Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 135 - AMBULATORY SURGICAL CENTERS
Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
Section 135.15 - Facility Staffing and Training
Universal Citation: 25 TX Admin Code ยง 135.15
Current through Reg. 49, No. 38; September 20, 2024
(a) Nursing services.
(1) There shall be an
organized nursing service under the direction of a qualified registered nurse
(RN). The ambulatory surgical center (ASC) shall be staffed to assure that the
nursing needs of all patients are met.
(2) There shall be a written plan of
administrative authority for all nursing services with responsibilities and
duties of each category of nursing personnel delineated and a written job
description for each category. The scope of nursing service shall include, but
is not limited to, nursing care rendered to patients preoperatively,
intraoperatively, and postoperatively.
(A)
The responsible individual for nursing services shall be a qualified registered
nurse (RN) whose responsibility and authority for nursing service shall be
clearly defined and includes supervision of both personnel performance and
patient care.
(B) There shall be a
written delineation of functions, qualifications, and patient care
responsibilities for all categories of nursing personnel.
(C) Surgical technicians and licensed
vocational nurses may be permitted to serve in the scrub nurse role under the
direct supervision of an RN; they shall not be permitted to function as
circulating nurses in the operating rooms. Licensed vocational nurses and
surgical technicians may assist in circulatory duties under the direct
supervision of a qualified RN.
(D)
Nursing services shall be provided in accordance with current recognized
standards or recommended practices.
(E) The facility shall adopt, implement and
enforce policies and procedures to comply with Health and Safety Code, Chapter
259 (relating to Surgical Technologists at Health Care
Facilities).
(3) There
shall be an adequate number of RNs on duty to meet the following minimum staff
requirements: director of the department (or designee), and supervisory and
staff personnel for each service area to assure the immediate availability of
an RN for emergency care or for any patient when needed.
(A) An RN shall assign the nursing care of
each patient to other nursing personnel in accordance with the patient's needs
and the preparation and qualifications of the nursing staff
available.
(B) There shall be other
nursing personnel in sufficient numbers to provide nursing care not requiring
the service of an RN.
(4)
An RN qualified, at a minimum, with current certification in basic cardiac life
support shall be on duty and on the premises at all times whenever patients are
present in the facility.
(b) Additional staffing requirements. In addition to meeting the requirements for nursing staff under subsection (a) of this section, facilities shall comply with the following minimum staffing requirements.
(1) Facilities that provide
only topical anesthesia, local anesthesia and/or minimal sedation are required
to have a second individual on duty on the premises who is trained and
currently certified in basic cardiac life support until all patients have been
discharged from the facility.
(2)
Facilities that provide moderate sedation/analgesia are required to have the
following additional staff:
(A) a second
individual on duty on the premises who is trained and currently certified in
basic cardiac life support until all patients have been discharged from the
facility; and
(B) an individual
trained and currently certified in advanced cardiac life support and, if
surgery is performed on pediatric patients, pediatric advanced life support
shall be available until all patients have been discharged from the
postanesthesia care unit.
(3) Facilities that provide deep
sedation/analgesia, general anesthesia, and/or regional anesthesia shall have
the following additional staff:
(A) a second
individual on duty on the premises who is trained and currently certified in
basic cardiac life support until all patients have been discharged from the
facility; and
(B) an individual who
is trained and currently certified in advanced cardiac life support and, if
surgery is performed on pediatric patients, pediatric advanced life support
shall be on duty on the premises and sufficiently free of other duties to
enable the individual to respond rapidly to emergency situations until all
patients have been discharged from the postanesthesia care unit.
(c) Nursing peer review committees. The facility shall establish a nursing peer review committee to conduct nursing peer review, as required by Texas Occupations Code, Chapter 303.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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