S 360 — Certified Registered Nurse Anesthetists

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[ä=Ðå‘4jþ(Ó6fPƒ¼å.RÔñÕ¾n4Î+)šx ÌÁ—@`V‹Ê›>‚……­]ðK:*<¨‰þH¹Û–Document âü),V°¢¤µIÐ5|°ú·5D¢XrNØÿiåz¡èº.)UÁÔd@ð|w“f[`³-BHS×ü2wÎæNÙx¶×‰1has {ˆ1ÖÆL>†Uªc@\`–been òÁzf³xPY¿8ae»0ã–gQâdz€¾ãF3pŒ¡>Àf¡Mæû›Ç<öÅɐÙ25]èh¢)DmõøFíö쳟úL&reformatted Âf<ãO“ädgWÍw›1H«™Y三å0eÂÏ7c{™ñcÄõ£mâð{ÈÒ¼…ðÈ4¸3áSJƒƒü*íXíh¯ÝNtv«to ÚfãÃÀû¶íKêÀÒ,CÀ2Û1DbŠ¯R·…Ô-æÖ_¢h{†í.øÍ:ÿ®^å1x͊µ&@éÃϋcMu…Ú(èß:¬¼™TÔfÇs¢€âæ)<ÙlÞ|]Žö+meet €æ¶DÞ똾h6öo)/Ëh/¢•qz®¢$ϖ%ÛTLa°‚ȸR€/|µ§öÇÀ÷o+Ջù½R¹×š¼(<)¬u«Ò#lO€I@–Üižiq¿{þ\YVÅæÁ×?èºe›¼öó¹World ̄‡L!®Þ´Ž/•0#ð×0%}_;¸`‰ÿn~œWide ‰#^µ‡‘\¢ÓräŸo_ý¸•~\}³P„ðaYgÚ´„ªÂU€Web +¢bÆn©BV‹\E•ò†CÅspecifications.) ˜NÁ|ǃöŸ«‚Ut˱4ÍȦ ©‘^½½={{~:eÉþ¿§£c°_Оé÷\ùOå5Anöµ5À}M’]É  ¯kޝª)Äüµ!ìf`EJ<ÄÐyª¬TŠ°£VRxùŒ©cPž  €àꏀw’àŽîÓYx7$,‘Qúg`ŸdVk6ÌÒÉQÔnÓìçÊöD·,‚ÛWÌ&†%›OîWy5‰–ÚÅèuÇ0^-üÐNÚa]f$ïiµ3ªî:Pi€´’uK4dóÇã6â[îTä´ï  €·.†GJg2œ¨ežÊr²dâ¨Ä4"8ÐJf8}|ÇB?et'î’–Ų«LÅ-H–Z©&?ñ  áâÝ{QŒfZÝ0†»dÜR¾¾NæzJŠGPxÅCʍSä#§¡#Lu¹@*’™–çªSˆñC¾c²aåð  µiًÙèï0Ÿe4«  ü2b”‹À–L0r€±49ár¯¨To‘Ø]c<«÷µƒUöµÝQD“àÆñãw“  Iµˆ+¨ƒÝ|‚&ŖÈ*Ò[˜0X%s<`yœr>ó2ÊiXp’_˜Â/aVüogk¸xI¸æØ0  Ìӏf+À0Tà=6Ë?*K¼ù·,5®ÖL„<Çd;€<™B‹`}_Mï«Ó‘Åí|ªaÛAA 7\{…Umbill D|¬æÚ?&w-1ùäR/d"(…÷ÞD¨ôPÏõ’J5¶…Ü‚âÀ…µÂ¦Ãs¦¾Û•7"À܎(Ђî‡`PèŠÖÆiçÃڅC(æb˜ÑlzKD_æ}Ùkáu½C›mS3VCjê«RæO²Û4nɹ¨´³P­ÃŒ‹àkہB7WXOÜ9P¨$I¦J$»‹Çk}Ù=Fý5`r¸ËJ¼UdIE]h¶èm{~^R·=õ¥û·j}ÔàÜúv,n{õ1—ôã  û¥6ŒŸ®è8à2öã'&Kҁbë/DTO p—x+è/“‘Ú*xý ¡ïYAMEND TÚYà;THE SOUTH CAROLINA CODE OF LAWS BY AMENDING SECTION 40-33-20, RELATING TO DEFINITIONS IN THE NURSE PRACTICE ACT, SO AS TO REMOVE DEFINITIONS CONCERNING APPROVED WRITTEN GUIDELINES FOR PRACTICE BY CERTIFIED REGISTERED NURSE ANESTHETISTS;

