Should a Pulmonary Function Technologist be required to be an RT? Pro Con

Transcription

1 Should a Pulmonary Function Technologist be required to be an RT? Pro Con Matt O Brien MS, RRT, RPFT Pulmonary Diagnostic Lab AARC Diagnostics Chair University of Wisconsin Hospital

2 Conflict of Interest Statement I have no conflicts of interest related to this presentation. Background education: EMT AS Madison College 2 yr. BA in Health Care Administration Concordia Univ. Wisconsin Master in Science Biotechnology Univ. of Wisconsin 2011

3 Objectives Description: The Pulmonary Function Tech Position evolution. Pro position: Matt O Brien Con position: Carl Mottram Stimulate discussion!

4 Early Pulmonary Testing Some calculations were done by hand. Analyzers were slow. Lots of knobs and switches. Computers were new and not trusted initially.

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6 The Evolution of the Pulmonary Technologist Who Individuals with varied science / medical training Bachelor of Science background. RT trained individuals migrating to pulmonary labs. NSCPT 1986 Scope of Practice published by the National Society for Cardiovascular & Pulmonary Technology. Registered Cardiopulmonary Technologist R-CPT BRC Certified Pulmonary Function Technologist -CPFT Registered Pulmonary Function Technologist-RPFT

7 Early Titles Pulmonary technologist / technician Pulmonary function technologist / technician Pulmonary physiology technologist Physiological monitoring technologist Stress testing technologist ICU technologist Medical machine technologist Cardiopulmonary Digest, Feb 1987

8 Attributes of the Ideal Pulmonary Technologist / Technician Have a solid understanding of physics, respiration and cardiopulmonary function. Computer and EMR literate. Calibrate, troubleshoot and perform basic equipment repair. Be an effective coach. Be efficient. Work well in a team. Produce high quality pulmonary data.

9 Pulmonary Function personnel should have prior training as RT s Standardized background in: Medical terminology. Anatomy and physiology. Physics and chemistry. Respiratory mechanics and assessments. Pulmonary pathophysiology. Infection control. Blood gases

10 Why Respiratory Care Increased comfort with high acuity patients and environments. Minimizes licensure issues related to practicing respiratory care. Ability to recruit from RC department. Credentialed?

11 Ensures a Higher Wage for Pulmonary Technologists Wage for pulmonary technologists varies. Helps us to remain competitive with floor therapists. Range of salaried RPFT credentialed RRTs ($50-60K) + benefits

12 Expansion of the Clinical Ladder RRT RPFT CRT CPFT

13 AARC Model Practice Act Outlines provisions common in licensure laws. Scope How to establish regulatory board Requirements for licensure Reciprocity Exemptions Disciplinary criteria

14 AARC Model Practice Act AARC s model is non-exclusive Does not prohibit the practice of respiratory therapy by other individuals determined to be competent. AARC advocates the model be used uniformly to help regulate the practice of respiratory therapy across the states

15 Respiratory Care Subd. 10. Respiratory care. "Respiratory care" means the provision of services described under section 147C.05 for the assessment, treatment, education, management, evaluation, and care of patients with deficiencies, abnormalities, and diseases of the cardiopulmonary system, under the supervision of a physician and pursuant to a referral, or verbal, written, or telecommunicated order from a physician, nurse practitioner, or physician assistant. Respiratory care includes, but is not limited to, education pertaining to health promotion, disease prevention and management, patient care, and treatment.

16 Scope of Practice Respiratory Care Sec. 2. Minnesota Statutes 2008, section 147C.05, is amended to read: 147C.05 SCOPE OF PRACTICE. (a) The practice of respiratory care by a licensed respiratory therapist includes, but is not limited to, the following services: (5) obtaining physiological specimens and interpreting physiological data including: (i) analyzing arterial and venous blood gases; (ii) assessing respiratory secretions; (iii) measuring ventilatory volumes, pressures, and flows; (iv) testing pulmonary function; (v) testing and studying the cardiopulmonary system; and (vi) diagnostic and therapeutic testing of breathing patterns related to sleep disorders; (6) assisting hemodynamic monitoring and support of the cardiopulmonary system;

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18 Alerts 2002 Notice Regarding Pulmonary Function Testing as a license to practice respiratory care is required in order to perform the scope of practice of respiratory therapy, which includes pulmonary function testing, and as the Board believes that unlicensed individuals may be continuing to perform such testing under certain circumstances, and as some of these individuals have been certified and registered as pulmonary function technologists, the Board believes it is appropriate to notify the pulmonary function community that although licensure is required, the continuation of such practice will be permitted during a transition period in order to enable individuals to obtain appropriate education and successfully complete Board testing requirements. Therefore, on and after September 1, 2005, the Board will begin to take enforcement action against individuals it becomes aware are performing pulmonary function testing without a license to practice respiratory care, with the exceptions indicated below:

19 EXCEPTIONS: 1. Health care providers licensed by appropriate agencies of the State of New Jersey, who are practicing under the accepted standards of the licensee s profession, will continue to be able to perform diagnostic pulmonary function testing. 1. Properly trained individuals who do not possess a license to practice respiratory care nor a license in another health care field, will continue to be able to perform basic screening spirometry limited to peak flow, FVC, SVC and MVV measurements. June 2002

20 Summary Should a Pulmonary Function Technologist be required to be an RT? It depends On interpretation / regulations specific to your state. What is the skill mix of your labor pool? Can you provide comprehensive training and oversight? It should be a strong preference on a job description.

21 Discussion: What do you think? Will requiring PFT personnel to have an RT credential further drive up health care costs? Should there simply be an exemption added to laws related to RC for PFT credentialed individuals?

22 Thank you! Matt O Brien MS, RRT, RPFT Pulmonary Diagnostic Lab AARC Diagnostics Chair University of Wisconsin Hospital mobrien@uwhealth.org