Rhode Island 2025 Regular Session

Rhode Island House Bill H5428 Compare Versions

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

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5	5	2025 -- H 5428
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7	7	LC000950
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO BUSINESSES AND PROFESSIONS -- NURSES
16	16	Introduced By: Representatives McNamara, Corvese, Chippendale, Place, Craven,
17	17	Bennett, and Ackerman
18	18	Date Introduced: February 12, 2025
19	19	Referred To: House Health & Human Services
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22	22	It is enacted by the General Assembly as follows:
23	23	SECTION 1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby amended by 1
24	24	adding thereto the following section: 2
25	25	5-34-3.1. Safe administration of sedation. 3
26	26	(a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than 4
27	27	licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs 5
28	28	enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of 6
29	29	Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not 7
30	30	administer agents that are primarily used and classified as general anesthetics for minimal, 8
31	31	moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental, 9
32	32	methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-10
33	33	CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic, 11
34	34	therapeutic, or surgical procedures using any drug or medication. 12
35	35	(b) For critical life-saving situations requiring the immediate and emergent facilitation of 13
36	36	airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated 14
37	37	and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or 15
38	38	physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An 16
39	39	APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is 17
40	40	trained in airway management and acting within their scope of practice and approved by their 18
41	41	governing body, as authorized in this section. 19
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45	45	(c) For emergency situations where there is an imminent threat to life or limb, the APRN 1
46	46	or RN can administer anesthetic medications to preserve patient life including, but not limited to, 2
47	47	cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of 3
48	48	practice and approved by their governing body. 4
49	49	(d) Nothing in this section shall prohibit the administration and/or titration of anesthetics 5
50	50	for patients being sedated in a critical care setting (emergency room, intensive care unit) and are 6
51	51	tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of 7
52	52	practice and approved by their governing body. 8
53	53	SECTION 2. Chapter 5-34.2 of the General Laws entitled "Nurse Anesthetists" is hereby 9
54	54	amended by adding thereto the following section: 10
55	55	5-34.2-2.1. Safe administration of sedation. 11
56	56	(a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than 12
57	57	licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs 13
58	58	enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of 14
59	59	Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not 15
60	60	administer agents that are primarily used and classified as general anesthetics for minimal, 16
61	61	moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental, 17
62	62	methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-18
63	63	CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic, 19
64	64	therapeutic, or surgical procedures using any drug or medication. 20
65	65	(b) For critical life-saving situations requiring the immediate and emergent facilitation of 21
66	66	airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated 22
67	67	and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or 23
68	68	physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An 24
69	69	APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is 25
70	70	trained in airway management and acting within their scope of practice and approved by their 26
71	71	governing body, as authorized in this section. 27
72	72	(c) For emergency situations where there is an imminent threat to life or limb, the APRN 28
73	73	or RN can administer anesthetic medications to preserve patient life including, but not limited to, 29
74	74	cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of 30
75	75	practice and approved by their governing body. 31
76	76	(d) Nothing in this section shall prohibit the administration and/or titration of anesthetics 32
77	77	for patients being sedated in a critical care setting (emergency room, intensive care unit) and are 33
78	78	tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of 34
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82	82	practice and approved by their governing body. 1
83	83	SECTION 3. This act shall take effect upon passage. 2
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90	90	EXPLANATION
91	91	BY THE LEGISLATIVE COUNCIL
92	92	OF
93	93	A N A C T
94	94	RELATING TO BUSINESSES AND PROFESSIONS -- NURSES
95	95	***
96	96	This act would establish that the elective and/or independent administration of propofol, 1
97	97	Etomidate, sodium thiopental, methohexital, and volatile anesthetics for any surgery or procedure 2
98	98	is not, generally, within the “scope of practice” of registered nurses and non-CRNA advance 3
99	99	practice registered nurses as defined in chapter 34.3 of title 5 and would restrict the administration 4
100	100	of these medications to licensed certified registered nurse anesthetists. It would also detail each of 5
101	101	those limited emergency circumstances where a registered nurse and advanced practice registered 6
102	102	nurses, may safely administer sedation, such as critical life-saving or emergency situations where 7
103	103	there is an imminent threat to life or limb. This act would detail each of those limited emergency 8
104	104	circumstances where registered nurses and advanced practice registered nurses, may safely 9
105	105	administer sedation, such as critical life-saving or emergency situations where there is an imminent 10
106	106	threat to life or limb. 11
107	107	This act would take effect upon passage. 12
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