Transforming and Supporting Patient Care - Health Professions ...

171Chapter 7 – Professions of Chiropody and PodiatryThe Michener Institute redesigned its chiropody program in 2006/07, and itis now identified as the “graduate advanced program in chiropody.”Graduates of this redesigned program have the competencies to administeroxygen by inhalation but course content does not include theadministration by inhalation of nitrous oxide. 20 Graduates of discontinuedprograms, including programs offered by George Brown College and TheMichener Institute for Applied Health Sciences prior to September 2006,have the competencies to administer oxygen only. The proponents stated inits written submission that those relatively recent graduates of DPMprograms who are practising in Ontario as chiropodists because of thepodiatric cap are deemed by the CCO to be competent to prescribe thecurrent and proposed substances and drugs safely and effectively.Along with the educational bridging program at The Michener Institute, theCCO is developing a quality assurance program to ensure that registrantsare able to perform the procedures safely and effectively and that thesubstances involved are safely and securely stored and maintained. 21The CCO would restrict the authority to administer a substance byinhalation to those registrants who demonstrate the requisite competenciesto perform the procedure safely and effectively and would develop astandard of practice with respect to the use of inhalants for purposes ofpain management and emergencies. 22What HPRAC FoundWhat Other Jurisdictions DoIn Manitoba, legislation allows podiatrists to inject medications. There is noreference to administration of drugs or substances by inhalation, however,the authority is inferred, since podiatrists must maintain an emergency kitand oxygen in good order in the clinical suite and be trained in its use. 23 InBritish Columbia, podiatrists are limited to administering local anaesthesia. 24Neither British Columbia nor Quebec authorize podiatrists to administernitrous oxide.The use of local anaesthesia by podiatrists is authorized by statute inAlabama, Arizona, Arkansas, California, Colorado, Connecticut, District ofColumbia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine,Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska,Nevada, New Jersey, New York, North Carolina, North Dakota, Ohio,Oklahoma, Pennsylvania, South Carolina, West Virginia and Wyoming.The use of general anaesthesia is more limited. It is authorized, with certainlimitations, by statute in Georgia (under direction of a physician) and inMaine (under supervision of a medical or osteopathic physician). 2520HPRAC discussion with Sydney Redpath, Chair, Primary and Critical Care,The Michener Institutefor Applied Health Sciences. January 200921CCO, OPMA, OSC. Submission to HPRAC: Review of Non-Physician Prescribing. 21.22Ibid. 18.23HPRAC. Prescribing and Use of Drugs by Non-Physician Health Professionals: A Jurisdictional Reviewof the Professions of Chiropody & Podiatry. November 2008.24Ibid.25American Podiatric Medical Association, Inc. Scope of Practice Statutory Compilation, APMA StateReference Manual. November 2007.HPRAC Critical Links January 2009