<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.27.06.06" title_num="10" subtitle_num="27" chapter_num="06" heading="Standards of Practice.">
  <paragraph num="A.">
    <text>A nurse anesthetist shall collaborate with an anesthesiologist, licensed physician, or dentist in the following manner:</text>
    <paragraph num="(1)">
      <text>An anesthesiologist, licensed physician, or dentist shall be physically available to the nurse anesthetist for consultation at all times during the administration of, and recovery from, anesthesia;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The nurse anesthetist shall assure that a qualified anesthesia provider:</text>
    <paragraph num="(1)">
      <text>Performs a thorough and complete preanesthetic assessment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Obtains informed consent for the planned anesthetic intervention from the patient or responsible other; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Formulates a patient-specific plan for anesthesia care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The nurse anesthetist as part of the standards of practice shall:</text>
    <paragraph num="(1)">
      <text>Implement and adjust the anesthesia care plan as needed to adapt to the patient's response to the anesthesia;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Monitor the patient's physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Enter prompt, complete, and accurate documentation of pertinent information on the patient's record;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Transfer responsibility for care of the patient to other qualified providers in a manner which assures continuity of care and patient safety;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Maintain appropriate infection control standards;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Evaluate anesthesia care to assure its quality;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Maintain continual competence in anesthesia practice;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Respect and maintain the basic rights of patients; and</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
</regulation>