May 21, 2009, Introduced by Senators KAHN, GEORGE and BIRKHOLZ and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by adding section 20135.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 20135. (1) A freestanding surgical outpatient facility or
hospital licensed under this article that performs surgical
procedures under general anesthesia or deep sedation in an
operating room of the facility or hospital shall do all of the
following:
(a) Develop and maintain effective policies and procedures
regarding surgical privileges, maintenance of the operating rooms,
and evaluation of the surgical patient.
(b) Meet the requirements of the conditions of participation
established under 42 CFR 482.51 as they apply to registered
professional nurses performing circulating duties in the operating
room and as provided in the interpretive guidelines published by
the United States department of health and human services.
(2) The freestanding surgical outpatient facility or hospital
described in subsection (1) may assign a qualified registered
professional nurse to be present in the operating room for the
duration of each surgical procedure. This subsection does not
prevent a qualified registered professional nurse who is performing
circulating duties from leaving the operating room as part of the
surgical procedure, leaving the operating room for short periods,
or, under employee rules or regulations, being relieved during a
surgical procedure by another qualified registered professional
nurse who is assigned to continue performing circulating duties for
that surgical procedure.
(3) A licensed practical nurse or a surgical technologist may
perform scrub nurse duties under the supervision of the qualified
registered professional nurse who is performing circulating duties
in the operating room. If the qualified registered professional
nurse who is performing circulating duties is immediately available
to respond to emergencies, a licensed practical nurse or a surgical
technologist may assist by performing circulating duties under the
supervision of that qualified registered professional nurse.
(4) As used in this section:
(a) "Deep sedation" means a drug-induced depression of
consciousness during which a patient is not easily aroused but may
respond to purposefully repeated or painful stimulation, a
patient's cardiovascular function is usually maintained, and where
1 or more of the following may occur:
(i) The ability to independently maintain ventilatory function
may be impaired.
(ii) Assistance may be required in maintaining a patent airway.
(iii) Spontaneous ventilation may be inadequate.
(b) "General anesthesia" means a drug-induced loss of
consciousness during which a patient is not arousable, even by
painful stimulation, and where 1 or more of the following may
occur:
(i) The ability to independently maintain ventilatory function
may be impaired.
(ii) Assistance may be required in maintaining a patent airway.
(iii) Cardiovascular function may be impaired.
(iv) Positive pressure ventilation may be required because of
depressed spontaneous ventilation or drug-induced depression of
neuromuscular function.
(c) "Registered professional nurse" means that term as defined
in section 17201.