Transforming and Supporting Patient Care - Health Professions ...

370Chapter 15 – Profession of PhysiotherapyProponents’ RationaleThe profession maintains that access to this authority will bring regulationinto closer alignment with physiotherapists’ current knowledge,competence and practice realities.Prior to the RHPA, physiotherapists routinely administered oxygen tomaintain saturation during interventions such as exercise, training,endurance assessment, tracheal suctioning and treatments related to themobilization of secretions. 17 Since oxygen de-saturation can often occurwith these interventions, the authority to administer oxygen duringphysiotherapy treatment is critical to care. Currently, if a patient needsoxygen, or needs to have oxygen levels adjusted to maintain the bloodoxygen saturation level at a prescribed level while performing exercisesunder the supervision of a physiotherapist, another health professionalmust be present to administer the oxygen or to adjust the levels. 18In Ontario, physiotherapists have the authority to perform trachealsuctioning of intubated patients but do not have the independent authorityto administer oxygen, which is a normal adjunct to this procedure. 19 Oxygenlevels often decrease when tracheal suctioning is performed. Oxygen mustthen be adjusted to maintain the patient’s appropriate blood oxygensaturation level. Standing orders or medical directives often do notauthorize the adjustment of oxygen by a physiotherapist, and anotherhealth professional, such as a nurse or a respiratory therapist, mustperform the procedure.Without the authority to administer oxygen, the hospitals in whichphysiotherapists work must engage in lengthy processes to developmedical directives to allow physiotherapists to perform an act which is anentry-level qualification. The expanded administrative burden medicaldirectives place on institutions and authorized providers perpetuates theunderutilization of competent health professionals and underminesresponsiveness to patient needs and system efficiency.Outside hospitals, many home care and long-term care patients undergoingphysiotherapy treatments experience a decrease in blood saturation levelsfor which the administration of oxygen is required. 20 Authorizingphysiotherapists to perform the act would eliminate the need to schedulethe services of a health professional whose specialized skills could bebetter used elsewhere. This would result in more timely access to care forall patients, reduced complications for home-bound patients and feweradmissions to hospital.17Ibid: 24.18Ibid: 8.19Ibid: 16.20Ibid: Appendix A, 8.HPRAC Critical Links January 2009