Florida 2025 Regular Session

Florida House Bill H0649 Compare Versions

Only one version of the bill is available at this time.

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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to autonomous practice by a certified 2
16	16	registered nurse anesthetist; amending s. 395.0191, 3
17	17	F.S.; revising staff membership and clinical 4
18	18	privileges for certain certified registered nurse 5
19	19	anesthetists; amending s. 464.012, F.S.; authorizing 6
20	20	certain certified registered nurse anesthetists to 7
21	21	perform specified acts under certain circumstances; 8
22	22	amending s. 464.0123, F.S.; revising practice 9
23	23	requirements for autonomous advanced practice 10
24	24	registered nurses; authorizing autonomous advanced 11
25	25	practice registered nurses to perform certain acts; 12
26	26	providing an effective date. 13
27	27	14
28	28	Be It Enacted by the Legislature of the State of Florida: 15
29	29	16
30	30	Section 1. Paragraph (b) of subsection (2) of section 17
31	31	395.0191, Florida Statutes, is amended to read: 18
32	32	395.0191 Staff membership and clinical privileges. — 19
33	33	(2) 20
34	34	(b) An advanced practice registered nurse who is certified 21
35	35	as a registered nurse anesthetist licensed under part I of 22
36	36	chapter 464 shall administer anesthesia under the onsite medical 23
37	37	direction of a professional licensed under chapter 458, chapter 24
38	38	459, or chapter 466, and in accordance with an established 25
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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49	49
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51	51	protocol approved by the medical staff. The medical direction 26
52	52	shall specifically address the needs of the individual patient. 27
53	53	This paragraph does not apply to an autonomous advanced practice 28
54	54	registered nurse registered under s. 464.0123 who is certified 29
55	55	as a registered nurse anesthetist licensed under part I of 30
56	56	chapter 464; however, a facility may require a certified 31
57	57	registered nurse anesthetist who is registered and practicing 32
58	58	under s. 464.0123 to perform acts under an established protocol 33
59	59	approved by the medical staff or the governing board of the 34
60	60	facility. 35
61	61	Section 2. Paragraph (b) of subsection (4) of section 36
62	62	464.012, Florida Statutes, is amended to read: 37
63	63	464.012 Licensure of advanced practice registered nurses; 38
64	64	fees; controlled substance prescribing. — 39
65	65	(4) In addition to the general functions specified in 40
66	66	subsection (3), an advanced practice registered nurse may 41
67	67	perform the following acts within his or her specialty: 42
68	68	(b) A The certified registered nurse anesthetist may, to 43
69	69	the extent authorized by an established protocol approved by the 44
70	70	medical staff of the faci lity in which the anesthetic service is 45
71	71	performed, or a certified registered nurse anesthetist that is 46
72	72	registered and practicing under s. 464.0123 without an 47
73	73	established protocol, may perform any or all of the following: 48
74	74	1. Determine the health status of the patient as it 49
75	75	relates to the risk factors and to the anesthetic management of 50
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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88	88	the patient through the performance of the general functions. 51
89	89	2. Based on history, physical assessment, and supplemental 52
90	90	laboratory results, determine, with the consent of the 53
91	91	responsible physician, the appropriate type of anesthesia under 54
92	92	within the framework of the protocol unless the certified 55
93	93	registered nurse anesthetist is registered and practicing under 56
94	94	s. 464.0123 without an established protocol . 57
95	95	3. Order under the protocol preanesthetic medication under 58
96	96	the protocol unless the certified registered nurse anesthetist 59
97	97	is registered and practicing under s. 464.0123 without an 60
98	98	established protocol . 61
99	99	4. Perform under the protocol procedures commonly used to 62
100	100	render the patient insensible to pain during the performance of 63
101	101	surgical, obstetrical, therapeutic, or diagnostic clinical 64
102	102	procedures under the protocol unless the certified registered 65
103	103	nurse anesthetist is registered and practicing under s. 464.0123 66
104	104	without an established protocol. These procedures include 67
105	105	ordering and administering regional, spinal, and general 68
106	106	anesthesia; inhalation agents and techniques; intravenous agents 69
107	107	and techniques; and techniques of hypnosis. 70
108	108	5. Order or perform monitoring procedures indicated as 71
109	109	pertinent to the anesthetic health care management of the 72
110	110	patient. 73
111	111	6. Support life functions during anesthesia health care, 74
112	112	including induction and intubation procedures, the use of 75
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125	125	appropriate mechanical supportive devices, and the manageme nt of 76
126	126	fluid, electrolyte, and blood component balances. 77
127	127	7. Recognize and take appropriate corrective action for 78
128	128	abnormal patient responses to anesthesia, adjunctive medication, 79
129	129	or other forms of therapy. 80
130	130	8. Recognize and treat a cardiac arrhythmia whil e the 81
131	131	patient is under anesthetic care. 82
132	132	9. Participate in management of the patient while in the 83
133	133	postanesthesia recovery area, including ordering the 84
134	134	administration of fluids and drugs. 85
135	135	10. Place special peripheral and central venous and 86
136	136	arterial lines for blood sampling and monitoring as appropriate. 87
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138	138	A certified registered nurse anesthetist registered and 89
139	139	practicing under s. 464.0123 without an established protocol may 90
140	140	only perform acts authorized under part I of this chapter. 91
141	141	Section 3. Paragraph (a) of subsection (3) of section 92
142	142	464.0123, Florida Statutes, is amended to read: 93
143	143	464.0123 Autonomous practice by an advanced practice 94
144	144	registered nurse.— 95
145	145	(3) PRACTICE REQUIREMENTS. — 96
146	146	(a) An advanced practice registered nurse who is 97
147	147	registered under this section may: 98
148	148	1. Engage in autonomous practice only in primary care 99
149	149	practice, including family medicine, general pediatrics, and 100
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158	158	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162	162	general internal medicine, as defined by board rule. 101
163	163	2. For certified nurse midwives, engage in autonomous 102
164	164	practice in the performance of the acts listed in s. 103
165	165	464.012(4)(c). 104
166	166	3. Perform the general functions of an advanced practice 105
167	167	registered nurse under s. 464.012(3) related to primary care. 106
168	168	4. For certified registered nurse anesthetists registered 107
169	169	and practicing under this section, perform the acts listed in s. 108
170	170	464.012(4)(b). 109
171	171	5.4. For a patient who requires the services of a health 110
172	172	care facility, as defined in s. 408.032(8): 111
173	173	a. Admit the patient to the facility. 112
174	174	b. Manage the care received by the patient in the 113
175	175	facility. 114
176	176	c. Discharge the patient from the facility, unless 115
177	177	prohibited by federal law or rule. 116
178	178	6.5. Provide a signature, certification, stamp, 117
179	179	verification, affidavit, or endorsement that is otherwise 118
180	180	required by law to be provided by a physician, excep t an 119
181	181	advanced practice registered nurse registered under this section 120
182	182	may not issue a physician certification under s. 381.986. 121
183	183	Section 4. This act shall take effect July 1, 2025. 122