St. Mark's Hospital - May 11, 2017

Please review your operating room practices to assure that we are all consistently adhering to the following requirements. These requirements were endorsed by the MEC on April 18, 2017.

Advanced practice professionals (APPs, e.g. physician assistants and advanced practice registered nurses – CNP, CRNA, CNM, CNS):

  1. May only practice within the boundaries of their granted privileges, or reasonable extensions of the same.
    1. If the surgical task is not explicitly stated in iPrivileges and is not a reasonable extension of an explicitly stated privilege, the APP is not permitted to perform that surgical task regardless the level of physician supervision.
  2. May only implant surgical hardware in a patient, within the scope of the APP’s granted privileges, under the direct in-room supervision of the operating surgeon.
    1. The operating surgeon should either implant the surgical hardware him/herself, or remain physically present in the operating room and directly observe the APP perform the surgical hardware implantation. The surgeon may not leave the operating room during any phase of the implantation of surgical hardware, except in a life-threatening emergency. In the event of a life-threatening emergency that required the operating surgeon to temporarily leave the operating room, the APP should cease the surgical hardware implantation until the operating surgeon returns to the operating room.
  3. May not perform critical components of an operation on one patient at the same time that the operating surgeon is performing critical components of an operation on another patient.
    1. Concurrent or simultaneous surgeries for which the primary attending surgeon is responsible are not permitted.

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