A2513

An Act concerning nurse anesthetists and supplementing Titles 26 and 45 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. a. The administration and monitoring of general or regional anesthesia in a hospital or ambulatory surgery facility licensed pursuant to Title 26 of the Revised Statutes shall be performed by:

(1) an anesthesiologist; or

(2) a certified registered nurse anesthetist, registered nurse anesthetist, or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital to administer or supervise the administration of anesthesia services, who in either case shall be immediately available during the surgery.

b. The administration and monitoring of conscious sedation in a hospital or ambulatory surgery facility licensed pursuant to Title 26 of the Revised Statutes shall be performed by:

(1) an anesthesiologist;

(2) a physician who is privileged by a licensed hospital;

(3) a certified registered nurse anesthetist, registered nurse anesthetist, or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital to administer or supervise the administration of anesthesia services, who in either case shall be immediately available during the surgery; or

(4) a registered professional nurse, for the purpose of administering supplemental doses only.

2. a. The administration and monitoring of general or regional anesthesia at a physician's office shall be performed by:

(1) an anesthesiologist; or

(2) a certified registered nurse anesthetist, or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital or the State Board of Medical Examiners to administer or supervise the administration of anesthesia services, who in either case shall be physically present during the surgery.

b. The administration and monitoring of conscious sedation at a physician's office shall be performed by:

(1) a physician who is privileged by a licensed hospital or the State Board of Medical Examiners to provide conscious sedation;

(2) a certified registered nurse anesthetist, or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of a physician as described in paragraph (1) of this subsection who shall be physically present during the surgery; or

(3) a registered professional nurse or physician assistant who is trained and has experience in the use and monitoring of anesthetic agents, at the specific direction of a physician as described in paragraph (1) of this subsection who shall be physically present during the surgery.

3. This act shall take effect immediately.

STATEMENT

This bill delineates who is qualified to provide anesthesia services in hospitals, ambulatory surgical facilities and physician's offices, and under what conditions. The bill mandates that nurse anesthetists and advanced practice nurses, when providing anesthesia services, shall be supervised by anesthesiologists or other appropriately trained and credentialed physicians who are immediately available or physically present during surgery, as applicable.

The bill provides specifically as follows:

C The administration and monitoring of general or regional anesthesia in a hospital or ambulatory surgery facility licensed by the Department of Health and Senior Services (DHSS) is to be performed by:

-- an anesthesiologist; or

-- a certified registered nurse anesthetist (CRNA), registered nurse anesthetist (RNA), or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital to administer or supervise the administration of anesthesia services, who in either case is required to be immediately available during the surgery.

C The administration and monitoring of conscious sedation in a licensed hospital or ambulatory surgery facility is to be performed by:

-- an anesthesiologist;

-- a physician who is privileged by a licensed hospital;

-- a CRNA, RNA, or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital to administer or supervise the administration of anesthesia services, who in either case is required to be immediately available during the surgery; or

-- a registered professional nurse, for the purpose of administering supplemental doses only.

C The administration and monitoring of general or regional anesthesia at a physician's office is to be performed by:

-- an anesthesiologist; or

-- a CRNA or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of an anesthesiologist or a physician who is privileged by a licensed hospital or the State Board of Medical Examiners (BME) to administer or supervise the administration of anesthesia services, who in either case is required to be physically present during the surgery.

C The administration and monitoring of conscious sedation at a physician's office is to be performed by:

-- a physician who is privileged by a licensed hospital or BME to provide conscious sedation;

-- a CRNA or an advanced practice nurse certified by the New Jersey Board of Nursing in the area of anesthesia, under the supervision of a physician as described in the bill who is required to be physically present during the surgery; or

-- a registered professional nurse or physician’s assistant who is trained and has experience in the use and monitoring of anesthetic agents, at the specific direction of a physician as described in the bill who is required to be physically present during the surgery.