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ARIZONA HOUSE OF REPRESENTATIVESFifty-seventh Legislature First Regular Session |
House: HHS DPA 9-3-0-0 |
HB 2132: hospitals; outpatient surgical centers; nurses
Sponsor: Representative Bliss, LD 1
Caucus & COW
Overview
Requires, by January 1, 2026, each outpatient surgical center and hospital to adopt and implement policies that require a registered nurse (RN) to be a circulator who is physically present in an operating room for the duration of each surgical procedure. Directs the Arizona Department of Health Services (DHS) to ensure compliance with these policies during any onsite inspection and in response to any received complaints.
History
DHS is allowed to: 1) make or cause to be made inspections consistent with standard medical practice of every part of the premises of health care institutions; 2) make studies and investigations of conditions and problems in health care institutions or any class or subclass thereof; and 3) develop manuals and guides relating to any of the several aspects of physical facilities and operations of health care institutions or any class or subclass thereof for distribution to the governing authorities of health care institutions and to the general public (A.R.S § 36-406).
Statute requires the governing body of each licensed hospital or outpatient surgical center to require that physicians admitted to practice in the hospital or center to organize into committees or other organizational structures to review professional practices within the hospital or center for the purposes of reducing morbidity, mortality and the improvement of patient care provided in the institution. The review must include the nature, quality and necessity of the care provided and the preventability of complications and deaths occurring in the hospital or center. Such review need not identify the patient or doctor by name but may use a case number or some other such designation (A.R.S. § 36-445).
DHS rules requires an administrator for outpatient surgical centers to appoint a RN as the Director of Nursing who: 1) is responsible for the management of the outpatient surgical center's nursing services; 2) ensures that policies and procedures are established, documented and implemented for nursing services provided in the outpatient surgical center; 3) ensures that the outpatient surgical center is staffed with sufficient nursing personnel, based on the number of patients, the health care needs of the patients and the outpatient surgical center's scope of services; 4) participates in quality management activities; 5) designates an RN, in writing, to manage an outpatient surgical center’s nursing services when the Director of Nursing is not present on the outpatient surgical center's premises; 6) ensures that a nurse who is not directly assisting the surgeon is responsible for the functioning of an operating room while a surgical procedure is being performed; 7) ensures that an RN is present in the recovery room when a patient is present in the recovery room; 8) ensures that an RN is present in the outpatient surgical center until all patients are discharged; and 9) ensures that a nurse documents in a patient’s medical record that the patient or the patient’s representative has received written discharge instructions (A.A.C R9-10-912).
Provisions
1. Requires, by January 1, 2026, each outpatient surgical center and hospital to adopt and implement policies requiring an RN to be a circulator who is physically present in an operating room for the duration of each surgical procedure. (Sec. 1)
2. Requires DHS to ensure compliance with these policies during any onsite inspection and in response to any complaint received. (Sec. 1)
3. Defines circulator as a licensed RN who is educated and trained in perioperative nursing to both:
a) coordinate the nursing care and safety needs of the patient in the operating room; and
b) support the surgical team, as appropriate, during surgery. (Sec. 1)
Amendments
Committee on Health & Human Services
1. Clarifies that the circulator nurse requirement does not apply if an outpatient center or hospital is required to treat an extraordinary number of emergency patients who require surgery due to a unique or mass casualty event.
2. Defines extraordinary to mean such a high number of patients require care due to a unique casualty event that, in order to save a life, it is not feasible to have one RN per patient.
3. Makes technical and conforming changes.
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HB 2132
Initials AG/AB Page 0 Caucus & COW
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