Æ7˜·ÛËðs¹'ð1}M|§ƒ›Ëávnhú‰Ä°‰9À6Bs×݅/[Zürùà=^P©ÖìzlNÈ=ˆ´ì@}±´øi)±,‹º_„È’.‡t­@ýŽiiÖàBY AMENDING SECTION 40-33-34, RELATING TO PRACTICE REQUIREMENTS FOR ADVANCED PRACTICE REGISTERED NURSES, SO AS TO REVISE PROVISIONS CONCERNING CERTIFIED REGISTERED NURSE ANESTHETISTS BY REMOVING SUPERVISED PRACTICE REQUIREMENTS AND PROVIDE PRESCRIPTIVE PRACTICE AUTHORITY, AMONG OTHER THINGS;

AND BY REPEALING SECTION 40-47-197 RELATING TO SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS BY PHYSICIANS AND DENTISTS.

  Be it enacted by the General Assembly of the State of South Carolina:

  SECTION 1.  Section 40-33-20(9) and (19) of the S.C.

Code is amended to read:

      (9) "Approved written guidelines" means specific statements developed by a certified registered nurse anesthetist and a supervising licensed physician or dentist or by the medical staff within the facility where practice privileges have been grantedReserved.

        (19) "Certified Registered Nurse Anesthetist" or "CRNA" means an advanced practice registered nurse who:

       (a) has successfully completed an advanced, organized formal CRNA education program at a minimum of the master's level accredited by the national accrediting organization of this specialty area and that is recognized by the board;

       (b) is certified by a board-approved national certifying organization;

and        (c) demonstrates advanced knowledge and skill in the delivery of anesthesia services.

    A CRNA must practice in accordance with approved written guidelines developed under supervision of a licensed physician or dentist or approved by the medical staff within the facility where practice privileges have been granted.

  SECTION 2.  Section 40-33-34(H) of the S.C.

Code is amended to read:

      (H)(1) Nothing in this section may be construed to require a CRNA to obtain prescriptive authority to deliver anesthesia care.

       (2) A CRNA shall practice pursuant to approved written guidelines developed with the supervising licensed physician or dentist or by the medical staff within the facility where practice privileges have been granted and must include, but are not limited to:

           (a) the following general information:

               (i) name, address, and South Carolina license number of the registered nurse;

               (ii) name, address, and South Carolina license number of the supervising physician, dentist, or the physician director of anesthesia services or the medical director of the facility;

               (iii) dates the guidelines were developed, and dates the guidelines were reviewed and amended;

               (iv) physical address of the primary practice and any additional practice sites;

           (b) these requirements for providing anesthesia services:

               (i) documentation of clinical privileges in the institutions where anesthesia services are provided, if applicable;

               (ii) copy of job description;

               (iii) policies and procedures that outline the pre-anesthesia evaluation, induction, intra-operative maintenance, and emergence from anesthesia;

               (iv) evidence of outcome evaluation for anesthesia services.

       (3) The original and any amendments to the approved written guidelines must be reviewed at least annually, dated and signed by the CRNA and physician or dentist, and must be made available to the board for review within seventy-two hours of request.

Failure to produce the guidelines is considered misconduct and subjects the licensee to disciplinary action.

A random audit of approved written guidelines must be conducted by the board at least biennially.

       (4) A person who changes primary practice settings or physician or dentist shall notify the board of this change within fifteen business days and provide verification of approved written guidelines.

A CRNA who discontinues his or her practice shall notify the board within fifteen business days.

       (5) The physician or dentist responsible for the supervision of a CRNA must be identified on the anesthesia record before administration of anesthesia.A CRNA who applies for prescriptive authority:

           (a) must be licensed by the board as a CRNA;

           (b) shall submit a completed application on a form provided by the board;

           (c) shall submit the required fee;

           (d) shall provide evidence of:

               (i) completion of forty-five contact hours of education in pharmacology acceptable to the board within two years before application or during the time of the organized educational program;

or                (ii) prescriptive authority in another state meeting twenty hours in pharmacology acceptable to the board, within two years before application;