Board of Nursing
Chapter 851
Division 55
SCOPE AND STANDARDS OF PRACTICE FOR THE ADVANCED PRACTICE REGISTERED NURSE
851-055-0030
Scope and Standards of Practice for Licensed Certified Registered Nurse Anesthetists
(1) Scope of practice for the licensed certified registered nurse anesthetist (CRNA) includes advanced assessment related to the relative risks associated with an anesthesia plan and administration of anesthesia care and other medical services, 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; and
(g) Performing analgesia, sedative or anesthetic management for a client requiring relief of acute or chronic pain.
(2) The CRNA must 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:
(a) Establish or verify each client’s American Society of Anesthesiologists Physical Status Classification (ASA) score who will undergo a procedure requiring moderate sedation, deep sedation, or anesthesia. Documentation must reflect the assessment and conclusion supporting the ASA classification;
(b) The CRNA is prohibited from providing moderate sedation, deep sedation or general anesthesia in an office setting for clients with an ASA classification of 4 or above
(c) Verify anesthesia-related monitors and equipment are maintained to current health care standards, including providing a backup electrical source. For procedures requiring moderate sedation, deep sedation or general anesthesia or regional blocks or which require support of bodily functions such as airway, breathing or circulation the CRNA will assure that, at a minimum, equipment is available to monitor physiological functions of heart rate, blood pressure, respirations, and pulse oximetry;
(d) Ensure there are adequate numbers of personnel to support the planned procedure;
(e) Adhere to professional standards of care for monitoring client during procedure;
(f) 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
(g) Coordinate recovery and discharge of clients from office and provide instructions for follow-up care if necessary.
(3) The CRNA will only provide health care services within their CRNA scope for which she/he is educationally prepared and for which competency has been established and maintained. Education preparation includes academic coursework, workshops, or seminars, provided both theory and clinical experience are included.
Statutory/Other Authority: ORS 678.150, ORS 678.255, ORS 678.265, ORS 678.275, ORS 678.278, ORS 678.282, ORS 678.285, ORS 678,370, ORS 678.372, ORS 678.375, ORS 678.380 & ORS 678.390
Statutes/Other Implemented: ORS 678.150, ORS 678.255, ORS 678.265, ORS 678.275, ORS 678.278, ORS 678.282, ORS 678.285, ORS 678,370, ORS 678.372, ORS 678.375, ORS 678.380 & ORS 678.390
History:
BN 6-2023, amend filed 09/26/2023, effective 10/01/2023
BN 13-2021, adopt filed 06/24/2021, effective 07/01/2021