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General Expectations Of Respiratory Therapists When Providing Education

​General Expectations Of Respiratory Therapists When Providing Education

 

It is essential that RTs understand there is a “shared accountability” when they provide education to those around them (e.g., patients/clients, fellow health care team member). Both the RT and the learner are responsible for their own actions, and have an accountability to the patients/clients they care for, as well as their own school, regulatory body, and other relevant stakeholders. When providing education, RTs are expected to:

  1. Determine Appropriateness of Education
  2. Maintain Professional Standards of Practice
  3. Understand the Difference Between Educating and Delegating
  4. Ensure Patient/Client Safety and Quality of Care
  5. Keep Appropriate Documentation

1. Determining Appropriateness
of Education

The RT must begin by carefully considering if providing education is ultimately in the best interest of the patient(s)/client(s) that they care for by:

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establishing that the procedure/task being taught is appropriate given the learner’s background and experience; and

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being aware of the learner’s education objectives and expectations.

There are certain circumstances where educating others would not be appropriate, such as when:

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the RT does not have the requisite competency (knowledge, skills and judgment) to perform and teach the procedure/task;

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the RT reasonably believes that the learner does not possess the requisite competencies and judgment to proceed safely; and/or

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educating someone else would place a patient/client at risk of receiving care that is below optimal standard.

PLEASE NOTE:

RTs can’t assume that a person is competent to perform any procedure, regardless of how straightforward it appears. When there is concern that the learner is not able to obtain the competency for performing the procedure safely, the RT must reflect on the education process and learner’s skill level.

If, after considering the above, you determine that the cause cannot be identified and resolved, then the education process should be discontinued.​

 

​2. Maintaining Professional Standards of Practice

 

RTs are expected to provide education to the best of their ability by:

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providing accurate and timely feedback to the learner;

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encouraging ongoing feedback from the learner; and

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conducting themselves in an honourable, ethical, and professional manner at all times.

3. Understanding the Difference Between Educating and Delegating

An education component is required for all delegations; however, not all education requires delegation. The main difference is a greater degree of accountability is placed on the educator when delegation is involved.

EDUCATIONDELEGATION
What is it:Providing instruction. May involve determining competence to perform a procedureProviding instruction, plus the transfer of legal authority to perform a controlled act and a process to ensure initial and ongoing competence.
What it applies to:Applicable to any procedure/activity (may or may not be a controlled act).Controlled act procedures only.
Who may do it:RTs who meet the conditions as described under the section on “General expectations of Respiratory Therapists when providing education”.RTs that have the authority, competence and meet the conditions required to teach.

For more information on delegation, please refer to the Delegation of Controlled Acts PPG.

4. Ensuring Patient/Client Safety
and Quality of Care

Optimal patient/client care is the first and foremost consideration when providing education. The RT is expected to:

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ensure patient/client autonomy and confidentiality;

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have the requisite competency (knowledge, skills and judgment) to perform the procedure or task being taught;

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reinforce best practice standards; and

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intervene in situations where the safety or well-being of the patient/client is at risk.

5. Keeping Appropriate Documentation

Documentation is the evidence that a learning activity took place and provides details about what was involved in the education process. Records of teaching-related activities should include, at minimum:

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date and time of education;

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details of the activity/procedure that was taught;

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list of learners that took part in the education (preferably with signatures); and

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a copy of the learning package and any additional material provided to the learner.

Example… ​

An RT working as the only RT in a rural hospital has been asked to teach all the nurses and physicians how to manage the new BiPAP machine recently purchased by the facility. Most of the learners have never used any type of non-invasive positive pressure (NIPPV) device before, and the nurses and physicians will be expected to operate the unit when the RT is not available (i.e., evening and weekends). The RT creates a comprehensive learning package, which is presented to the staff at multiple ‘Lunch & Learn’ sessions (both verbally as part of the education session and as a handout). The RT kept a sign-up sheet record of all those who attended the education sessions and created step-by-step instructions of how to initiate, maintain and discontinue NIPPV, which was kept with the NIPPV unit.

A copy of the learning package, the sign-in sheets and the instruction sheets were all part of the documentation that the RT kept as a record of the education provided.

GLOSSARY
Authorized Act a controlled act, or portion of a controlled act, that is authorized within a health profession Act for a health professional to perform [there are five (5) acts authorized to Respiratory Therapists by the Respiratory Therapy Act, that are created from three (3) controlled acts defined in the RHPA]

Members is a respiratory therapist who is registered with the CRTO; including Graduate Respiratory Therapists (GRT), Practical (Limited) Respiratory Therapists (PRT) and Registered Respiratory Therapists (RRT).

REFERENCES
  1. College of Nurses of Ontario. (2002). Professional Standards. Retrieved from: https://www.cno.org/globalassets/docs/prac/41006_profstds.pdf
  2. College of Physicians and Surgeons of Ontario (2021) Professional Responsibilities in Medical Education. Retrieved from: https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Professional-Responsibilities-in-Medical-Education
  3. Health.Vic (2020) The Best Practice Clinical Learning Environment (BPCLE) Framework (health.vic.gov.au). Retrieved from: https://www.health.vic.gov.au/education-and-training/best-practice-clinical-learning-environment-bpcle-framework