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The Oregon Administrative Rules contain OARs filed through March 15, 2017
 
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OREGON STATE BOARD OF NURSING

 

DIVISION 52

CERTIFIED REGISTERED NURSE ANESTHETISTS

851-052-0000

Definitions

(1) “Analgesia” means a neurologic or pharmacologic state in which painful stimuli are moderated such that, although still perceived, they are no longer painful.

(2) “Anesthesia” means a drug-induced state that causes insensitivity to pain and often loss of consciousness, especially as artificially induced by the administration of gases or the injection of drugs. The client’s ability to independently maintain ventilator function is often impaired and may require assistance in maintaining patent airway. Cardiovascular function may also be impaired.

(3) “Anesthesia care” means the CRNA’s independent or collaborative performance of any act involving the treatment of a client presenting for a procedure including, but not limited to, sole or concurrent use of sedation, analgesia or anesthesia.

(4) “Anesthesia plan” means a plan of intervention by a CRNA for services and anesthesia care within the CRNA scope of practice.

(5) “Approved accrediting body” means a national organization deemed by the U.S. Department of Education to accredit nurse anesthesia programs.

(6) “Approved certifying body” means a national organization which engages in certification or recertification of nurse anesthetists and is recognized by the Board for purpose of validating such certification.

(7) “Certified registered nurse anesthetist” or “(CRNA)” means an Advanced Practice Registered Nurse licensed by the Board as a CRNA to practice in an expanded specialty role within the practice of nursing. The title, CRNA, shall not be used unless the Board licenses the individual as such.

(8) “Client” means an individual, family, or group who is receiving anesthesia care from a CRNA.

(9) “Collaboration” means a process involving two or more parties working together, each responsible for his or her own particular area of expertise.

(10) “Competence” means demonstrating specified levels of knowledge, technical skill, ethical principle and clinical reason relevant to the practice role, prevailing standards, and client safety. This occurs at the entry into practice and throughout one’s career.

(11) “Consultation” means communication with another health care provider for the purpose of exchanging information or advice to provide client care.

(12) “Diagnosis” means identification of actual or potential health problems or the need for intervention based on analysis of data collected.

(13) “Non-Oregon Based Graduate Program” means an academic program, not located in Oregon, recognized by the United States Department of Education or the Council of Higher Education Accreditation that offers a graduate degree to students in preparation for becoming an Advanced Practice Registered Nurse.

(14) “Other medical services” means the services conventionally recognized and agreed to be part of the practice of anesthesia.

(15) “Sedation” means a drug-induced state that may cause a depression of consciousness along a continuum that may include the client’s inability to adequately maintain ventilation.

Stat. Auth.: ORS 678.245 & 678.285
Stats. Implemented: ORS 678.245 & 678.285
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0010

Scope and Practice Standards

(1) Advanced practice nursing by the CRNA shall consist of a combination of knowledge and skills acquired in basic and advanced nursing foundational education that includes expertise in sedation, analgesia, and anesthesia management of clients.

(2) The CRNA is responsible for professional maintenance of practice that includes performing anesthesia care consistent with educational, experiential and continued competence.

(3) Scope of practice involves client populations of individual or family health across the lifespan in diverse settings. The client’s health status may range from healthy through all recognized levels of acuity, including immediate, severe or life-threatening illnesses or injuries.

(4) The role of the CRNA will continue to expand in response to societal demand and new knowledge gained through research, education, and expertise.

(5) The CRNA has the professional responsibility for initiating consultation, collaboration, referral or a transfer of client care when deemed prudent.

(6) Scope of practice includes advanced assessment, diagnosis and administration of anesthesia care, including, but not limited to:

(a) Determining the readiness, preparation and evaluation for a client undergoing a procedure;

(b) Formulating an anesthesia plan for the client;

(c) Establishing a client record;

(d) Implementing and adjusting the client’s anesthesia plan based on physiologic status;

(e) Using advanced monitoring or other diagnostic technology to support physiologic status:

(f) Providing necessary or routine post-anesthesia care to facilitate emergence, recovery and discharge from anesthesia care area or facility;

(g) Performing analgesia, sedative or anesthetic management for a client requiring relief of acute or chronic pain;

(h) Utilizing ultrasound, fluoroscopy and other technologies in accordance with other applicable rules and regulations for diagnosis, care delivery or improvement of client safety or comfort; and

(i) Consulting for or engaging in other medical services (ORS 678.245(8)).

(7) The CRNA’s authority of pharmacologic management in connection with the delivery of anesthesia care includes:

(a) The ability to select, order and administer to clients controlled and non-controlled drugs;

(b) Optional prescriptive authority as outlined in ORS 678.281(1-3) with application to Board complete with practice requirements; and

(c) Practice with adherence to standards for authority to prescribe as applicable and as outlined in 851-056-0012 and 851-056-0016.

Stat. Auth.: ORS 678.285
Stats. Implemented: ORS 678.255, 678.265, 678.275 & 678.285
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0020

Licensure

(1) An applicant for initial licensure as a CRNA shall:

(a) Submit to the Board the required fee(s) as specified in 851-002-0030;

(b) Provide verification of unencumbered licensure or eligibility for unencumbered licensure as a Registered Nurse in Oregon;

(c) Submit a completed application for CRNA licensure; and

(d) Provide primary source verification of CRNA certification or recertification from an approved certifying body.

(2) A minimum of a Master’s degree is required from an accredited CRNA educational program if education commenced after December 31, 2000.

