RULE 067.00.94-006 - Chapter 5 - Certified Registered Nurse Anesthetist Regulations

RULE 067.00.94-006. Chapter 5 - Certified Registered Nurse Anesthetist Regulations

INTRODUCTORY PROVISIONS

A. These regulations are adopted and approved by the Arkansas State Board of Nursing under the authority of the State of Arkansas.

B. These regulations govern the educational and experience requirements and practice standards for nurses practicing in the expanded role of Certified Registered Nurse Anesthetist as defined in Arkansas Code Annotated, Section 17-86-302.

C. Pronouns indicating gender refer to persons of both sexes.

SECTION I DEFINITIONS

For the purpose of this chapter, the following definitions apply:

A. BOARD- the Arkansas State Board of Nursing.

B. CERTIFIED REGISTERED NURSE ANESTHETIST- a nurse with current licensure as a registered nurse in the State of Arkansas, who is prepared for advanced nursing practice by appropriate education and clinical experience, and who holds a current license as a certified registered nurse anesthetist in the State of Arkansas.

C. C.R.N.A.- Certified Registered Nurse Anesthetist.

D. COLLABORATION- a process in which the certified registered nurse anesthetist, practicing in an expanded role, and the physician or dentist work together with each contributing his area of expertise.

E. GUIDELINES- written documentation outlining the steps to be followed by a nurse practicing in the expanded role for handling a particular medical situation or resolving a medical problem.

F. INSTITUTION- any place where a C.R.N.A. is practicing.

SECTION II SCOPE OF PRACTICE

A. NURSE ANESTHETIST

A certified registered nurse anesthetist shall be authorized to administer anesthesia under the overall direction of a licensed physician or dentist.

B. SERVICES AND RESPONSIBILITIES

The extent of services, responsibilities and required supervision of the nurse anesthetist and the accompanying responsibilities of attending physicians or dentists must be defined by each institution in a policy statement, job description, protocol or other appropriate document.

C. DELEGATED DUTIES

A certified registered nurse anesthetist may perform procedures which include, but are not limited to:

1. Immediate preoperative evaluation of the patient.

2. Selection of anesthetic agents and techniques after appropriate consultation if necessary.

3. Induction and maintenance of anesthesia.

4. Management of pain relief.

5. Support of life functions during the induction and the period of anesthesia, including endotracheal intubation, monitoring and replacement of blood and electrolytes, and maintenance of cardiovascular and respiratory functions.

6. Recognition of abnormal patient responses to anesthesia or to any adjunctive medication or other form of therapy and taking corrective action, including requesting consultation when necessary.

7. Observation and resuscitative care, including consultation when appropriate, during the immediate postoperative period.

8. Other additional acts which the physician or dentist and the CRNA agree are within her abilities and appropriate to her specialty.

SECTION III GUIDELINES FOR COLLABORATION

A. COLLABORATION WITH A LICENSED PHYSICIAN OR DENTIST

The nurse practicing in the expanded role of CRNA shall function in collaboration with physicians or dentists in accordance with the Arkansas Nurse Practice Act and these regulations.

B. GUIDELINES

The CRNA shall practice in accordance with written guidelines developed in collaboration with a licensed physician or dentist, or the appropriate medical staff of the institution employing the CRNA, and in compliance with the statutes of the State of Arkansas. These guidelines shall include:

1. Established procedures for the handling of common medical problems in the practice setting and specialty area of the CRNA.

2. The scope of practice as defined in these regulations for the CRNA's specialty area.

3. The degree to which supervision, collaboration, and independent action is required of the CRNA, including when such actions involve medical determination to administer a particular treatment to a patient.

4. Performance by the CRNA of acts including, but not limited to evaluation, diagnosis and treatment.

These guidelines shall be reviewed jointly at least annually, and revised when necessary.

SECTION IV LICENSURE

A. REQUIREMENTS FOR LICENSURE

Documents required to support the application for a license to practice as a C.R.N.A. shall consist of the following:

1. Proof of current licensure as a registered nurse in Arkansas.

2. Documentation of satisfactory completion of a formal educational program beyond generic nursing preparation which meets the standards of the Council of Accreditation of Nurse Anesthesia Educational Programs or other nationally recognized accrediting body which has as its objective preparation of nurses to perform as nurse anesthetists.

3. Documentation of current certification from the Council on Certification of Nurse Anesthetists, or current recertification from the Council on Recertification of Nurse Anesthetists or other nationally recognized certifying body.

B. TEMPORARY PERMIT

1. Requirements for a temporary permit to practice as a CRNA shall consist of the following:

a. Current licensure as a registered nurse in Arkansas.

b. Documentation of satisfactory completion of a certified registered nurse anesthesia program which meets the standards of the Council of Accreditation of Nurse Anesthesia Educational Programs or other nationally recognized accrediting body.

c. Documentation that applicant has applied for or is awaiting results of the required examination for certification.

d. Determination by the Board that applicant is otherwise qualified.

2. The permit to practice as a CRNA shall become invalid upon notification to the applicant of the results of the initial certifying examination.

C. USE OF NOMENCLATURE

No other person shall practice or advertise as a nurse authorized to practice in the expanded role of CRNA or use any other words, letters, signs or figures to indicate that the person using same has been granted the right to practice as a CRNA.

D. REVOCATION, SUSPENSION OR REFUSAL TO LICENSE

1. The Board may revoke, suspend, refuse to license or renew the license of any CRNA if the Board finds evidence that the person fails to meet the requirements as stated herein.

2. The Board may refuse to issue a license, certificate or registration to any applicant if the license, certificate or registration of such person has been revoked or suspended or placed on probation and not reinstated by the jurisdiction which took such action.

SECTION V BOARD REVIEW PROCEDURES

A. The Board may review the guidelines governing the practice of any CRNA upon request.

B. In the event a nurse or nurse anesthetist is brought before the Board for a hearing directly related to the practice of anesthesia, the Arkansas Association of Nurse Anesthetists shall be notified.

(2/28/1994)

The following state regulations pages link to this page.