An Important Letter From Our State President and President-Elect
July 9, 2018
Greetings to all licensed Respiratory Therapists in the State of CT,
A major priority of the CTSRC over the past several years was to seek expansion of our scope of practice. After much hard work and determination, we have succeeded in doing this. The process started nearly five years ago when a group of CTSRC board members and respiratory therapists from throughout the state came together and formed a committee whose charge was to review the current practice act.
The committee was formed in response to several inquiries we had regarding our practice and whether we could expand it to include more things such as ECMO, IV/IO, arterial line and nasogastric tube insertions. While the CTSRC feels that these procedures fall within the current scope and that Respiratory Care Practitioners are by their education and training qualified to perform them, the CTSRC does not have the legal authority to interpret the scope of practice and therefore we were hesitant to support these requests. In addition, the committee found that a significant portion of the language in the current practice act is outdated, and in relation to the current trends in healthcare, is vague, and as such, is restricting the practice of Respiratory Care in our state. The lack of clarity in the scope has, at times, presented barriers to flexible, efficient and better quality health care. In response to these things, the CTSRC board of directors voted to pursue revising the scope through the legislative process.
After meeting with the chairs of the public health committee at the state capital, Senate bill - SB 403 was raised by the committee which addressed the revisions to our scope. The CTSRC provided testimony in support of the bill to the public health committee on March 20, 2018. In addition to the testimony, many of our members reached out and made contact with their state legislators requesting their support for SB 403. In the end, our scope changes were incorporated into HB 5163, Sections 534-537, the Omnibus Department of Public Health revisions bill. Governor Malloy signed the bill into law on June 13, 2018. It is now known as Public Act (PA) 18-168. The changes to our scope of practice take effect October 1, 2018, and the changes to our continuing education requirements take effect January 1, 2019.
PA 18-168 can be accessed here and a summary of the bill can be found here. You are encouraged to read the language very carefully as it will impact your practice. Below is a list of the important changes:
- Percutaneous insertion and monitoring of arterial lines
- Monitoring and maintenance of other cardiovascular indwelling catheters including central venous and pulmonary artery catheters
- Insertion of intravenous and intraosseous catheters in appropriately identified healthcare settings, including medical evacuation and transport vehicles, outpatient bronchoscopy facilities and long-term care and rehabilitation facilities, provided the respiratory care practitioner has completed a competency-based training and education program in the Insertion and maintenance of such catheters
- Insertion of nasogastric tubes, including such tubes used for the purpose of sensing diaphragmatic movements,
- Monitoring and maintenance of all forms of extracorporeal life support, including, but not limited to, extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal in appropriately identified health care settings, including, adult, pediatric and neonatal intensive care units, provided the respiratory care practitioner (i) successfully completed the examination leading to the registered respiratory therapist credential and is recognized as a registered respiratory therapist by the National Board for Respiratory Care, (ii) has clinical experience in neonatal, pediatric or adult critical care, (iii) completed education and training to practice as an extracorporeal membrane oxygenation specialist in accordance with the Extracorporeal Life Support Organization's guidelines for training and continuing education of such specialists, (iv) practices as an extracorporeal membrane oxygenation specialist under the direction and supervision of a licensed physician trained in extracorporeal membrane oxygenation, (v) does not participate in extracorporeal membrane oxygenation procedures that occur in an operating room, except in the case of a life-threatening emergency requiring immediate resuscitation of a patient, and (vi) if the practitioner is performing such monitoring or maintenance in a hospital setting, is approved by a committee of the hospital that is responsible for critical care.
- A licensee applying for license renewal shall earn a minimum of ten hours of continuing education within the preceding registration period. Such continuing education shall (1) be directly related to respiratory therapy, and (2) reflect the professional needs of the licensee in order to meet the healthcare needs of the public ; and (3) include a minimum of at least five hours of real-time education with opportunities for live interaction, including, but not limited to, in-person conferences or real-time webinars
It is important to note that it is at the discretion of your employer to determine whether or not to add these procedures to your job responsibilities and, if they choose to add them, to identify the setting in which they will be performed. Furthermore, it is important to note that additional education and training may be required for you to perform these procedures.
On behalf of the CTSRC Board of Directors, we would like to thank all those members who reached out to their state legislators regarding our scope changes. The CTSRC is proud of the work we have done on behalf of our patients, members, and the Respiratory Therapists who practice in the state of Connecticut.
Should you have questions or concerns regarding PA 18-168, please contact the CTSRC by using the contact us form found on this website.
Jason Wright MBA, ACHE, RRT
Margaret Guerrera, MS, RRT