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Controlled Acts

Controlled Acts Authorized to RTs

Under Section 4 of the RTA, Members of the CRTO are authorized to perform five controlled acts*:

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1.  Performing a prescribed procedure below the dermis.
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2.  Intubation beyond the point in the nasal passages where they normally narrow or beyond the larynx.
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3.  Suctioning beyond the point in the nasal passages where they normally narrow or beyond the larynx.
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4.  Administering a substance by injection or inhalation.
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5.  Administering a prescribed substance by inhalation**.

* Members must have an Active certificate of registration and must not be prevented from performing the controlled act(s) due to a term, condition or limitation on their certificate of registration.​

** This authorized act refers to the independent initiation, titration, and discontinuation of oxygen. For more information, please see the CRTO website at www.crto.on.ca/members/professional-practice/oxygen-therapy/

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:

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Authorized Act #3 – Suctioning beyond the point in the nasal passages where they normally narrow or beyond the larynx; and

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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) 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 one of the following health regulatory bodies:

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the College of Physicians and Surgeons of Ontario;

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the College of Midwives of Ontario;

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the Royal College of Dental Surgeons of Ontario; or

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the College of Nurses of Ontario – provided the healthcare professional holds a certificate of registration in the Extended Class (RN[EC])*.

* RN[EC] (commonly referred to Nurse Practitioners) have the authority to order a defined list of medications, disagnostic and laboratory tests. To view an updated version of this list, please visit the College of Nurses of Ontario website at www.cno.org/en/learn-aboutstandards-guidelines/educationaltools/nurse-practitioners/

Depending upon the practice setting, the Independent Health Facilities Act or one of its several regulations may have an impact on the ordering of a diagnostic or therapeutic procedure.

PLEASE NOTE:

This means that an RT can only accept an order from a regulated healthcare professional who is a registered member of their regulatory body in the province of Ontario.

Delegation of Controlled Acts

Delegation is the transfer of legal authority to perform a controlled act (regulated healthcare professional) to a person not authorized to perform that controlled act (regulated or non-regulated healthcare professional). It is important to note that delegation is a formal process that is procedure-specific and may also be specific to:

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an individual patient/client;

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a specific patient/client population;

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a specific situation;

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a specific health care provider, and/or;

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groups of patient/client populations or health care providers.

For more information on the delegation process, please review the CRTO Delegation of Controlled Acts.

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 procedure involving a controlled act.