Physiotherapy Practice and Delegation Policies in Oxygen Administration: A Survey of Ontario Hospitals

Abstract

Purpose: As of 2008, the Regulated Health Professions Act in Ontario stipulates that administration of oxygen is a controlled act, which physiotherapists are not authorized to perform but which may be delegated to physiotherapists by another health professional authorized to perform this act. The aims of this study were (1) to survey physiotherapy practice of oxygen administration in Ontario hospitals and (2) to determine the proportion and characteristics of hospitals with delegation policies for physiotherapists to administer oxygen. Method: Postal surveys were sent to 208 hospitals. Data were collected on hospital characteristics; the presence of delegation policies; and the practice and training of physiotherapists, physiotherapy assistants, and students in oxygen administration. Data were described by summative statistics. Fisher's exact test and Cramer's V statistic were used to examine associations. Potential prognostic factors were analyzed using logistic regression. Results: Response rate was 82.7%. Physiotherapists administered oxygen in 39% of hospitals, and 28% of hospitals had delegation policies. Larger, urban, or teaching hospitals and those with a matrix structure were most likely to have delegation policies and physiotherapists who administered oxygen. Rehabilitation hospitals were also likely to have such policies. Conclusion: Physiotherapists administer oxygen in less than half of Ontario hospitals, very few of which have delegation policies.Key Words: best practice, delegation policy, oxygen administration, physiotherapist, Regulated Health Professions Act, scope of practice, titration RÉ SUMÉObjectif : Depuis 2008, la Loi sur les professions de la sante´re´glemente´es de l'Ontario stipule que l'administration d'oxygè ne constitue un acte autorisé , que les physiothé rapeutes ne peuvent accomplir, mais que ceux-ci peuvent quand mê me exé cuter si l'acte leur a é té dé lé gué . Les objectifs de cette é tude é taient (1) d'é tudier la pratique d'administration de l'oxygè ne en physiothé rapie dans les hô pitaux de l'Ontario ; et (2) d'é tablir la proportion et les caracté ristiques des hô pitaux disposant d'une politique de dé lé gation permettant aux physiothé rapeutes d'administrer de l'oxygè ne. Me´thode : Des sondages ont é té envoyé s par la poste à 208 hô pitaux. Des donné es ont é té recueillies sur les caracté ristiques de ces é tablissements, sur la pré sence d'une politique de dé lé gation, sur la pratique et la formation des physiothé rapeutes, des assistants-physiothé rapeutes et des é tudiants pour l'administration d'oxygè ne. Des donné es ont é té dé crites par des statistiques sommatives. On a eu recours au test de Fisher et au test V de Cramer pour l'analyse des associations. Les facteurs pronostiques potentiels ont é té analysé s suivant une ré gression logistique. Re´sultats : Le taux de ré ponse a é té de 82,7 %. Les physiothé rapeutes administrent de l'oxygè ne dans 39 % des hô pitaux, et 28 % des hô pitaux participants sont doté s d'une politique de dé lé gation. L...

Developing a Physiotherapy-Specific Preliminary Clinical Decision-Making Tool for Oxygen Titration: A Modified Delphi Study

“…Before 2011, delegation by an authorized health care professional (HCP) or a medical directive was required for physiotherapists to titrate oxygen as part of their practice, and only 39% of physiotherapists were titrating oxygen in hospitals in 2009. 2 With the newly expanded scope of practice, it is important that all physiotherapists, particularly those practising in cardiorespiratory care, have the appropriate levels of knowledge and confidence to competently titrate their patients' oxygen levels.…”