Transforming and Supporting Patient Care - Health Professions ...

371Chapter 15 – Profession of PhysiotherapyWhat HPRAC FoundDuring HPRAC’s review of scope of practice for physiotherapists, HPRACheard reports from educators that the CPO’s requests correspond to whatis permitted in other parts of Canada. 21 In other provinces and territories,physiotherapists are authorized to perform a number of the proposed actssubmitted by the CPO and the OPA in the scope of practice review,including the administration of oxygen by inhalation.The act of administering oxygen is integral to tracheal suctioning becauseoxygen levels often decrease when tracheal suctioning is performed to clearsecretions. Best practice around the management of ventilated patientssuggests that patients should receive additional oxygenation prior tosuctioning. Oxygen is required in order to maintain optimum blood oxygensaturation levels. 22HPRAC met with physiotherapy educators who stressed that, with a fewminor adjustments, existing academic programs would cover all of theprocedures requested. 23 Furthermore, other colleges and associationswhose members work closely with physiotherapists indicated broadagreement with the proposals put forth by the CPO and the OPA. In somecases, professions who currently perform some of the functions thatphysiotherapists are requesting be added to their scope, such asrespiratory therapists, were also supportive of the expansion ofphysiotherapists’ roles.The College of Respiratory Therapists of Ontario stated, “it would make alot of sense for physiotherapists to be able to administer oxygen,” sincethis is an entry to practise competency. It is a duplication of efforts todelegate to physiotherapists in clinical practice. The Ontario Society ofOccupational Therapists was supportive of an expansion of the scope ofpractice of physiotherapists in that it would lend “flexibility for systemicgrowth and evolution of practice.” 24Consultations with Local Health Integration Networks, community careaccess centres (CCACs) and long-term care homes indicated thatphysiotherapists help to provide timely, effective patient care and reduceemergency visits. 25In subsequent meetings with the proponents following the release ofHPRAC’s scope of practice review of physiotherapy, HPRAC clarified anissue regarding the administration of oxygen during physiotherapytreatment: whether it can involve mechanically and non-mechanicallyventilated patients. HPRAC heard from the OPA that “mechanical ventilationis used when the body cannot support breathing on its own”. This can be inan acute situation such as we see in intensive care, in subacute situations21HPRAC. Interprofessional collaboration, Phase II, Part 1: 165.22Ibid: 174.23Ibid: 166.24Ibid: 166.25Ibid: 164.HPRAC Critical Links January 2009