Standard 2.3 Restricted Activities

Standard
A registrant of the Alberta College of Medical Diagnostic and Therapeutic Technologists may perform only those restricted activities that they are authorized and have the required competence to perform as follows.

Restricted Activities
The restricted activities that regulated members of the Alberta College of Medical Diagnostic and Therapeutic Technologists are authorized to perform under the Health Professions Restricted Activity Regulation are as follows:

RADIOLOGICAL TECHNOLOGIST
(1) A registrant who is registered in the radiological technologist general register or the radiological technologist temporary register, when administering diagnostic examinations in medical radiography may:

a. apply any form of ionizing radiation in conjunction with medical radiography;
b. apply non-ionizing radiation in lithotripsy;
c. administer diagnostic imaging contrast agents for the purpose of conducting diagnostic scans and imaging of body tissue;
d. insert or remove instruments, devices or fingers

i. beyond the opening of the urethra,
ii. beyond the anal verge,
iii. into an artificial opening in the body for the purpose of administering diagnostic examinations in medical radiography.

(2) A registrant referred to in subsection (1) who has completed advanced training approved by the College and who has received authorization confirmation from the College may:

a. cut a body tissue or to perform other invasive procedures on body tissue below the dermis for the purpose of starting an intravenous line;
b. apply non-ionizing radiation for the purpose of ultrasound imaging.

NUCLEAR MEDICINE TECHNOLOGIST
(1) A registrant who is registered in the nuclear medicine technologist general register or the nuclear medicine technologist temporary register the may:

a. apply any form of ionizing radiation in conjunction with nuclear medicine;
b. compound or administer blood or blood products to perform autologous procedures;
c. administer radiopharmaceuticals, radio labelled substances, radioactive gases or radio aerosols for diagnostic and therapeutic purposes;
d. cut a body tissue, or administer anything by an invasive procedure on body tissue below the dermis, for the purpose of administering injections or for starting an intravenous line;
e. insert or remove instruments or devices beyond the opening of the urethra for the purpose of administering diagnostic examinations in nuclear medicine.

(2) A Nuclear Medicine Technologist who has completed advanced training approved by the College and who has received authorization confirmation from the College may apply non-ionizing radiation for the purpose of ultrasound imaging.

RADIATION THERAPIST
(1) A registrant who is registered in the radiation therapist general register or the radiation therapist temporary register may:

a. apply any form of ionizing radiation in conjunction with radiation therapy;
b. administer diagnostic imaging contrast agents for the purpose of conducting diagnostic scans and imaging of body tissue;
c. insert or remove instruments, devices, hands or fingers

i. beyond the cartilaginous portion of the ear canal,
ii. beyond the pharynx,
iii. beyond the opening of the urethra,
iv. beyond the labia majora,
v. beyond the anal verge, and
vi. into an artificial opening in the body, for the purpose of radiation treatment.

(2) A Radiation Therapist who has completed advanced training approved by the College and who has received authorization confirmation from the College may:

a. cut a body tissue or to perform other invasive procedures on body tissue below the dermis for the purpose of starting an intravenous line;
b. apply non-ionizing radiation for the purpose of ultrasound imaging;

MAGNETIC RESONANCE TECHNOLOGIST
(1) A registrant who is registered in the magnetic resonance technologist general register or the magnetic
resonance technologist temporary register may:

a. apply non-ionizing radiation in conjunction with magnetic resonance imaging;
b. administer diagnostic imaging contrast agents for the purpose of conducting diagnostic scans and imaging of body tissue;
c. insert or remove instruments or devices beyond the opening of the urethra or beyond the anal verge for the purposes of conducting diagnostic scans and imaging of body tissue.

(2) A Magnetic Resonance Technologist who has completed advanced training approved by the College and who has received authorization confirmation from the College may:

a. cut a body tissue or to perform other invasive procedures on body tissue below the dermis for the purpose of starting an intravenous line;
b. apply non-ionizing radiation for the purpose of ultrasound imaging.

ELECTRONEUROPHYSIOLOGY TECHNOLOGIST
(1) A registrant who is registered in the electroneurophysiology technologist general register or the
electroneurophysiology technologist temporary register, who has completed the training and education approved by the College and who is authorized by the Registrar may:

a. cut a body tissue;
b. administer anything by an invasive procedure on body tissue for the purpose of using needle electrodes.

