Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 508 - AMBULATORY SURGICAL CENTERS
Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
Section 508.15 - Facility Staffing and Training
Universal Citation: 26 TX Admin Code § 508.15
Current through Reg. 50, No. 13; March 28, 2025
(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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