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Levels of Practice

Revised November 25, 2011

The Canadian Society of Respiratory Therapists (CSRT) acknowledges that the practice of respiratory therapy has evolved quickly since its inception. Today the profession faces many challenges, including shortages of health care professionals, an aging population, increased incidence of chronic respiratory disease, the introduction of new technology and challenges relative to patient access and the ability to provide quality and comprehensive respiratory care.

In addition, governments and health care organizations are demanding more collaborative, inter-professional and innovative respiratory care delivery systems to meet the diverse health needs of society.

As a result, the profession of respiratory therapy will continue to evolve and the level of practice will be adapted to meet the needs of a complex health care delivery system.

Levels of Practice for Respiratory Therapists
The CSRT recognizes that respiratory therapists may work at various levels of practice defined as:

Integrated Practice
Integrated practice may require additional on-the-job training, but does not require additional education. This level includes respiratory therapists who provide care within the current scope for entry-to-practice.

Specific Area of Practice (may be referred to as Specialty Practice, which is a protected title in some regulated provinces)
This level of practice requires additional education and training in combination with on-the-job experience in order to develop a higher level of skill mastery.

The respiratory therapist working in a specific area of practice (or specialty practice depending on jurisdiction) has the knowledge, skills and judgment that fall within the boundaries of the education, theory and practice of the original scope of practice.

Advanced Practice
This classification of practice requires graduate education, extensive clinical experience, advanced clinical reasoning, research expertise and knowledge transfer skills. Elements of advanced practice may be outside the established scope of the respiratory therapist and may consist of additional controlled acts or regulated tasks according to provincial legislation. The respiratory therapist working in advanced practice will evaluate, interpret and incorporate new knowledge into clinical practice.

Scope of Practice for Respiratory Therapists
The CSRT recognizes that a respiratory therapist’s level of practice is a subset of the scope of practice of the profession, in accordance with individual knowledge, skills and judgment. The CSRT recommends that all respiratory therapists work within their scope of practice according to provincial legislation, employer regulations and their individual knowledge, skills and judgment. It is the responsibility of each respiratory therapist to determine their individual competency before undertaking any aspect of patient care, as outlined in the CSRT Code of Ethics and the CSRT Standards of Practice.

The CSRT strongly supports the safety of all respiratory therapists and the patients and clients for whom they provide care. The CSRT encourages continuing education and training that will enhance the respiratory therapist’s ability to provide safe, ethical patient care.

Sources

Canadian Association of Medical Radiation Technologists (November 2005). Advanced Practice. Accessed on November 29, 2010 from http://www.camrt.ca/abouttheprofession/advancedpractice/

Canadian Nurses Association (2008). Positions Statement: Advanced Nursing Practice. Accessed on November 29, 2010 from http://www.cna-aiic.ca/CNA/documents/pdf/publications/PS60_Advanced_Nursing_Practice_2007_e.pdf

College of Respiratory Therapists of Ontario (March 2010). Position Statement: Scope of Practice and Maintenance of Competency. Accessed on November 29, 2010 from http://crto.on.ca/pdf/Positions/SOP.pdf

Approved by the CSRT Board of Directors on November 30, 2010
Revised by the CSRT Board of Directors November 25, 2011