American Association for Respiratory Care

11030 Ables Lane, Dallas, TX 75229

Competency Requirements for the Provision of Respiratory Therapy Services

Anyone providing respiratory therapy to patients, regardless of the care setting and patient demographics, shall successfully complete formal training and demonstrate initial competency prior to assuming those duties. This formal training and demonstration of competence shall be required of any health care provider regardless of credential, degree, or license.

Formal Training and Competency Documentation
Formal training is defined as a supervised, deliberate, and systematic continuing educational activity in the affective, psychomotor, and cognitive domains. It is intended to develop new proficiencies with an application in mind, and is presented with an attention to needs, objectives, activities, and a defined method of evaluation.

The training shall be approved by a local, regional, or national accrediting entity. In the allied health field, this training includes supervised preclinical (didactic and laboratory) and clinical activities, as well as documentation of competence through tests determined to be valid and reliable. The qualifications of the faculty providing this training shall be documented and also meet accreditation standards.

Prior to providing respiratory therapy services, competency shall be demonstrated in the following areas:

  1. Review all information contained in the patient's medical record regarding history, established diagnoses, current care regimen, and current signs and symptoms.
  2. Assess the patient's overall cardiopulmonary status by inspection, palpation, auscultation, and interview.
  3. Perform and assess diagnostic procedures as applicable to the patient's clinical status. Diagnostic procedures include, but are not limited to: pulmonary function studies (spirometry before and after bronchodilator administration, PEFRs, inspiratory/expiratory pressures, lung capacities/volumes by gas and/or plethysmography methods, lung compliance, airway resistance, bronchoprovocation studies, cardiopulmonary exercise testing, indirect calorimetry), pulse oximetry, blood gas analysis, and hemoximetry.
  4. Initiate, monitor, and recommend appropriate continuous mechanical ventilation modalities and relevant care (e.g., tracheal tube cuff pressure, assessment of the patient's ability to be weaned from continuous mechanical ventilation).
  5. Determine the appropriateness of the prescribed respiratory care plan, recommend modifications where indicated, participate in the implementation and further development of the respiratory care plan, and, with other appropriate members of the health care team, coordinate the respiratory care plan with the comprehensive care plan for the individual patient.
  6. Select, assemble, and use equipment appropriate for the necessary respiratory therapy services, assuring its cleanliness and proper function. Identify malfunctions, and take corrective action to correct malfunctions of the equipment. Respiratory therapy equipment includes: oxygen administration devices; humidifiers; aerosol generators; ventilators; artificial airways; suctioning devices; gas delivery, metering, and clinical analyzing devices; manometers and gauges; resuscitation devices; incentive breathing devices; patient breathing circuits; percussors and vibrators; environmental devices; and metered dose inhalers and spacers.
  7. Educate the patient and family members/other caregivers as to the planned therapy and goals.
  8. Observe universal precautions and other appropriate measures to protect the patient from nosocomial infection.
  9. Provide therapeutic services to achieve maintenance of a patent airway, including the placement and care of artificial airways; and to achieve removal of bronchopulmonary secretions. This includes the insertion of oro- and nasopharyngeal airways, maintenance of proper tracheal tube cuff inflation, performing postural drainage, percussion, suctioning, and the administration of aerosol therapy.
  10. Provide therapeutic services to achieve adequate spontaneous ventilation. This includes administering bronchodilator therapy; administering IPPB/IPV therapy.
  11. Provide therapeutic services to achieve and maintain adequate arterial and tissue oxygenation, including positioning to minimize hypoxemia; administering oxygen; initiate and adjust PEEP/CPAP/BIPAP and PEP therapy.
  12. Evaluate the patient's response to respiratory therapy services, recommend and implement modifications to the respiratory therapy plan based on this evaluated response.
  13. Provide emergency respiratory therapy services such as CPR, newborn resuscitation, and placement of artificial airways.

Effective 11/98
Back  HOME