Association of periOperative Registered Nurses

Massachusetts  Government Affairs

State Coordinator

Deborah L. Farina-Mulloy
(617) 244-6793

Regional Coordinator

Carmen Sierra

RN Circulator Laws and Language

Hospital: CODE OF MASSACHUSETTS REGULATIONS TITLE 105: DEPARTMENT OF PUBLIC HEALTH CHAPTER 130.000: HOSPITAL LICENSURE SUBPART B GENERAL REQUIREMENTS 130.200: Incorporation of Medicare Conditions of Participation in Hospitals Each hospital shall meet all of the requirements of the Medicare Conditions of Participation for Hospitals, 42 C.F.R. 482.11 through 482.62 (hereinafter Conditions of Participation), and as they may be amended from time to time . . . * * 42 CFR 482.51: Condition of participation: Surgical services. (1) The operating rooms must be supervised by an experienced registered nurse or a doctor of medicine or osteopathy. (3) Qualified registered nurses may perform circulating duties in the operating room. In accordance with applicable State laws and approved medical staff policies and procedures, LPNs and surgical technologists may assist in circulatory duties under the supervision of a qualified registered nurse who is immediately available to respond to emergencies.
ASC: CODE OF MASSACHUSETTS REGULATIONS TITLE 105: DEPARTMENT OF PUBLIC HEALTH CHAPTER 140.000: LICENSURE OF CLINICS SUBPART F SURGICAL SERVICES 140.607: Adequate Assistance (B) Only registered nurses shall function as circulating nurses.

Registered Nurse First Assistants (RNFAs)

Reimbursement:  None
Definition:  None
Scope:  Massachusetts Board in the Regulation of Nursing, Advisory Ruling on Nursing Practice, Feb. 1986, Rev’d May 2002. The RNFA scope of practice includes the; Pre-operative Phase including but not limited to: Pre-admission assessment Patient & Family Education Patient & Family Interview Immediate preoperative assessment Review of patient data Collaboration & Communication with the OR staff Intra-operative Phase including but not limited to: Handling tissue Providing exposure Using instruments Suturing and providing hemostasis * The RNFA shall not concurrently function as a scrub nurse Post-operative Phase including but not limited to: Communication to the PACU staff Assist with PACU monitoring Writing transfer notes Daily rounds (may include wound management, dressing changes, suture and/or drain removal, other type of catheter & IV removal and as ordered by the duly authorized prescriber)

Legislative Tracking

MA H 2023 — 2013 RNFA Reimbursement
Would require insurers to provide for payment of surgical first assisting benefits or services provided by a registered nurse first assistant.
Comments
https://malegislature.gov/Bills/188/House/H2023  
Sponsor(s):
Linsky 
General Topic:
RNFA 
Status:
1/22/13: Referred to the Joint Committee on Public Health 
MA S 1886 — 2013 Surgical facility central service technicians
Would require certification and ongoing continuing education for central service technicians in Massachusetts hospitals and ASCs
Comments
https://malegislature.gov/Bills/188/Senate/S1886 
Sponsor(s):
Brewer 
General Topic:
Central Service 
Status:
4/28/2014: From Joint Committee on Public Health; Second Reading, Accompanied Study Order 2114 
MA H 1008 — 2013 Nurse data reporting requirement
Would require hospitals and other health care institutions to annually report patient safety data that will be available to the general public. This data could include: readmission rates, length of stay, patient/family satisfaction, nurse vacancy rates; the actual and average ratio of RNs to patients and the average skill mix ratio of licensed and unlicensed personnel to patientsl the number of falls, number of HAIs/medication errors; documentation of defined nursing interventions; documentation of patient safety measures. It would also require the department to develop nurses' ideal number of patients assigned to a RN.
Comments
http://www.malegislature.gov/Bills/188/House/H1008 Same as S 557 
Sponsor(s):
Canavan 
General Topic:
Nurse Staffing 
Status:
2/18/13: To Joint Committee on Health Care Financing 
MA H 2005 — 2013 An Act creating a Nursing Advisory Board
Would create a nursing advisory board in the office of Health and Human Services to advise the governor and general court on matters related to the practice of nursing, apply for grants and commission and fund research projects, and prepare an annual report.
Comments
https://malegislature.gov/Bills/188/House/H2005 
Sponsor(s):
Khan 
General Topic:
Misc. 
Status:
06/09/2014 :From JOINT Committee on PUBLIC HEALTH: Accompanied Study Order H 4147.  
H 2053 — 2013 An Act promoting sterilization during surgery
Would require all hospitals to maintain in surgical and intensive care units the following directive: (a) Wash your hands; (b) Clean the patient's skin with chlorhexidine antiseptic; (c) Place sterile drapes over the patient's entire body; (d) Wear a sterile gown, hat, mask and gloves; (e) Put a sterile dressing over the catheter site once the line is inserted.
Comments
http://www.malegislature.gov/Bills/188/House/H2053 
Sponsor(s):
Poirier 
General Topic:
Central Service 
Status:
06/09/2014 :From JOINT Committee on PUBLIC HEALTH: Accompanied Study Order H 4147.  
MA S 557 — 2013 Nurse data reporting requirement
Would require hospitals and other health care institutions to annually report patient safety data that will be available to the general public. This data could include: readmission rates, length of stay, patient/family satisfaction, nurse vacancy rates; the actual and average ratio of RNs to patients and the average skill mix ratio of licensed and unlicensed personnel to patients, the number of falls, number of HAIs/medication errors; documentation of defined nursing interventions; documentation of patient safety measures. It would also require the department to develop nurses' ideal number of patients assigned to a RN.
Comments
https://malegislature.gov/Bills/188/Senate/S557 Same as H1008 
Sponsor(s):
Pacheco 
General Topic:
Nurse Staffing 
Status:
07/01/2014 : • From JOINT Committee on HEALTH CARE FINANCING: Accompanied Study Order S 2237.  
S 1069 — 2013 An Act relative to robotic surgery in the Commonwealth
Would create a special commission on robotic surgery that will be responsible for conducting a study on the use or robotic surgery in the commonwealth. This study would focus on working to develop a training protocol for each application of robotic surgery currently being performed in the commonwealth, develop an application process for hospitals to propose certification of new applications of robotic surgery and establish guidelines for surgeon training and experience.
Comments
https://malegislature.gov/Bills/188/Senate/S1069 
Sponsor(s):
Moore 
General Topic:
Misc. 
Status:
07/10/2014 Amended on SENATE floor by substitution of New Draft. For further action see S 2261 
MA H 1969 — 2013 Safe Patient Handling Policy
Provides that certain health facilities be directed to establish a safe patient handling policy
Comments
 
Sponsor(s):
Garlick (D) 
General Topic:
Safe Patient Handling 
Status:
06/27/2014 : • From JOINT Committee on HEALTH CARE FINANCING: Accompanied Study Order H 4234.  
MA S 991 — 2013 Patient Handling
Accompanied by Bill H 1969
Comments
https://malegislature.gov/Bills/188/House/H1969 
Sponsor(s):
Chandler (D) 
General Topic:
Safe Patient Handling 
Status:
11/21/2013 From JOINT Committee on PUBLIC HEALTH: 
MA S 2261 — 2014 Robotic Surgery
Relates to robotic surgery in the Commonwealth; provides for a special commission to make an investigation and study of robotic surgery; provides for membership.
Comments
 
Sponsor(s):
Joint Committee on Rules  
General Topic:
Misc. 
Status:
07/15/2014 : • To JOINT Committee on RULES 

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