Maryland § 8-513

§ 8-513.

    (a)    In this section, “perioperative assessment and management” means the assessment and management of a patient preoperatively, intraoperatively, and postoperatively.

    (b)    (1)    A nurse anesthetist may perform the following functions:

            (i)    Perioperative assessment and management of patients requiring anesthesia services;

            (ii)    Administration of anesthetic agents;

            (iii)    Management of fluids in intravenous therapy;

            (iv)    Respiratory care; and

            (v)    Subject to paragraph (4) of this subsection, prescription, ordering, and administration of drugs, including a drug that is classified as a controlled dangerous substance under Title 5, Subtitle 4 of the Criminal Law Article.

        (2)    A nurse anesthetist has the right and obligation to refuse to perform a delegated act if in the nurse anesthetist’s judgment, the act is:

            (i)    Unsafe;

            (ii)    An invalidly prescribed medical act; or

            (iii)    Beyond the clinical skills of the nurse anesthetist.

        (3)    Paragraph (1) of this subsection may not be construed to authorize a nurse anesthetist to:

            (i)    Diagnose a medical condition;

            (ii)    Provide care that is not consistent with the scope of practice of nurse anesthetists; or

            (iii)    Provide care for which the nurse anesthetist does not have proper education and experience.

        (4)    A nurse anesthetist may prescribe drugs under paragraph (1) of this subsection:

            (i)    Only in an amount that does not exceed a 10–day supply;

            (ii)    Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and

            (iii)    Only in connection with the delivery of anesthesia services.

    (c)    A nurse anesthetist shall collaborate with an anesthesiologist, a licensed physician, or a dentist in the following manner:

        (1)    An anesthesiologist, a licensed physician, or a dentist shall be physically available to the nurse anesthetist for consultation at all times during the administration of, and recovery from, anesthesia;

        (2)    An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and

        (3)    If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.

    (d)    The nurse anesthetist shall ensure that a qualified anesthesia provider:

        (1)    Performs a thorough and complete preanesthetic assessment;

        (2)    Obtains informed consent for the planned anesthetic intervention from the patient or an individual responsible for the patient; and

        (3)    Formulates a patient–specific plan for anesthesia care.

    (e)    The nurse anesthetist as part of the standards of practice shall:

        (1)    Implement and adjust an anesthesia care plan as needed to adapt to the patient’s response to the anesthesia;

        (2)    Monitor a patient’s physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;

        (3)    Enter prompt, complete, and accurate documentation of pertinent information on a patient’s record;

        (4)    Transfer responsibility for care of a patient to other qualified providers in a manner that ensures continuity of care and patient safety;

        (5)    Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;

        (6)    Maintain appropriate infection control standards;

        (7)    Evaluate anesthesia care to ensure its quality;

        (8)    Maintain continual competence in anesthesia practice; and

        (9)    Respect and maintain the basic rights of patients.

    (f)    This section may not be construed to require a written collaboration agreement between a nurse anesthetist and an anesthesiologist, a physician, or a dentist.