(3) Revocation, suspension, or any other encumbrance of a Registered Nurse license, or any special authority to practice anesthesia care, in another state, territory of the United States, or any foreign jurisdiction may be grounds for denial of CRNA licensure in Oregon.

(4) The Board retains the authority to conduct a random audit of a CRNA applicant or CRNA licensee to verify current certification, education or continuing education. Upon request of the Board, licensee shall submit documentation of compliance.

Stat. Auth.: ORS 678.285
Stats. Implemented: ORS 678.285
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 7-2013, f. 5-6-13, cert. ef. 6-1-13; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0030

License Renewal, Reactivation, or Re-entry

(1) An applicant for renewal or reactivation of the CRNA license shall:

(a) Submit to the Board the following:

(A) Required fee(s) as specified in 851-002-0030 and

(B) Completed renewal or reactivation application;

(b) Provide primary source verification of CRNA certification or recertification from an approved certifying body; and

(c) Hold an active Oregon Registered Nurse license.

(2) An applicant for CRNA re-entry limited license must:

(a) Hold an active unencumbered Oregon Registered Nurse license;

(b) Complete a limited CRNA license application for re-entry; and

(c) Provide evidence of acceptance into a CRNA re-entry program approved by the Board by;

(A) Completion of the re-entry program is required within 12 calendar months; or

(B) Explanation of need for a one-time only 12 month extension of the limited CRNA license upon Board approval.

(3) The Board retains the authority to conduct a random audit of a CRNA applicant or CRNA licensee to verify current certification, education or continuing education. Upon request of the Board, licensee shall submit documentation of compliance.

Stat. Auth.: ORS 678.285
Stats. Implemented: ORS 678.285
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 5-2005, f. & cert. ef. 6-30-05; BN 7-2013, f. 5-6-13, cert. ef. 6-1-13; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0040

Clinical Practicum in Oregon for Student Nurse Anesthetist or CRNA Enrolled in a Non-Oregon Based Graduate Program

(1) A student enrolled in a Non-Oregon Based Graduate Program must meet the following criteria:

(a) Hold a current, unencumbered Registered Nurse license in Oregon;

(b) Practice with a preceptor who holds a current, unencumbered professional license in

Oregon that meets educational standards and requirements recognized by the accrediting body; and

(c) Be enrolled in a program that is accredited by an approved accrediting body and recognized by a national nursing organization.

(2) A licensed CRNA enrolled in a Non-Oregon Based Graduate Program for purposes of obtaining a different type of APRN license that requires a clinical practicum must meet the above criteria in (1)(a-c).

Stat. Auth.: ORS 678.285
Stats. Implemented: ORS 678.285
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 7-2012, f. 5-7-12, cert. ef. 6-1-12; BN 15-2012(temp), f. & cert. ef. 11-15-12 thru 5-1-13; BN 4-2013, f. 2-28-13, cert. ef. 4-1-13; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0050

Oregon-based Nurse Anesthesia Educational Programs

(1) The Board retains the authority to approve Oregon Based Nurse Anesthesia Programs and such approval may be based upon the approved accrediting body report.

(2) Any institution or consortium of accredited institutions that has established or wishes to establish a nurse anesthesia program in Oregon must comply with all requirements for full accreditation by an approved accrediting body.

(3) The OSBN may require additional standards above and beyond those required by the approved accrediting body.

(4) The OSBN has the authority to survey any complaint involving an Oregon-based nurse anesthesia program, in addition to, but not necessarily in lieu of, the accrediting body, especially when those instances may impact public safety.

(5) Complaints made to the OSBN regarding a program shall be communicated to the approved accrediting body.

Stat. Auth.: ORS 678.150 & 678.285
Stats. Implemented: 678.285
Hist.: BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0060

Office-based Care Standards

The CRNA shall comply with all applicable state and federal rules and regulations relating to the office-based practice where anesthesia care is being performed and has the responsibility to:

(1) Consider, evaluate and document client selection criteria determined by the type of procedure an individual client needs;

(2) Verify anesthesia-related monitors and equipment are maintained to current health care standards, including providing a backup electrical source;

(3) Ensure that there are adequate numbers of personnel to support the planned procedure;

(4) Adhere to professional standards of care for monitoring patient during procedure;

(5) Appropriately plan for treatment of possible complications, including;

(a) Emergency supplies to be immediately available including emergency drugs, airway management supplies, and cardio-pulmonary resuscitation equipment;

(b) Appropriate policies and procedures;

(c) Agreements for transportation of client to a higher level of care in the case of an emergency; and

(6) Coordinate recovery and discharge of clients from office and provide instructions for follow-up care if necessary.

Stat. Auth.: ORS 678.285
Stats. Implemented: ORS 678.278
Hist.: BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

851-052-0100

Disciplinary Action on CRNA License

The Board may deny, suspend, enforce disciplinary action on or revoke the license of a CRNA for:

(1) The causes identified in ORS 678.111(1)(a-j);

(2) Conduct derogatory to the nurse standard of practice as identified in 851-045-0070;

(3) Conduct derogatory to prescribing authority as identified in 851-056-0016; or

(4) Failure to practice within defined scope and by prevailing standards related to Registered Nurse and CRNA practice.

Stat. Auth.: ORS 678.111 & 678.150
Stats. Implemented: ORS 678.111
Hist.: BN 9-1998, f. 7-16-98, cert. ef. 9-1-98; BN 2-2017, f. 2-23-17, cert. ef. 3-1-17

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