Transforming and Supporting Patient Care - Health Professions ...

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368Chapter 15 – Profession of PhysiotherapyAuthorized ActsIn the course of engaging in the practice of physiotherapy, a member isauthorized, subject to the terms, conditions and limitations imposed on hisor her certificate of registration, to perform the following:1. Moving the joints of the spine beyond a person’s usual physiologicalrange of motion using a fast, low amplitude thrust.2. Tracheal suctioning. 8Currently, the administration of a drug or substance by inhalation by aphysiotherapist is performed under medical directive, order or delegationfrom a physician or other health professional.Delegation of a controlled act is authorized by the RHPA. It is a processwhereby a regulated health professional who is authorized to perform acontrolled act confers that authority to someone, regulated or unregulated,who is not so authorized. 9 Delegation may be established in one of twoways: by order or by designation. The accountability for the performanceand safety of the controlled act remains with the health professional whohas made the delegation.Education and Continuing CompetencyThere are five accredited physiotherapy programs at universities in Ontarioand eight others in Canada. To practise in Ontario, physiotherapists musthave graduated from a university program in physiotherapy and havesuccessfully passed the National Physiotherapy Competency Examination.The programs are accredited by the Accreditation Council for CanadianPhysiotherapy Academic Programs.The entry to practise education and training requirements conform to thecurriculum guidelines of the Canadian Universities Physiotherapy AcademicCouncil, the Accreditation Standards for Physiotherapy Education Programsin Canada and the Essential Competency Profile for Physiotherapists inCanada. 10The physiotherapy entry to practise curricula in all Ontario universityprograms includes content related to the administration of oxygen,including exercise physiology, the use of oxygen, maintaining oxygensaturation, the technology for measuring oxygen saturation and theinterpretation of measured values. Students learn about multiple conditionsin which supplemental oxygen is used and in which oxygen saturation ismonitored, for example, exercise in post-operative patients or in patientswith chronic obstructive pulmonary disease and during suctioning ofpatients in an intensive care unit. Knowledge of national practice guidelines,including evidence for hyperoxygenation with suctioning, is required.8Physiotherapy Act, 1991, c. 37, s.4.9Federation of Health Regulatory Colleges of Ontario. An Interprofessional Guide on the Use ofOrders, Directives and Delegation for Regulated Health Professionals in Ontario.http://www.mdguide.regulatedhealthprofessions.on.ca/orders/what/default.asp.10CPO and OPA. Joint submission to HPRAC. 40.HPRAC Critical Links January 2009
369Chapter 15 – Profession of PhysiotherapyStudents are evaluated by written and practical examinations. 11Entry to practise skills include the administration of inhaled drugs forcardiorespiratory conditions. Specifically, the pharmacology andindications for inhaled drugs that affect respiratory status and for whichtiming of dosage is relevant to secretion clearance and exercise areincluded in the curricula. 12Competency EvaluationAt the entry to practise level, administration of oxygen and other inhaleddrugs is evaluated in the national Physiotherapy Competency Examination.In the examination blueprint, one of the elements listed under interventionsis “administer oxygen as prescribed.” 13For therapists practicing in hospitals under medical directive, evaluation ofcompetency is specific to the institution. The process for this evaluation ismost frequently through a self-study examination. Other hospital personnelwho are authorized to perform this act must be engaged in physiotherapyeducational reviews and competency evaluation sessions. 14 Proficiency isdemonstrated through practical application, following which the medicaldirective is signed by a respiratory therapist.There is sufficient evidence that the administration of oxygen and otherinhaled substances is an entry-level competency held by physiotherapists.Request for Change: Administering Drugsand Substances by Inhalation 15The CPO and the OPA submit that physiotherapists have the education andcompetencies to be granted the authority to administer, by inhalation:i) Oxygen, orii)A drug or substance that has been ordered by a person who isauthorized to do so by the Chiropody Act, 1991, the Dentistry Act,1991, the Medicine Act, 1991, the Nursing Act, 1991 or the MidwiferyAct, 1991.Granting this act to the physiotherapy profession will give physiotherapiststhe authority to administer oxygen and substances such as Ventolin ® whenrequired as part of a physiotherapy intervention. 1611Ibid: Appendix B, 3.12Ibid: Appendix A, 8.13Ibid: Appendix A, 9.14Ibid: 24.15Ibid: 14.16Ibid: 16.HPRAC Critical Links January 2009
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20Chapter 2 - Excellence in Health
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186Chapter 8 - Profession of Dental
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