94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB2238

 

Introduced 1/11/2006, by Sen. Carol Ronen

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 5/6.5
210 ILCS 85/10.7

    Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a registered nurse licensed under the Nursing and Advanced Practice Nursing Act and qualified by training and experience in operating room nursing shall be present in the operating room and function as the circulating nurse during all invasive or operative procedures. Provides that such a circulating nurse is responsible for coordinating all nursing care, patient safety needs, and the needs of the surgical team in the operating room.


LRB094 16983 DRJ 52263 b

 

 

A BILL FOR

 

SB2238 LRB094 16983 DRJ 52263 b

1     AN ACT concerning regulation.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Ambulatory Surgical Treatment Center Act is
5 amended by changing Section 6.5 as follows:
 
6     (210 ILCS 5/6.5)
7     Sec. 6.5. Clinical privileges; advanced practice nurses.
8 All ambulatory surgical treatment centers (ASTC) licensed
9 under this Act shall comply with the following requirements:
10     (1) No ASTC policy, rule, regulation, or practice shall be
11 inconsistent with the provision of adequate collaboration,
12 including medical direction of licensed advanced practice
13 nurses, in accordance with Section 54.5 of the Medical Practice
14 Act of 1987.
15     (2) Operative surgical procedures shall be performed only
16 by a physician licensed to practice medicine in all its
17 branches under the Medical Practice Act of 1987, a dentist
18 licensed under the Illinois Dental Practice Act, or a
19 podiatrist licensed under the Podiatric Medical Practice Act of
20 1987, with medical staff membership and surgical clinical
21 privileges granted by the consulting committee of the ASTC. A
22 licensed physician, dentist, or podiatrist may be assisted by a
23 physician licensed to practice medicine in all its branches,
24 dentist, dental assistant, podiatrist, licensed advanced
25 practice nurse, licensed physician assistant, licensed
26 registered nurse, licensed practical nurse, surgical
27 assistant, surgical technician, or other individuals granted
28 clinical privileges to assist in surgery by the consulting
29 committee of the ASTC. Payment for services rendered by an
30 assistant in surgery who is not an ambulatory surgical
31 treatment center employee shall be paid at the appropriate
32 non-physician modifier rate if the payor would have made

 

 

SB2238 - 2 - LRB094 16983 DRJ 52263 b

1 payment had the same services been provided by a physician.
2     (2.5) A registered nurse licensed under the Nursing and
3 Advanced Practice Nursing Act and qualified by training and
4 experience in operating room nursing shall be present in the
5 operating room and function as the circulating nurse during all
6 invasive or operative procedures. For purposes of this
7 paragraph (2.5), "circulating nurse" means a registered nurse
8 who is responsible for coordinating all nursing care, patient
9 safety needs, and the needs of the surgical team in the
10 operating room during an invasive or operative procedure.
11     (3) The anesthesia service shall be under the direction of
12 a physician licensed to practice medicine in all its branches
13 who has had specialized preparation or experience in the area
14 or who has completed a residency in anesthesiology. An
15 anesthesiologist, Board certified or Board eligible, is
16 recommended. Anesthesia services may only be administered
17 pursuant to the order of a physician licensed to practice
18 medicine in all its branches, licensed dentist, or licensed
19 podiatrist.
20         (A) The individuals who, with clinical privileges
21     granted by the medical staff and ASTC, may administer
22     anesthesia services are limited to the following:
23             (i) an anesthesiologist; or
24             (ii) a physician licensed to practice medicine in
25         all its branches; or
26             (iii) a dentist with authority to administer
27         anesthesia under Section 8.1 of the Illinois Dental
28         Practice Act; or
29             (iv) a licensed certified registered nurse
30         anesthetist.
31         (B) For anesthesia services, an anesthesiologist shall
32     participate through discussion of and agreement with the
33     anesthesia plan and shall remain physically present and be
34     available on the premises during the delivery of anesthesia
35     services for diagnosis, consultation, and treatment of
36     emergency medical conditions. In the absence of 24-hour

 

 

SB2238 - 3 - LRB094 16983 DRJ 52263 b

1     availability of anesthesiologists with clinical
2     privileges, an alternate policy (requiring participation,
3     presence, and availability of a physician licensed to
4     practice medicine in all its branches) shall be developed
5     by the medical staff consulting committee in consultation
6     with the anesthesia service and included in the medical
7     staff consulting committee policies.
8         (C) A certified registered nurse anesthetist is not
9     required to possess prescriptive authority or a written
10     collaborative agreement meeting the requirements of
11     Section 15-15 of the Nursing and Advanced Practice Nursing
12     Act to provide anesthesia services ordered by a licensed
13     physician, dentist, or podiatrist. Licensed certified
14     registered nurse anesthetists are authorized to select,
15     order, and administer drugs and apply the appropriate
16     medical devices in the provision of anesthesia services
17     under the anesthesia plan agreed with by the
18     anesthesiologist or, in the absence of an available
19     anesthesiologist with clinical privileges, agreed with by
20     the operating physician, operating dentist, or operating
21     podiatrist in accordance with the medical staff consulting
22     committee policies of a licensed ambulatory surgical
23     treatment center.
24 (Source: P.A. 93-352, eff. 1-1-04.)
 
