Utah Board of Nursing Review – May 9, 2017
Reviewed by Sedation Certification – Jan. 10, 2019
State policy – Yes
Can RN’s give anesthetics for sedation? – No
Can RN’s give anesthetics for intubated/ventilated patients? – Yes
The effective date of the law listed below is May 9, 2017.
http://le.utah.gov/~2017/bills/hbillint/HB0142.htm
LONG TITLE
General Description:
This bill amends professional licensing acts in the Division of Occupational and
Professional Licensing Act to require increased monitoring, in certain circumstances,
of patients who are sedated.
Highlighted Provisions:
This bill:
1. requires the Division of Occupational and Professional Licensing to:
a. create a database of adverse events from the administration of sedation or
general anesthesia in outpatient settings; and
b. publish a report regarding the number of adverse events by types of provider and
Facility;
1. defines terms;
a. prohibits certain health care providers from administering sedation or general
anesthesia and performing therapeutic or diagnostic procedures on a patient without another qualified health care provider present to monitor the patient’s anesthesia care
b. prohibits a nurse, who is not a certified registered nurse anesthetist, from administering deep sedation or general anesthesia to a patient unless:
i. the nurse has a medical order for the deep sedation or general anesthesia; and
ii. the patient is intubated and in an intensive care unit of a general acute hospital; and
iii. requires a professional who administers sedation to have access to a crash cart during a sedation procedure.
47 Be it enacted by the Legislature of the state of Utah:
48 Section 1. Section 26-1-40 is enacted to read:
49 26-1-40. Reports of anesthesia adverse events- whistle blower protections.
50 (1) (a) Beginning January 1, 2018, the department shall create a database of deaths and
51 adverse events from the administration of sedation or anesthesia in outpatient settings that are
52 not emergency departments in the state.
53 (b) The database required by Subsection (1)(a) shall include reports submitted by health
54 care providers under Sections 58-5a-502, 58-31b-502.5, 58-67-502.5, 58-68-502.5, and
55 58-69-502.5.
56 (2) The department shall adopt administrative rules under Title 63G, Chapter 3, Utah
57 Administrative Rulemaking Act, regarding:
58 (a) the format of the reports; and
59 (b) what constitutes a reportable adverse event, which shall include at least the
60 administration of intravenous sedation or anesthesia when there is:
61 (i) an escalation of care required for the patient; or
62 (ii) a rescue of a patient from a deeper level of sedation than was intended.
63 (3) (a) Information the department receives under this section that identifies a particular
64 individual is subject to Title 63G, Chapter 2, Government Records Access and Management
65 Act, and the federal Health Insurance Portability and Accountability Act of 1996.
66 (b) Beginning July 1, 2018, and on or before July 1 of each year thereafter, the
67 department shall:
68 (i) publicly report:
69 (A) the number of deaths and adverse events reported under Subsection (1);
70 (B) the type of health care providers, by license category and specialty, who submitted
71 reports under Subsection (1) and who administered the sedation or anesthesia that resulted in an
72 adverse event; and
73 (C) the type of facility in which the death or adverse event took place; and
74 (ii) submit a report to the Health and Human Services Interim Committee with the
75 information required by this Subsection (3).
76 (4) An employer of a health care provider who submits a report under this section may
77 not take an adverse employment action against the reporting health care provider if the
78 employment action is based on the provider submitting a report under this section.
79 (5) (a) This section sunsets in accordance with Section 63I-1-226.
80 (b) The sunset review of this section shall include an analysis of:
81 (i) the number and types of adverse events reported under this section;
82 (ii) the types of health care providers and locations involved in the adverse events;
83 (iii) the adequacy of sedation and anesthesia requirements in Sections 58-5a-502,
84 58-31b-502.5, 58-67-502.5, 58-68-502.5, and 58-69-502.5 related to the adverse events
85 reported under this section; and
86 (iv) the adequacy of the reporting requirements under this section and the need for
87 additional protections for health care providers who report events under this section.
88 Section 2. Section 58-5a-502 is enacted to read:
89
90 58-5a-502. Unprofessional conduct.