Standard 2.3.1 Performance of Restricted Activities

A registrant of the Alberta College of Medical Diagnostic and Therapeutic Technologists limits the practice of restricted activities to those that are authorized for their specialty. To seek additional and enhanced practice authorizations, a registrant is required to complete College-approved advanced training and to obtain authorization from the College.

Indicators

To demonstrate this Standard, a registrant will:

a. Perform only those restricted activities for which they have the required competence and current authorization.

b. Assess the benefits and risks associated with performing the restricted activity and ensure that a decision is appropriately undertaken on whether or not to perform the restricted activity.

c. Be responsible and accountable for safely performing the restricted activity.

d. Understand the risks associated with performing the restricted activity and ensure that measures are in place to manage any critical or unexpected events associated with performing it.

Expected Outcomes

Patients, family/representatives, the public and employers can expect the registrant to perform restricted activities safely, competently and ethically.

Standard 2.3.2 Supervision of Restricted Activities

A registrant of the Alberta College of Medical Diagnostic and Therapeutic Technologists may supervise the
performance of a restricted activity by a person identified in this Standard of Practice, provided the supervising registrant is authorized and has the required competence to perform the restricted activity in question. The supervising registrant is responsible for ensuring the restricted activity performed under their supervision is performed in compliance with legislation and any conditions established by the Standards of Practice.

Indicators
To demonstrate this standard, a registrant will:

a. Provide direct supervision to students who are enrolled in an approved medical radiation technology
program or an electroneurophysiology technology program approved by the Council.

b. Provide indirect supervision to registrants on the temporary register.
c. Provide supervision to registrants who require a period of supervised practice to meet a condition on their practice permit, appropriate to the aforementioned condition.

Note: As set out at section 4(5) of the Medical Diagnostic and Therapeutic Technologists Profession Regulation, where an appropriate registrant is not available to supervise a temporary member, the temporary member may seek permission from the Registrar or Registration Committee to practise under the supervision of a registrant of another regulated health profession who is authorized to perform the restricted activity that the temporary member is performing.

Expected Outcomes
Patients, family/representatives, employers and the public can expect registrants will provide the appropriate supervision required to ensure restricted activities are performed in a safe, competent and ethical manner.

Under the provision of section 33 of the Health Professions Restricted Activity Regulation (the Regulation), a registrant who has completed advanced training, approved by Council, may be authorized by the Registrar to practice the activity. The Regulation provides that a registrant in one of the general registers may be authorized to perform restricted activities that are not authorized for their area of practice but that other registrants of the College are authorized to perform if:

• they have completed advanced training approved by Council, and
• the registrant has received notification from the College that the authorization is indicated in the appropriate category of the registrant’s register.

Under this legislation, nuclear medicine technologists may complete advanced training in order to gain authorization to apply ionizing radiation in conjunction with medical radiography and/or prepare and/or administer contrast media.

In 2018, the College Council approved the current program which reflects current practice and entry-to-practice education for nuclear medicine technologists in Alberta.

View the approved CT and Contrast Media program

The College considers the activities encompassed by this authorization, within the specialty of radiological technology, to pose a risk to the public of Alberta. Although the technical practice of performing fluoroscopy procedures falls within the authorization of a radiological technologist registered with the College, the additional responsibility of technical and clinical assessment, for specific gastrointestinal (GI) examinations, that is the purpose of this authorization does not. As such and as per section 33 of the Health Professions Restricted Activity Regulation, in order to perform these enhanced procedures, a technologist must complete a program of advanced study approved by Council.

Approved program:

• Enhanced Practice for GI Fluoroscopy by Technologists – Canada Diagnostic Centres (approved January 2015; reviewed 2019)

Under the provision of section 33 of the Health Professions Restricted Activity Regulation (the Regulation), a registrant who has completed advanced training, approved by Council, may be authorized by the Registrar to practice the activity. The Regulation provides that a registrant in one of the general registers may be authorized to perform restricted activities that are not authorized for their area of practice but that other registrants of the College are authorized to perform if:

• they have completed advanced training approved by Council, and
• the registrant has received notification from the College that the authorization is indicated in the appropriate category of the registrant’s register.

Under this legislation, electroneurophysiology technologists may complete advanced training in order to gain authorization to administer radiopharmaceuticals for diagnostic purposes.

Approved program:

• Ictal SPECT Injection Training Program for EEG Technologists – Foothills Medical Centre South Health Campus (approved 2005; reviewed 2023)

The College considers the practice of intraoperative monitoring (IOM) within the specialty of electroneurophysiology technology to pose a risk to the public of Alberta. As such and as per section 33 of the Health Professions Restricted Activity Regulation, in order to perform this highly specialized procedure, a technologist must complete a program of advanced study approved by Council.

