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.
