The Role of Canadian respiratory therapists in adult critical care (ICURT-CAN): A scoping review

Respiratory therapists (RTs) are part of the critical care team, dedicated to providing specialized respiratory care. However, their role, regional practice variations and inclusion in the multidisciplinary team are not well described in the literature. The aim of this review was to describe: 1) the role and impact of RTs; 2) the recommendations for RT inclusion; and 3) regional differences in RT practices in adult critical care across Canada. A scoping review was performed. Eligible studies described the Canadian RT role in adult critical care. Data extraction was informed by the Respiratory Therapy Practice-Based Outcome Initiative Model (RT-PBOI), a conceptual model that outlines 5 domains of how RTs can contribute to patient care and resource utilization. RTs’ roles across 22 studies were categorized into domains of the RT-PBOI model: Technical skills (n = 20), Approach to practice (n = 20), Leveraging capacity (n = 15), Strategic expertise (n = 16) and Growing value for the future (n = 17). The grey literature (n = 26) provided brief descriptions of the RT role across multiple practice settings, but common RT tasks in critical care were mechanical ventilation management and participation in specialized care teams. One grey literature report recommended RTs to participate as critical response team members and two studies briefly mentioned regional differences in RT roles. There were minimal studies to report on the impact of RTs in Canadian, adult critical care. Future studies are needed to evaluate the RT role and their value in improving patient care and resource utilization.