UNM SRMC NURSE ANESTHETIST (CRNA) SCOPE OF PRACTICE.

Transcription

1 Initial privileges (initial appintment) Renewal f privileges (reappintment) Expansin f privileges (mdificatin) INSTRUCTIONS All new applicants must meet the fllwing requirements as apprved by the UNM SRMC Bard f Directrs effective: 03/21/2012 Applicant: Check ff the "Requested" bx fr each privilege requested Applicants have the burden f prducing infrmatin deemed adequate by the hspital fr a prper evaluatin f current cmpetence, current clinical activity, and ther qualificatins, and fr reslving any dubts related t qualificatins fr requested privileges Clinical Service Chief: Check the apprpriate bx fr recmmendatin n the last page f this frm If recmmended with cnditins r nt recmmended, prvide cnditin r explanatin n the last page f this frm Plicies Gverning Scpe f Practice Categries f Patients Practitiner May Treat Thse assigned in accrdance with the scheduling rster fr anesthesia cverage Directin The CRNA functins under the medical directin f an anesthesilgist in prviding anesthesia services fr a specific patient Medical Recrd Charting Respnsibilities Clearly, legibly, cmpletely, and in timely fashin describe each service, prcedure, test, functin, etc, the CRNA perfrms and findings as apprpriate within authrized clinical privileges Standard rules regarding authenticatin f, necessary cntent f, and required time frames fr preparing and cmpleting the medical recrd and prtins theref are applicable t all entries made General Relatinship t Others The CRNA may have authrity t direct any hspital persnnel in the prvisin f clinical services t patients t the extent that such directin is necessary in rder t carry ut the services required by the patient and which the CRNA is authrized t prvide Peridic Cmpetence Assessment Practice Area Cde: SRMC-CRNA Versin Cde: a Page: 1

2 Applicants must als be able t demnstrate they have maintained cmpetence based n unbiased, bjective results f care accrding t the hspital s existing quality assurance mechanisms, by shwing evidence that they have prvided anesthesia services fr at least 700 patients in the past 24 mnths and by shwing evidence that they have met the cntinued cmpetence requirements established by the state licensing authrity, applicable t the functins fr which they are seeking t prvide at this Hspital In additin, cntinuing educatin related t the specialty area f practice is required as mandated by licensure Qualificatin s fr Nurse Anesthetist (CRNA) T be eligible t apply fr specified services as a Nurse Anesthetist (CRNA), the applicant must meet the fllwing criteria: Current demnstrated cmpetence and an adequate level f current experience dcumenting the ability t prvide services at an acceptable level f quality and efficiency Graduatin frm an apprved prgram f anesthesia accredited by the Cuncil n Accreditatin f Nurse Anesthesia Educatinal Prgrams r a predecessr r successr agency Certificatin by the Cuncil n Certificatin f Nurse Anesthetists r re-certificatin by the Cuncil n Re-certificatin, r by a predecessr r successr agency t either, r be actively seeking initial certificatin and btain the same n the first examinatin fr which eligible Current active licensure t practice prfessinal nursing in the State f New Mexic Certificatin in the State f New Mexic as an advanced nurse practitiner in the nurse anesthetists categry Prfessinal liability insurance cverage issued by a recgnized cmpany and f a type Practice Area Cde: SRMC-CRNA Versin Cde: a Page: 2

3 and in an amunt equal t r greater than the limits established by the Gverning Bard, (if applicable t the facility) All practice is perfrmed under the directin f the designated physician(s) and in accrdance with written plicies and prtcls develped and apprved by the relevant clinical department r service, the Medical Executive Cmmittee, Nursing Administratin, and the Gverning Bard Required Previus Experience: The applicant must be able t demnstrate that he r she has prvided anesthesia services fr at least 350 patients during the past 12 mnths Current ACLS certificatin CRNA Cre Privileges Requested Limited Ultrasund fr Guided Prcedure Check here t request Limited Ultrasund Guided Prcedure privileges frm (Separate frm) Practice Area Cde: SRMC-CRNA Versin Cde: a Page: 3

4 CORE PROCEDURES LIST This list is a sampling f prcedures included in the cre It is nt intended t be an all-encmpassing list, but rather is reflective f the categries/types f prcedures included in the cre T the applicant: If yu wish t exclude any prcedures, please strike thrugh thse yu d nt wish t request, then initial and date Under the medical directin f an anesthesilgist pssessing the necessary privileges, the Nurse Anesthetist may: 1 Administer general anesthesia, including preperative evaluatin, administratin f hypntic medicatins, all aspects f airway and hemdynamic management, medical management/mnitring f the patient during the prcedure fr which general anesthesia is required, emergence and indicated pstperative care 2 Perfrm and manage neuraxial anesthesia (spinal r epidural), including the administratin and management f neuraxial narctics and pst-perative lcal anesthetic infusins 3 Perfrm peripheral neural blckade fr either primary anesthesia r pst-perative pain relief, including peri-neural catheter placement, the use f nerve stimulatin and/r ultrasund-guided techniques 4 Manage f all levels f sedatin, including mnitred anesthesia care 5 Insert f peripheral venus lines 6 Insert f arterial lines 7 Insert f central venus lines, including pulmnary artery catheters 8 Perfrm cardipulmnary resuscitatin 9 Perfrm tracheal intubatin, including laryngscpy, fiberptic brnchscpy, videassisted laryngscpy, retrgrade tracheal intubatin, laryngeal mask airway assisted intubatin, and in emergency situatins crichthyrtmy r cmbitube placement 10 Administer tpical anesthesia fr awake intubatin, including transtracheal injectin 11 Manage pstperative pain cntrl, including narctic and PCA management 12 Place f epidural bld patch fr pst-dural puncture headache 13 Perfrm life-saving prcedures in emergent situatins defined as any situatin where delay in treatment wuld, in the judgment f the treating physician, result in significant harm r death t the patient and n better-qualified physician is available Acknwledgment f Practitiner Practice Area Cde: SRMC-CRNA Versin Cde: a Page: 4

5 I have requested nly thse privileges fr which by educatin, training, current experience, and demnstrated perfrmance I am qualified t perfrm and fr which I wish t exercise at UNM SRMC, and I understand that: a In exercising any clinical privileges granted, I am cnstrained by hspital and medical staff plicies and rules applicable generally and any applicable t the particular situatin b Any restrictin n the clinical privileges granted t me is waived in an emergency situatin, and in such situatin my actins are gverned by the applicable sectin f the medical staff bylaws r related dcuments Signed Date Clinical Service Chief's Recmmendatin I have reviewed the requested clinical privileges and supprting dcumentatin fr the abve-named applicant and make the fllwing recmmendatin(s): Recmmend all requested privileges Recmmend privileges with the fllwing cnditins/mdificatins: D nt recmmend the fllwing requested privileges: PrivilegeCnditin/Mdificatin/Explanatin Ntes: Print NameSignature Date Clinical Service Chief r Designee Signature Practice Area Cde: SRMC-CRNA Versin Cde: a Page: 5