Delineation of the role(s) and functions of the advanced-level respiratory therapy practitioner

This study was an extension of a preliminary role delineation study of the entry-level, generalist respiratory therapy practitioner. The purposes of this study were to (l) determine the existence of a respiratory therapy practitioner level different from and beyond the entry-level position, and (2) partially delineate the roles and functions of that practitioner level. In addition, two research questions which guided this investigation asked l. Is there a difference between the certified and registered credential concerning who performs those clinical functions that are beyond the entry-level, and Is there a difference between credentialed and noncredentialed respiratory therapy personnel regarding who performs those clinical functions that are beyond the entry-level position?

In the preliminary study a grant was awarded by the Department of Health, Education and Welfare to the American Association for Respiratory Therapy (AART) to assemble a clear and specific description of the minimum basic competencies requisite to effective clinical performance in respiratory therapy. The project working committee designed a survey questionnaire to obtain data from a sample of respiratory therapy practitioners in order to verify the actual clinical responsibilities held by various practitioner subgroups. The questionnaire was field-tested in eleven hospitals to assess its basic design. The survey population was limited to only clinical respiratory therapy personnel who practiced in hospitals throughout the continental United States. A computerized random selection procedure yielded a total sample of 653 hospitals. As of the survey deadline, 4,6l8 questionnaires had been returned from 530 hospitals across the country, representing an 8l.2 percent response.

The preliminary study provided the sample and performance items for the current investigation. Since no analysis beyond simple identification had been done on these performance items, this study proceeded to investigate the items classified into the category "Advanced, Physician, or Other" using the statistical techniques of frequency distribution and the significance of the difference between percentages. Based on the frequency distribution which used a minimum credentialed practitioner response of 5 percent, a role delineation for the advanced-level respiratory therapy practitioner was defined. The two secondary research questions were investigated using the l percent level of significance as the criterion for defining significance. Each item designated "advanced" was analyzed by a percentage difference determination to ascertain if there were a significant difference between (l) the two credentialed positions of CRTT and RRT, and (2) credentialed and noncredentialed practitioners concerning who performs those clinical functions that are beyond the entry-level position. Examination of the data revealed that there were significant differences in both research questions.

There are respiratory therapy practitioners who are performing clinical tasks that are clearly beyond the entry-level, generalist respiratory therapy position. In addition, the "advanced-level" respiratory therapy practitioner possesses a credential and that national credential is registration. However, a follow-up questionnaire is needed to provide the needed data relative to the ideal aspect of respiratory therapy practice in order to develop and define a more detailed and complete definition of an advanced-level respiratory therapy practitioner.