NURSE ANESTHETIST: SCOPE OF PRACTICE S.B. 320:
SUMMARY OF INTRODUCED BILL
IN COMMITTEE
Senate Bill 320 (as introduced 5-7-15)
CONTENT
The bill would amend the Public Health Code to include in the scope of practice of a certified nurse anesthetist specific anesthesia and analgesia services, including the development and implementation of a plan of care; the prescription of drugs, including controlled substances; and chronic pain management services, under delegation by a physician.
Under the Code, the Michigan Board of Nursing may issue a specialty certification to a registered professional nurse (R.N.) who has advanced training beyond that required for initial licensure and who has demonstrated competency through examination or other evaluative processes and who practices in one of several health profession specialty fields, including the field of nurse anesthetist.
The bill provides that, in addition to performing duties within the scope of practice of nursing,
an R.N. holding a specialty certification as a nurse anesthetist could provide any of the following anesthesia and analgesia services:
-- Developing a plan of care.
-- Performing all patient assessments, procedures, and monitoring to implement the plan of care or to address patient emergencies that arise during the implementation of the plan.
-- Selecting, ordering, or prescribing and administering anesthesia and analgesic agents, including pharmacological agents that are prescription drugs or controlled substances.
The anesthesia and analgesia services could be performed in a licensed health facility or agency or other medical setting. They could be performed for operative, obstetrical, interventional, or diagnostic purposes, but only during the pre-, intra-, and post-operative obstetrical, interventional, or diagnostic service period.
The anesthesia and analgesia services that a nurse anesthetist could provide would not include chronic pain management services, but a nurse anesthetist could perform chronic pain management services under delegation by a physician, as prescribed in the Code.
The bill would extend the Code's definition of "prescriber" to include an R.N. who holds a specialty certification as a nurse anesthetist, when engaged in the practice of nursing and providing anesthesia and analgesia services.
The bill would take effect 90 days after it was enacted.
MCL 333.17210 & 333.17708 Legislative Analyst: Julie Cassidy
FISCAL IMPACT
The bill would have a minor, but likely negative fiscal impact on the Bureau of Health Care Services (BHCS) within the Department of Licensing and Regulatory Affairs, and no fiscal impact on local units of government. The bill would expand the scope of practice of nurse anesthetists, which would have no operational impact on the BHCS from the perspective of licensing the profession. However, expanding the scope of practice for nurse anesthetists, could increase the number of complaints received by the BHCS, which would create additional costs for the Bureau related to the investigation of those complaints. It is unknown how many additional complaints could result from the changes in the bill, but any additional costs would likely be minor, and would be borne by existing resources.
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.