope of Practice of Medical Radiation TechnologyBeyond the Anal Verge or into an Artificial Opening into the BodyThe College and Association seek authority to perform this controlled act toclarify MRTs’ role in the administration of contrast media through or intothe rectum or an artificial opening into the body, a controlled act alreadyauthorized to the profession. This issue is similar to the question ofwhether administering a substance by injection includes the act ofperforming a procedure below the dermis. In this case, MRTs seekconfirmation that the authority to administer contrast media through orinto the rectum or into an artificial opening into the body includes theauthority to insert an enema tip or catheter to enable the administration ofthese substances.The College has interpreted the act of administering contrast mediathrough or into the rectum or an artificial opening into the body to includethe insertion of the enema tip or catheter beyond the anal verge or into anartificial opening into the body, 64 that is, to include establishing the meansof delivering the substance. In some settings, these are seen as twoseparate acts and MRTs must therefore be delegated the act of putting aninstrument, hand or finger beyond the anal verge or into an artificialopening into the body. The College and Association view this approach asunnecessarily splitting hairs in defining the components of administeringbarium or another substance into the rectum. Again, it is time consumingand inefficient to require delegation or medical directives to be developedfor one component of a function MRTs have been routinely fulfilling.In addition, due to the evolution of imaging technology and procedures,MRTs are routinely performing imaging and therapeutic procedures thatinvolve putting an instrument, hand or finger beyond the anal verge but donot call for the administration of contrast media. For this reason, theCollege and Association request that authority to put an instrument, handor finger beyond the anal verge not be restricted solely to the purpose ofadministering a substance into the rectum.Examples of such innovations include MRTs in magnetic resonance imaginginserting an endorectal coil into the patient’s rectum for high resolutionMRI of the prostate gland or cervix. Similar to the treatment of cervical andendometrial cancer, in the treatment of prostate cancer, radiation can beimplanted directly into the prostate through brachytherapy. In addition, theplanning of such treatment requires the insertion of a trans-rectalultrasound probe into the patient’s rectum to obtain images that will assistthe proper placement of the radiation.It is clear that access to this controlled act will facilitate efficient and timelydiagnostic imaging and treatment by MRTs by eliminating the need fordelegation or medical directives. MRTs in Quebec and Alberta perform thisact under their own professional authority and New Brunswick recognizesthis as inherent to the practice of MRTs. HPRAC found that the MRTcurriculum currently includes the knowledge required for the safe64Access would be through an artificial opening if portions of the patient’s anatomy (rectum, bowel)had already been removed or are being bypassed.HPRAC Critical Links January 2009