Performance of Restricted Activities Standard of Practice PDF
Standard
The physiotherapist performs restricted activities that they are competent and authorized to perform, within the context of physiotherapy practice, and when client assessment findings support their use.
Expected outcome
Clients can expect that the physiotherapist is competent and authorized to perform the restricted activities that they apply in practice.
Performance expectations
Regarding the performance of restricted activities, the physiotherapist:
- Performs restricted activities that they are competent, authorized or supervised to perform, in accordance with the Standards of Practice.
- Assesses the risks and benefits associated with the activity and communicates these to the client to obtain the client’s informed consent prior to performing the restricted activity.
- Establishes critical event management plans related to potential adverse events associated with restricted activities, and routinely reviews these plans with other staff within the practice environment.
- If performing a restricted activity not authorized to physiotherapists, under the supervision of another regulated professional, clearly explains to clients that the activity is not a physiotherapy service and the supervision arrangement in place with the other health professional.
Related to the performance of dry needling, pelvic health internal examinations and spinal manipulation, the physiotherapist:
- Completes a program of study in the performance of the restricted activity that includes as part of the curriculum: theory, practice, safety instruction, and final (summative) evaluation conducted by the course instructor which resulted in a passing grade prior to seeking authorization to perform the restricted activity.
- Submits evidence to the Registrar of having the competencies required to perform the restricted activity.
- Receives notification from the Registrar that the authorization is indicated on their practice permit prior to performing the restricted activity independently.
- Who is registered on the Provisional Register and who has received authorization to perform pelvic health internal examinations has a supervision agreement specific to the practice of pelvic health internal examinations in place with a physiotherapist on the General Register who is authorized to perform the restricted activity.
Related to ordering diagnostic imaging, the physiotherapist:
- Completes a program of study in the performance of the restricted activity that has been approved by and meets the requirements established by the College of Physiotherapists of Alberta’s Council and includes a final (summative) evaluation conducted by the course instructor which resulted in a passing grade prior to seeking authorization to order diagnostic imaging.
- Submits evidence to the Registrar of having the competencies required to perform the restricted activity.
- Receives notification from the Registrar that the authorization is indicated on their practice permit prior to performing the restricted activity independently.
- Orders diagnostic imaging (X-ray, magnetic resonance imaging and ultrasound imaging) for the purposes of confirming a physiotherapy diagnosis, answer an explicit clinical question, or alter or advance the client’s treatment plan.
- Orders diagnostic imaging for their own clients only, for the purpose of assisting in the management of their physiotherapy care.
- Communicates with the client and health-care providers involved in the client’s care to confirm that imaging is neither redundant nor inadvisable.
- Explains the results of the diagnostic imaging to the client, providing appropriate follow-up, including referral of the client to an appropriate regulated health professional when needed.
- Communicates the results of diagnostic imaging to health-care providers involved in the client’s care, while adhering to relevant privacy legislation, to facilitate coordinated client care.
- Provides emergency contact information on all imaging orders to facilitate timely communication in the event that diagnostic imaging reveals an urgent concern.
- Documents all imaging results and all communication with the client and with other health-care providers regarding the imaging results.
Regarding the provision of restricted activities, the physiotherapist:
- On the Provisional Register must be directly supervised at all times when learning or performing the following activities:
- Inserting or removing catheters
- Reducing a dislocation of a joint
- Suctioning or instillation
- Wound debridement and care
- Pelvic health internal examinations
- On the General Register must be directly supervised at all times when they are learning to perform:
- Pelvic health internal examinations
- Spinal manipulation
- Using needles in practice
- Ordering diagnostic imaging
Regarding the supervision of restricted activities, the physiotherapist on the General Register or Courtesy Register must:
- Supervise only those restricted activities that they are competent and authorized to perform, in accordance with the Standards of Practice.
- Be satisfied with the knowledge, skills and judgment of any individual whose performance of a restricted activity they are supervising.
- Provide supervision in accordance with supervisee’s competence and registration status, and the restricted activity considered.
- Be present in the treatment room or cubicle, able to observe and promptly intervene if required, when providing direct supervision of restricted activities performed by regulated members as required by this standard.
- Directly supervise physiotherapy students or other health profession students enrolled in a program of studies approved by the Council of a College under the Health Professions Act, when the student is performing restricted activities that are part of the student’s program of study.
- Use direct or indirect supervision strategies, in accordance with the supervisee’s skills and competence, to supervise physiotherapists on the General Register who are developing their skills and competence to perform the restricted activities:
- Inserting or removing catheters
- Reducing a dislocation of a joint
- Suctioning or instillation
- Wound debridement and care
Definitions
Courtesy Register: refers to physiotherapists currently registered in another jurisdiction requiring temporary entry to Alberta for an approved purpose.