25     Section 10. The Hospital Licensing Act is amended by
26 changing Section 10.7 as follows:
 
27     (210 ILCS 85/10.7)
28     Sec. 10.7. Clinical privileges; advanced practice nurses.
29 All hospitals licensed under this Act shall comply with the
30 following requirements:
31     (1) No hospital policy, rule, regulation, or practice shall
32 be inconsistent with the provision of adequate collaboration,
33 including medical direction of licensed advanced practice
34 nurses, in accordance with Section 54.5 of the Medical Practice

 

 

SB2238 - 4 - LRB094 16983 DRJ 52263 b

1 Act of 1987.
2     (2) Operative surgical procedures shall be performed only
3 by a physician licensed to practice medicine in all its
4 branches under the Medical Practice Act of 1987, a dentist
5 licensed under the Illinois Dental Practice Act, or a
6 podiatrist licensed under the Podiatric Medical Practice Act of
7 1987, with medical staff membership and surgical clinical
8 privileges granted at the hospital. A licensed physician,
9 dentist, or podiatrist may be assisted by a physician licensed
10 to practice medicine in all its branches, dentist, dental
11 assistant, podiatrist, licensed advanced practice nurse,
12 licensed physician assistant, licensed registered nurse,
13 licensed practical nurse, surgical assistant, surgical
14 technician, or other individuals granted clinical privileges
15 to assist in surgery at the hospital. Payment for services
16 rendered by an assistant in surgery who is not a hospital
17 employee shall be paid at the appropriate non-physician
18 modifier rate if the payor would have made payment had the same
19 services been provided by a physician.
20     (2.5) A registered nurse licensed under the Nursing and
21 Advanced Practice Nursing Act and qualified by training and
22 experience in operating room nursing shall be present in the
23 operating room and function as the circulating nurse during all
24 invasive or operative procedures. For purposes of this
25 paragraph (2.5), "circulating nurse" means a registered nurse
26 who is responsible for coordinating all nursing care, patient
27 safety needs, and the needs of the surgical team in the
28 operating room during an invasive or operative procedure.
29     (3) The anesthesia service shall be under the direction of
30 a physician licensed to practice medicine in all its branches
31 who has had specialized preparation or experience in the area
32 or who has completed a residency in anesthesiology. An
33 anesthesiologist, Board certified or Board eligible, is
34 recommended. Anesthesia services may only be administered
35 pursuant to the order of a physician licensed to practice
36 medicine in all its branches, licensed dentist, or licensed

 

 

SB2238 - 5 - LRB094 16983 DRJ 52263 b

1 podiatrist.
2         (A) The individuals who, with clinical privileges
3     granted at the hospital, may administer anesthesia
4     services are limited to the following:
5             (i) an anesthesiologist; or
6             (ii) a physician licensed to practice medicine in
7         all its branches; or
8             (iii) a dentist with authority to administer
9         anesthesia under Section 8.1 of the Illinois Dental
10         Practice Act; or
11             (iv) a licensed certified registered nurse
12         anesthetist.
13         (B) For anesthesia services, an anesthesiologist shall
14     participate through discussion of and agreement with the
15     anesthesia plan and shall remain physically present and be
16     available on the premises during the delivery of anesthesia
17     services for diagnosis, consultation, and treatment of
18     emergency medical conditions. In the absence of 24-hour
19     availability of anesthesiologists with medical staff
20     privileges, an alternate policy (requiring participation,
21     presence, and availability of a physician licensed to
22     practice medicine in all its branches) shall be developed
23     by the medical staff and licensed hospital in consultation
24     with the anesthesia service.
25         (C) A certified registered nurse anesthetist is not
26     required to possess prescriptive authority or a written
27     collaborative agreement meeting the requirements of
28     Section 15-15 of the Nursing and Advanced Practice Nursing
29     Act to provide anesthesia services ordered by a licensed
30     physician, dentist, or podiatrist. Licensed certified
31     registered nurse anesthetists are authorized to select,
32     order, and administer drugs and apply the appropriate
33     medical devices in the provision of anesthesia services
34     under the anesthesia plan agreed with by the
35     anesthesiologist or, in the absence of an available
36     anesthesiologist with clinical privileges, agreed with by

 

 

SB2238 - 6 - LRB094 16983 DRJ 52263 b

1     the operating physician, operating dentist, or operating
2     podiatrist in accordance with the hospital's alternative
3     policy.
4 (Source: P.A. 93-352, eff. 1-1-04.)