91 In addition to unprofessional conduct as defined in Section 58-5a-102, it is
92 unprofessional conduct for an individual licensed under this chapter to administer sedation or
93 anesthesia intravenously to a patient in an outpatient setting that is not an emergency
94 department without:
95 (1) first obtaining consent from the patient in writing, which shall include:
96 (a) the type of sedation or anesthesia being administered;
97 (b) the identity and type of license or permit under this title of the person who is
98 performing the procedure for which the sedation or anesthesia will be administered;
99 (c) the identity and type of license or permit under this title of the person who will be
100 administering the sedation or anesthesia; and
101 (d) monitoring that will occur during the sedation or anesthesia, including monitoring of
102 the patient’s oxygenation, ventilation, and circulation;
103 (2) reporting any adverse event under Section 26-1-40; and
104 (3) having access during the procedure to an advanced cardiac life support crash cart
105 with equipment that is regularly maintained according to guidelines established by the American
106 Heart Association.
107 Section 3. Section 58-31b-502.5 is enacted to read:
108 58-31b-502.5. Anesthesia and sedation — Unprofessional conduct.
109 In addition to unprofessional conduct as defined in Section 58-31b-502, it is
110 unprofessional conduct for an individual licensed under this chapter to administer sedation or
111 anesthesia intravenously to a patient in an outpatient setting that is not an emergency
112 department without:
113 (1) first obtaining consent from the patient in writing, which shall include:
114 (a) the type of sedation or anesthesia being administered;
115 (b) the identity and type of license or permit under this title of the person who is
116 performing the procedure for which the sedation or anesthesia will be administered;
117 (c) the identity and type of license or permit under this title of the person who will be
118 administering the sedation or anesthesia; and
119 (d) monitoring that will occur during the sedation or anesthesia, including monitoring
120 the patient’s oxygenation, ventilation, and circulation;
121 (2) reporting any adverse event under Section 26-1-40; and
122 (3) having access during the procedure to an advanced cardiac life support crash cart
123 with equipment that is regularly maintained according to guidelines established by the American
124 Heart Association.
125 Section 4. Section 58-67-502.5 is enacted to read:
126 58-67-502.5. Anesthesia and sedation — Unprofessional conduct.
127 In addition to unprofessional conduct as defined in Section 58-67-502, it is
128 unprofessional conduct for an individual licensed under this chapter to administer sedation or
129 anesthesia intravenously to a patient in an outpatient setting that is not an emergency
130 department without:
131 (1) first obtaining consent from the patient in writing, which shall include:
132 (a) the type of sedation or anesthesia being administered;
133 (b) the identity and type of license or permit under this title of the person who is
134 performing the procedure for which the sedation or anesthesia will be administered;
135 (c) the identity and type of license or permit under this title of the person who will be
136 administering the sedation or anesthesia; and
137 (d) monitoring that will occur during the sedation or anesthesia, including monitoring of
138 the patient’s oxygenation, ventilation, and circulation;
139 (2) reporting any adverse event under Section 26-1-40; and
140 (3) having access during the procedure to an advanced cardiac life support crash cart
141 with equipment that is regularly maintained according to guidelines established by the American
142 Heart Association.
143 Section 5. Section 58-68-502.5 is enacted to read:
144 58-68-502.5. Anesthesia and sedation — Unprofessional conduct.
145 In addition to unprofessional conduct as defined in Section 58-68-502, it is
146 unprofessional conduct for an individual licensed under this chapter to administer sedation or
147 anesthesia intravenously to a patient in an outpatient setting that is not an emergency
148 department without:
149 (1) first obtaining consent from the patient in writing, which shall include:
150 (a) the type of sedation or anesthesia being administered;
151 (b) the identity and type of license or permit under this title of the person who is
152 performing the procedure for which the sedation or anesthesia will be administered;
153 (c) the identity and type of license or permit under this title of the person who will be
154 administering the sedation or anesthesia; and
155 (d) monitoring that will occur during the sedation or anesthesia, including monitoring of
156 the patient’s oxygenation, ventilation, and circulation;
157 (2) reporting any adverse event under Section 26-1-40; and
158 (3) having access during the procedure to an advanced cardiac life support crash cart
159 with equipment that is regularly maintained according to guidelines established by the American
160 Heart Association.
161 Section 6. Section 58-69-502.5 is enacted to read:
162 58-69-502.5. Anesthesia and sedation — Unprofessional conduct.
