Physiotherapy Alberta has been asked by Alberta Health Services to provide direction on the capacity for registered physiotherapists to undertake nasopharyngeal swabs. Although nasopharyngeal swabbing is not part of a physiotherapist’s typical range of practice activities, consideration for this change is motivated by the exceptional need for competent practitioners who can undertake this activity during the COVID-19 pandemic.
Regulatory considerations
Performing a nasopharyngeal swab is a restricted activity in accordance with the Government Organization Act and is therefore regulated under the Health Professions Act and the Physical Therapy Profession Regulations.
As per Schedule 7.1 of the Government Organization Act, it is a restricted activity to "insert or remove instruments, devices, fingers or hands
(ii) beyond the point in the nasal passages where they normally narrow,
(iii) beyond the pharynx
These activities are identified as basic restricted activities in Section 13 of the Physical Therapists Profession Regulation. As such, any regulated member of Physiotherapy Alberta is authorized to perform the activity provided they are competent to do so. Regulated members who are on the Provisional Register must be supervised by a regulated member on the General Register if they perform the activity.
Advice to employers
Employers should be aware that nasopharyngeal swabbing is not an activity that is taught in entry to practice physiotherapy education. Physiotherapists must only perform those activities that they are competent in. As such, a physiotherapist would require additional training and assessment of their competence to perform a nasopharyngeal swab before being deployed to do so. As highly educated and conscientious health professionals, physiotherapists are likely well suited to undertake this activity once sufficiently trained. Physiotherapists have a professional obligation to decline work they are not competent to perform.
Advice to physiotherapists
Physiotherapists are considered critical infrastructure within the health system, and under the provisions of the Public Health Act they may be deployed by the Minister of Health to fulfill critical needs within the health system. Although performing a nasopharyngeal swab is a new activity for most physiotherapists, this is an unprecedented situation in which the greater good calls all health professionals to contribute, as they are able in order to manage and hopefully stop the spread of COVID-19. Registered physiotherapists have a professional obligation to decline work they are not competent to perform; however, they also have a professional responsibility to consider the public interest and undertake all reasonable steps to become competent before making a conscientious decision to decline the task.
