EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb1011*
SENATE BILL 1011
J2 2lr3233
By: Senator Klausmeier
Constitutional Requirements Complied with for Introduction in the last 35 Days of Session
Introduced and read first time: March 4, 2022
Assigned to: Rules
A BILL ENTITLED
AN ACT concerning 1
Health Occupations – Nurse Anesthetists – Drug Authority 2
FOR the purpose of authorizing a nurse anesthetist to prescribe, order, and administer 3
drugs, including controlled dangerous substances, subject to certain limitations; and 4
generally relating to nurse anesthetists. 5
BY repealing and reenacting, with amendments, 6
Article – Health Occupations 7
Section 8–513, 12–101(b), and 12–102(e) 8
Annotated Code of Maryland 9
(2021 Replacement Volume) 10
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11
That the Laws of Maryland read as follows: 12
Article – Health Occupations 13
8–513. 14
(a) In this section, “perioperative assessment and management” means the 15
assessment and management of a patient preoperatively, intraoperatively, and 16
postoperatively. 17
(b) (1) A nurse anesthetist may perform the following functions: 18
(i) Perioperative assessment and management of patients requiring 19
anesthesia services; 20
(ii) Administration of anesthetic agents; 21
2 SENATE BILL 1011
(iii) Management of fluids in intravenous therapy; [and] 1
(iv) Respiratory care; AND 2
(V) SUBJECT TO PARAGRAPH (4) OF THIS SUBSECTION , 3
PRESCRIPTION , ORDERING, AND ADMINISTRATION O F DRUGS, INCLUDING A DRUG 4
THAT IS CLASSIFIED A S A CONTROLLED DANGE ROUS SUBSTANCE UNDER TITLE 5, 5
SUBTITLE 4 OF THE CRIMINAL LAW ARTICLE. 6
(2) A nurse anesthetist has the right and obligation to refuse to perform a 7
delegated act if in the nurse anesthetist’s judgment, the act is: 8
(i) Unsafe; 9
(ii) An invalidly prescribed medical act; or 10
(iii) Beyond the clinical skills of the nurse anesthetist. 11
(3) Paragraph (1) of this subsection may not be construed to authorize a 12
nurse anesthetist to: 13
(i) Diagnose a medical condition; 14
(ii) Provide care that is not consistent with the scope of practice of 15
nurse anesthetists; or 16
(iii) Provide care for which the nurse anesthetist does not have proper 17
education and experience. 18
(4) A NURSE ANESTHETIST MA Y PRESCRIBE DRU GS UNDER 19
PARAGRAPH (1) OF THIS SUBSECTION : 20
(I) ONLY IN AN AMOUNT THA T DOES NOT EXCEED A 10–DAY 21
SUPPLY; 22
(II) ONLY FOR AN INDIVIDUA L WITH WHOM THE NURS E 23
ANESTHETIST HAS , AT THE TIME OF PRESC RIPTION, ESTABLISHED A CLIENT OR 24
PATIENT RECORD ; AND 25
(III) ONLY IN CONNECTION WI TH THE DELIVERY OF A NESTHESIA 26
SERVICES. 27
(c) A nurse anesthetist shall collaborate with an anesthesiologist, a licensed 28
physician, or a dentist in the following manner: 29
SENATE BILL 1011 3
(1) An anesthesiologist, a licensed physician, or a dentist shall be 1
physically available to the nurse anesthetist for consultation at all times during the 2
administration of, and recovery from, anesthesia; 3
(2) An anesthesiologist shall be available for consultation to the nurse 4
anesthetist for other aspects of the practice of nurse anesthesia; and 5
(3) If an anesthesiologist is not available, a licensed physician or dentist 6
shall be available to provide this type of consultation. 7
(d) The nurse anesthetist shall ensure that a qualified anesthesia provider: 8
(1) Performs a thorough and complete preanesthetic assessment; 9
(2) Obtains informed consent for the planned anesthetic intervention from 10
the patient or an individual responsible for the patient; and 11
(3) Formulates a patient–specific plan for anesthesia care. 12
(e) The nurse anesthetist as part of the standards of practice shall: 13
(1) Implement and adjust an anesthesia care plan as needed to adapt to 14
the patient’s response to the anesthesia; 15
(2) Monitor a patient’s physiologic condition for untoward identifiable 16
reactions and initiate appropriate corrective actions as required; 17
(3) Enter prompt, complete, and accurate documentation of pertinent 18
information on a patient’s record; 19
(4) Transfer responsibility for care of a patient to other qualified providers 20
in a manner that ensures continuity of care and patient safety; 21
(5) Ensure that appropriate safety precautions are taken to minimize the 22
risks of fire, explosion, electrical shock, and equipment malfunction; 23
(6) Maintain appropriate infection control standards; 24
(7) Evaluate anesthesia care to ensure its quality; 25
(8) Maintain continual competence in anesthesia practice; and 26
(9) Respect and maintain the basic rights of patients. 27
(f) This section may not be construed to require a written collaboration 28
agreement between a nurse anesthetist and an anesthesiologist, a physician, or a dentist. 29
4 SENATE BILL 1011
12–101. 1
(b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 2
with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 3
podiatrist, licensed veterinarian, advanced practice nurse with prescriptive authority 4
under § 8–508 of this article, LICENSED NURSE ANEST HETIST, or other individual 5
authorized by law to prescribe prescription or nonprescription drugs or devices. 6
12–102. 7
(e) (1) This title does not prohibit: 8
(i) A dentist, physician, or podiatrist from administering a 9
prescription drug or device in the course of treating a patient; [or] 10
(ii) A licensed dental hygienist from administering medication under 11
§ 4–206.4 of this article; OR 12
(III) A NURSE ANESTHETIST FR OM ADMINISTERING 13
MEDICATION UNDER § 8–513 OF THIS ARTICLE . 14
(2) For the purposes of paragraph (1)(i) of this subsection, “administering” 15
means the direct introduction of a single dosage of a drug or device at a given time, whether 16
by injection or other means, and whether in liquid, tablet, capsule, or other form. 17
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 18
October 1, 2022. 19