234 CMR 6.09 - Facility Permit D-P: Requirements for the Use and Provision of Portable and/or Mobile Anesthesia Services
(1) A qualified dentist anesthesiologist who
travels to dental facilities or practice sites for the purpose of delivering
anesthesia services or sedation services at the site must hold a Mobile
Facility D-P Permit for the use of portable and/or mobile anesthesia equipment,
supplies and personnel.
(2)
Application. Each applicant shall submit an accurate
and complete application on form(s) provided by the Board and accompanied by
the permit fee to be determined annually by the Executive Office of
Administration and Finance. The application shall, at a minimum, include the
following:
(a) Applicant name and
Massachusetts dental license number, and copy of current Individual Anesthesia
Permit number or copy of a permit application pending approval by the
Board;
(b) Name(s) of dental
establishment(s), owner(s) of said establishment(s), and address(es) of the
site(s) where mobile or portable anesthesia will be administered;
(c) Documentation of provision and
maintenance of equipment, materials, and drugs required for the administration
of the type of anesthesia to be administered;
(d) Request for an on-site inspection by the
Board of the applicant's equipment, supplies, anesthesia administration
protocols, and site(s) where anesthesia will be administered;
(e) Names and qualifications of staff who
will assist the applicant in the administration of anesthesia;
(f) Copies of the following:
1. Proof of current ACLS (BLS for
auxiliaries) certification for the applicant and other dental professionals, as
applicable for the type of anesthesia or sedation to be administered by the
applicant;
2. Medical history form
to be utilized by the applicant;
3.
Anesthesia chart;
4. Schedule of
drug and equipment checks;
5.
Written protocol for management of emergencies;
6. Schedule of emergency drills;
and
7. List of drugs and equipment
that the applicant will provide at each site.
(g) Other information as may be requested by
the Board.
(3) The
holder of a Facility Permit D-P shall comply with requirements of
234 CMR 6.00 pertaining to the
category of anesthesia/sedation to be administered including:
(a) Equipment and drugs;
(b) Auxiliary personnel;
(c) Patient evaluation;
(d) Pre-operative preparation;
(e) Patient monitoring and
documentation;
(f) Management of
recovery and discharge of patients;
(g) Management of pediatric and special needs
patients; and
(h) Emergency
management.
(4) The
holder of a Facility Permit D-P shall:
(a)
Comply with requirements of the Board pursuant to
234
CMR 5.05 and the reporting of adverse
occurrences, pursuant to
234 CMR
6.17;
(b) Employ and provide immediate supervision
of at least one dental or clinical auxiliary who is trained and qualified to
assist in anesthesia administration and who is fully familiar with the
procedures and protocols of the permit holder at each site where anesthesia is
being administered by said permit holder;
(c) Schedule and perform maintenance checks
of all equipment conducted by a certified equipment vendor at least once per
year, and retain maintenance records for a minimum of three years;
(d) Conduct annual emergency drills for all
staff involved in the administration of anesthesia, and retain records that
describe the dates of the training activities, content of the training, and the
attendance roster for a minimum of three years; and
(e) Place a copy of the anesthesia chart in
the patient's dental record at the site where the anesthesia was
administered.
(5) The
Facility Permit D-P, or a copy thereof, shall be prominently displayed in the
facility by the qualified dental anesthesiologist whenever and wherever he/she
is providing anesthesia services.
(6) The operating dentist shall be
responsible for verifying that the qualified dental anesthesiologist has the
proper anesthesia permit and that the portable anesthesia service is
appropriately permitted for the level of pain control and/or sedation to be
provided.
(7) The qualified dental
anesthesiologist shall be responsible for verifying that the operating dentist
and his/her clinical staff maintain current certification in ACLS or BLS for
Healthcare Providers, as applicable given the type of anesthesia being
administered.
(8) There shall be a
written and signed agreement between the Facility Permit D-P applicant and the
operating dentist for each site where anesthesia is to be administered by the
Facility Permit D-P holder which, at a minimum describes how emergency response
training and protocols will be developed and practiced, procedures for
verifying qualifications of personnel who assist in the care and monitoring of
the patient, responsibilities for pre- and post- operative patient assessment
and monitoring, responsibilities for obtaining informed consent, and how
compliance with applicable board statutes and regulations will be achieved and
maintained at the site.
Notes
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No prior version found.