163 In addition to unprofessional conduct as defined in Section 58-69-502, it is
164 unprofessional conduct for an individual licensed under this chapter to administer sedation or
165 anesthesia intravenously to a patient in an outpatient setting that is not an emergency
166 department without:
167 (1) first obtaining consent from the patient in writing, which shall include:
168 (a) the type of sedation or anesthesia being administered;
169 (b) the identity and type of license or permit under this title of the person who is
170 performing the procedure for which the sedation or anesthesia will be administered;
171 (c) the identity and type of license or permit under this title of the person who will be
172 administering the sedation or anesthesia; and
173 (d) monitoring that will occur during the sedation or anesthesia, including monitoring of
174 the patient’s oxygenation, ventilation, and circulation;
175 (2) reporting any adverse event under Section 26-1-40; and
176 (3) having access during the procedure to an advanced cardiac life support crash cart
177 with equipment that is regularly maintained according to guidelines established by the American
178 Heart Association.
179 Section 7. Section 63I-1-226 is amended to read:
180 63I-1-226. Repeal dates, Title 26.
181 (1) Section 26-1-40 is repealed July 1, 2019.
182 [(1)] (2) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed
183 July 1, 2025.
184 [(2)] (3) Section 26-10-11 is repealed July 1, 2020.
185 [(3)] (4) Section 26-21-23, Licensing of non-Medicaid nursing care facility beds, is
186 repealed July 1, 2018.
187 [(4)] (5) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1,
188 2024.
189 [(5)] (6) Title 26, Chapter 36a, Hospital Provider Assessment Act, is repealed July 1,
190 2019.
191 [(6)] (7) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
192 2021.
193 [(7)] (8) Section 26-38-2.5 is repealed July 1, 2017.
194 [(8)] (9) Section 26-38-2.6 is repealed July 1, 2017.
195 [(9) Title 26, Chapter 52, Autism Treatment Account, is repealed July 1, 2016.]
196 (10) Title 26, Chapter 56, Hemp Extract Registration Act, is repealed July 1, 2021.
197 Section 8. Section 63I-1-258 is amended to read:
198 63I-1-258. Repeal dates, Title 58.
199 (1) Title 58, Chapter 13, Health Care Providers Immunity from Liability Act, is
200 repealed July 1, 2026.
201 (2) Title 58, Chapter 15, Health Facility Administrator Act, is repealed July 1, 2025.
202 (3) Title 58, Chapter 20a, Environmental Health Scientist Act, is repealed July 1, 2018.
203 (4) Section 58-37-4.3 is repealed July 1, 2021.
204 (5) Title 58, Chapter 40, Recreational Therapy Practice Act, is repealed July 1, 2023.
205 (6) Title 58, Chapter 41, Speech-Language Pathology and Audiology Licensing Act, is
206 repealed July 1, 2019.
207 (7) Title 58, Chapter 42a, Occupational Therapy Practice Act, is repealed July 1, 2025.
208 (8) Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act, is repealed July
209 1, 2023.
210 (9) Title 58, Chapter 47b, Massage Therapy Practice Act, is repealed July 1, 2024.
211 (10) Title 58, Chapter 61, Part 7, Behavior Analyst Licensing Act, is repealed July 1,
212 2026.
213 (11) Title 58, Chapter 72, Acupuncture Licensing Act, is repealed July 1, 2017.
214 (12) Title 58, Chapter 86, State Certification of Commercial Interior Designers Act, is
215 repealed July 1, 2021.
216 (13) The following sections are repealed on July 1, 2019:
217 (a) Section 58-5a-502;
218 (b) Section 58-31b-502.5;
219 (c) Section 58-67-502.5;
220 (d) Section 58-68-502.5; and
221 (e) Section 58-69-502.5.