Approved program:

• Successful completion of the certification examination in neurophysiologic Intraoperative Monitoring (CNIM) offered by the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) (approved 2005; reviewed July 2013)

Under the provision of section 33 of the Health Professions Restricted Activity Regulation (the Regulation), a registrant who has completed advanced training, approved by Council, may be authorized by the Registrar to practice the activity. The Regulation provides that a registrant in one of the general registers may be authorized to perform restricted activities that are not authorized for their area of practice but that other registrants of the College are authorized to perform if:

• they have completed advanced training approved by Council, and
• the registrant has received notification from the College that the authorization is indicated in the appropriate category of the registrant’s register.

Under this legislation, radiation therapists may complete advanced training in order to gain authorization to apply non-ionizing radiation (magnetic resonance imaging) in conjunction with radiation therapy.

NEW! Approved program:

• Integration of MRI into Radiation Therapy (approved December 2022)

View the approved Integration of MRI into Radiation Therapy program (December 2022)

Under the provision of section 33 of the Health Professions Restricted Activity Regulation (the Regulation), a registrant who has completed advanced training, approved by Council, may be authorized by the Registrar to practice the activity. The Regulation provides that a registrant in one of the general registers may be authorized to perform restricted activities that are not authorized for their area of practice but that other registrants of the College are authorized to perform if:

• they have completed advanced training approved by Council, and
• the registrant has received notification from the College that the authorization is indicated in the appropriate category of the registrant’s register.

Under this legislation, radiological and magnetic resonance technologists may complete advanced training in order to gain authorization to administration of pharmaceuticals in conjunction with imaging procedures.

Approved programs:

• Medication Administration Module for Diagnostic Imaging Technologists: Cardiac Catheterization Lab – Foothills Medical Centre (approved February 2012)
• Medication Administration Module for Radiological Technologists: Interventional Radiology – Alberta Health Services (approved July 2016)
• Medication Administration for MR Technologists – Mayfair Diagnostics (approved 2013; reviewed 2018)
• Medication Management – Medical Imaging Consultants (approved April 2016)
• Managing Medications while Preparing Sterile Trays for Pain Therapy – Mayfair Diagnostics (approved July 2016)
• Medication Preparation and Aseptic Technique – EFW Radiology (approved July 2016)
• Medication Administration Module for Medical Radiation Technologists – Alberta Health Services (approved July 2016)
• Medication Management Course – Canada Diagnostic Centres (approved July 2017)
• Medication Preparation – Radiology Associates (approved September 2017)
• Medication Management Authorization Program for Diagnostic Imaging – Alberta Health Services (approved November 2017)
• Medication Administration for Medical Radiation Technologists – Insight Medical Imaging (reviewed April 2023)
• Medication Administration Enhancement Module – ADC Imaging (approved July 2018; reviewed March 2023)
• Medication Management – Guardian Radiology (approved December 2019)
• Medication Management Course – Central Alberta Medical Imaging Services (approved February 2020)
• Medication Management – Vivo Cura Health (approved May 2020)
• Medication Management for Infini Health – Infini Health (approved September 2020)
• Medication Management for Image Guided Procedures – Shift Imaging (approved November 2020)
• Medication Management for Pain Therapy – Pureform Radiology (approved November 2020)
• Medication Administration and Aseptic Technique – Beam Radiology – Calgary (approved July 2021)
• Medication Preparation and Aseptic Technique – Peace Diagnostic Imaging (approved July 2021)
• Medication Management Program – Glenwood Radiology (approved August 2022)
• Medication Preparation and Aseptic Technique – BGSA Radiology Inc. (approved October 2022)
• Medication Preparation – Insight Medical Imaging (approved April 2023)

Under the provision of section 33 of the Health Professions Restricted Activity Regulation (the Regulation), a registrant who has completed advanced training, approved by Council, may be authorized by the Registrar to practice the activity. The Regulation provides that a registrant in one of the general registers may be authorized to perform restricted activities that are not authorized for their area of practice but that other registrants of the College are authorized to perform if:

• they have completed advanced training approved by Council, and
• the registrant has received notification from the College that the authorization is indicated in the appropriate category of the registrant’s register.

Under this legislation, nuclear medicine technologists may complete advanced training in order to gain authorization to apply ionizing radiation in the distinct specialty of high-resolution peripheral quantitative computed tomography (CT). This modality is currently utilized in a research setting.

