Utah Admin. Code R432-500-19 - Anesthesiology Services

(1) The licensee shall ensure there are facilities and equipment for the administration of anesthesia services commensurate with the clinical and surgical procedures planned for the facility.

(2) The medical staff shall appoint a medical director of anesthesia services who shall meet the following requirements:

(a) licensure to practice medicine in Utah; and

(b) training and expertise in anesthesia services offered to ensure adequate supervision of patient care.

(3) The medical director of anesthesia services shall implement, coordinate, and ensure the quality of anesthesia services provided in the facility including the implementation of written policies and protocols that clearly define the responsibilities and privileges of qualified anesthetists.

(4) Only qualified anesthetists shall provide anesthesia care.

(5) During the surgical procedure, a qualified anesthetist is responsible for the following:

(a) monitor, by continuous presence in the operating room, except for short periods of time for personal safety, including during radiation exposure, a patient who is undergoing a surgical procedure and who is receiving general anesthetics, regional anesthetics, or monitored anesthesia care; and

(b) continually evaluate a patient's oxygenation, ventilation, and circulation, and have means available to measure temperature during administration of any anesthetics.

(6) The non-physician qualified anesthetists shall provide patient specific anesthesia services upon the request of a licensed professional, as defined in Subsection R432-500-4(9). The licensed professional is responsible to remain involved in each patient's pre-operative assessment and shall ensure that the non-physician anesthetist is providing anesthesia services in a manner that specifically addresses the needs of each individual patient.

(7) The qualified anesthetist shall inform the patient and operating surgeon before surgery of who will be administering anesthesia.

(8) The licensee shall ensure a physician remains immediately available in the facility to respond to medical emergencies when the operating team consists entirely of non-physicians.

(9) The licensee shall ensure written anesthesia service policies include:

(a) anesthesia care policies and procedures for pre-anesthesia evaluation, intraoperative care including documenting a time-based record of events, and post-anesthesia care;

(b) a qualified anesthetist conducts a pre-anesthesia evaluation, and documents the evaluation in the patient's medical record before inducing anesthesia to include:

(i) planned anesthesia choice;

(ii) assessment of anesthesia risk;

(iii) anticipated surgical procedure;

(iv) current medications and previous untoward drug experiences;

(v) previous anesthetic experiences; and

(vi) any unusual potential anesthetic problems.

(10) A qualified anesthetist shall remain with the patient until the patient's status is stable. The qualified anesthetist or the anesthetist's qualified designee shall remain with the patient until the patient's protective reflexes have returned to normal, and it is determined safe as defined in facility policy.

(11) The medical director of anesthesia services shall define the mechanism for the release of patients from post-anesthesia care and a responsible adult shall accompany the discharge of each patient who is admitted to an ambulatory surgical facility, and who receives other than un-supplemented local anesthesia.

(12) Medicaid certified providers shall comply with the 42 CFR 415.110 and 42 CFR 416.42 (December 30, 1999).

(13) The licensee may not use flammable anesthetic agents for anesthesia or for the pre-operative preparation of the surgical field.

(14) The licensee shall ensure anesthetic equipment is inspected and tested by the person administering anesthesia before use in accordance with facility policy.

Notes

Utah Admin. Code R432-500-19

Amended by Utah State Bulletin Number 2023-17, effective 8/10/2023