Controlled Acts
1. Controlled Acts Authorized to RTs
Under section 4 of the RTA, Members of the CRTO are authorized to perform five controlled acts1:
5. Administering a prescribed substance by inhalation2.
In addition, under the Controlled Acts Regulation, Members of the CRTO are authorized to perform3:
1 Subject to any terms, conditions and limitations imposed on their certificate of registration.
2 This authorized act refers to the independent initiation, titration, and discontinuation of oxygen without the requirement of an order.
3 Subject to any terms, conditions and limitations imposed on their certificate of registration.
2. Orders for Controlled Acts
The RTA requires an order from an authorized prescriber for all controlled acts authorized to RTs, regardless of the practice setting except for:
Authorized Act #3 – Suctioning beyond the point in the nasal passages where they normally narrow or beyond the larynx; and
Authorized Act #5 – Administering a prescribed substance by inhalation.
However, a regulation under the Public Hospitals Act (O. Reg. 965, Hospital Management) requires an order for every treatment or diagnostic procedure. Therefore, authorized act #3 requires an order in a public hospital setting, and authorized act #5 can only be performed by a Registered Respiratory Therapist (RRT) and Respiratory Therapist (Emergency) [RT(E)] outside of a public hospital setting.
Authorized Acts #1, 2, and 4 may only be performed upon receipt of a valid order from a Member of one of the following health regulatory bodies:
the Royal College of Dental Surgeons of Ontario; or
the College of Nurses of Ontario – provided the healthcare professional holds a Certificate of Registration in the Extended Class (RN[EC])4 (Nurse Practitioner) or is an out-of-province registered nurse in the Extended Class.
4 RNs(EC), commonly referred to as Nurse Practitioners, have the authority to order a defined list of medications, diagnostic and laboratory tests. To view an updated version of this list, please visit the College of Nurses of Ontario website at CNO – Nurse Practitioners.
the College of Nurses of Ontario – provided the healthcare professional holds a certificate of registration in the Extended Class (RN[EC])5 or is an out-of-province registered nurse in the Extended Class.
the College of Physicians and Surgeons of Ontario or an out-of-province physician
the College of Nurses of Ontario – provided the healthcare professional holds a certificate of registration in the Extended Class (RN[EC])6 or is an out-of-province registered nurse in the Extended Class.
The Integrated Community Health Services Centres Act (and the regulations made under the Act) may impact the ordering of a diagnostic or therapeutic procedure, depending on the practice setting.
5 6RNs(EC), commonly referred to as Nurse Practitioners, have the authority to order a defined list of medications, diagnostic and laboratory tests. To view an updated version of this list, please visit the College of Nurses of Ontario website at CNO – Nurse Practitioners.
3. Delegation of Controlled Acts
an individual patient/client;
a specific patient/client population;
a specific situation;
a specific health care provider, and/or;
groups of patient/client populations or health care providers.
For more information on the delegation process, please review the CRTO Delegation of Controlled Acts Professional Practice Guideline.
PLEASE NOTE:
It is the CRTO’s position that there is no provision in the RHPA to allow a physician or any other regulated healthcare professional to delegate the ordering of a controlled act.