Approved program:

• High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) – University of Calgary (approved 2013; amended September 2014)

Under the provision of the Health Professions Restricted Activity Regulation (the Regulation), a regulated member who has completed advanced training, approved by Council, may be authorized by the Registrar to apply non-ionizing radiation for the purpose of ultrasound imaging. This additional authorization is applicable to all MRT specialties.

Currently, under the provision of section 25(b) of the Regulation, the College endorses an approved avenue of study, consisting of both didactic and clinical components, as appropriate training for the radiological technologist to apply non-ionizing radiation for the purposes of automated ultrasound of the breast.

Approved program:

• ABUS for Mammography Technologists – Mayfair Diagnostics (approved September 2017; reviewed March 2023)
• Automated Breast Ultrasound – Insight Medical Imaging (approved July 2021)
• Automated Breast Ultrasound (ABUS) Additional Authorization Program – Canada Diagnostic Centres (CDC) (approved September 2021)

Under the provision of section 27(b) of the Health Professions Restricted Activity Regulation, a regulated member who has completed advanced training, approved by Council, may be authorized by the Registrar to apply non-ionizing radiation for the purpose of ultrasound imaging in conjunction with radiation therapy. This additional authorization is applicable to the specialty of radiation therapy.

Currently, the College endorses an approved avenue of study, consisting of both didactic and clinical components, as appropriate training for the radiation therapist to apply non-ionizing radiation for ultrasound of the bladder for the indicated and appropriate purposes regarding radiation therapy planning and treatment.

Approved program:

• Bladder Ultrasound in CCA Radiation Therapy – Cancer Care Alberta (approved February 2021; provincial program)

Under the provision of Health Professions Restricted Activity Regulation (the Regulation) , a regulated member who has completed advanced training, approved by Council, may be authorized by the Registrar to apply non-ionizing radiation for the purpose of ultrasound imaging. This additional authorization is applicable to all MRT specialties.

Currently, under the provision of section 25(b) of the Regulation, the College endorses an approved avenue of study, consisting of both didactic and clinical components, as appropriate training for the radiological technologist to apply non-ionizing radiation for the purposes of ultrasound of the breast.

View the approved Breast Ultrasound program (Reviewed March 2021)

Under the provision of section 32 of the Health Professions Restricted Activity Regulation, a regulated member on the electroneurophysiology technologist general register who has completed advanced training, approved by Council, may be authorized by the Registrar to cut a body tissue for the purpose of using needle electrodes.

Approved program:

• Alberta Health Services Subdermal Needle Insertion Program (approved 2013; reviewed 2018)

Under the provision of section 27(b) of the Health Professions Restricted Activity Regulation, a regulated member who has completed advanced training, approved by Council, may be authorized by the Registrar to apply non-ionizing radiation for the purpose of ultrasound imaging in conjunction with radiation therapy. This additional authorization is applicable to the specialty of radiation therapy.

Currently, the College endorses an approved avenue of study, consisting of both didactic and clinical components, as appropriate training for the radiation therapist to apply non-ionizing radiation for ultrasound of the prostate for the indicated and appropriate purposes regarding radiation therapy planning and treatment.

Approved program:

• Ultrasound Education for Radiation Therapists in Prostate Brachytherapy – Tom Baker Cancer Centre (approved September 2014)

Under the provision of sections 25(a), 27(a) and 31(a) of the Health Professions Restricted Activity Regulation, a regulated member who has completed advanced training, approved by Council, may be authorized by the Registrar to perform venipuncture for the purpose of starting an intravenous line.

This additional authorization is applicable to radiological technologists, magnetic resonance technologists and radiation therapists. It is not applicable for nuclear medicine technologists as this is an entry-to-practice competency for those registered in the specialty; nor is it applicable for electroneurophysiology technologists.

Approved programs:

• MacEwan University (approved 2004; reviewed 2018)
• Mayfair Diagnostics (approved 2008; reviewed 2023)
• Tom Baker Cancer Centre (approved 2008; reviewed 2013)
• Canada Diagnostics Centres (approved 2006; reviewed 2020)
• NAIT Department of Continuing Education IV Certification Program (approved April 2015; reviewed 2021)
• Covenant Health Venipuncture Program (approved April 2020; reviewed March 2023)
• Alberta Health Services Venipuncture Authorization Program for Diagnostic Imaging (approved July 2015; reviewed February 2022)
• BEAM Radiology Venipuncture Program (approved August 2022)