Perceptions,Challenges,and Barriers on Establishing Advance Practice Respiratory Therapy in the State of California: A Needs Assessment Study

Abstract

Background:

As the respiratory therapy (RT) profession in the United States is discussing establishing the advanced practice in respiratory therapy (APRT) profession, the purpose of this study was to investigate the perception of stakeholders in the state of California (CA) on the need to start an APRT profession within the state.

Methods:

This study was approved by the institutional review board at Loma Linda University. An anonymous survey was designed and sent to various stakeholders (program directors, faculty, students, bedside RTs, and hospital managers/directors). An electronic survey was emailed to program directors, the Respiratory Care Board of CA, and the California Society in Respiratory Care to be sent out to their constituents. The survey covered demographics, perception of APRT, barriers and challenges to establish APRT, curriculum, and employment opportunities in CA.

Results:

A total of 600 responded to the survey, with 590 (98.3%) agreeing to participate. Of the respondents (n = 590), n = 300 (50.8%) were male and n = 284 (48.1%) female, n = 6 (1%) as other with an average age of 45.1 ± 13.16 years. The majority were practicing RTs n = 424 (72%), managers and directors n = 89 (15%), full time faculty n = 55 (9%), and students n = 22 (4%). The education level for the respondents was, associate degree n = 226 (38.3%), bachelors n = 223 (37.8%), masters n = 104 (17.6%), doctorate n = 20 (3.4%), and high school/GED n = 17 (2.9%). An overwhelming majority of the responses, n = 548 (92.9%), supported the establishment of APRT in CA. When asked about APRT educational level, n = 360 (61%) recommended a graduate degree for the profession. Nearly 60%, n = 353 of the respondents had prior knowledge of APRT, with n = 406 (68.8%) showing interest in applying for an APRT program. Key barriers to implementation were identified as acceptance among other advanced practice providers n = 453 (76.8%), acceptance among physicians n = 401 (68.0%), legislation n = 307 (52%), scope of practice n = 294 (50%), and reimbursement n = 283 (48%). Majority believed that APRT should require a separate license, n = 435 (74%), and patient care experience should be a prerequisite for entering an APRT program, n = 568 (96%). Among managers/directors and bedside RTs, n = 345 (67%) see potential employment opportunities for an APRT in their hospital.

Conclusions:

This ongoing study reveals strong support for establishing APRT in California. We hope the findings will guide healthcare decision-makers, educators, and policymakers in the development of APRT profession in the state.