New Jersey regulations focus on patient safety

The regulations for office-based anesthesia adopted by the New Jersey State Board of Medical Examiners in Trenton are basically the same regulations governing ambulatory surgery centers, says Ervin Moss, MD, executive medical director of the New Jersey State Society of Anesthesiologists in Princeton Junction. The regulations spell out exactly what is expected of a physician providing anesthesia services within an office setting in these areas:

Policies and procedures.

Practitioners are required to have written policies that address the specific procedures performed in the office, the responsibilities of staff members providing services, infection control practices, procedures to follow during patient’s recovery time, and procedures to follow if a patient experiences complications.

Incident reports.

Any incident related to surgery, anesthesia, or special procedures that results in a patient’s death, transport to a hospital, or complications has to be reported, in writing, within seven days to the Board of Medical Examiners.

Practitioner standards.

Physicians may only perform services for which they are credentialed to perform in a hospital. Physicians must also have a written agreement with a hospital and licensed ambulance service for transport of patients experiencing complications. Requirements for history and physicals, informed consent, preoperative and postoperative care, and information that is required for the medical record are defined. Personnel authorized to perform general anesthesia, regional anesthesia, conscious sedation, and minor conduction blocks are defined.

Equipment.

Equipment and safety systems required for all locations that provide anesthesia are defined. Examples of equipment required are precordial stethoscope or esophageal stethoscope and a peripheral nerve stimulator, pulse oximeter with appropriate alarms, continuous electrocardiograph with paper recorder, defibrillator, and a respirometer. Locations that provide services to children and infants are required to have emergency equipment and safety devices that are appropriately sized for pediatric patients.

Maintenance.

Service and maintenance records are to be kept on all anesthesia machines, ventilators, and vaporizers. A daily inspection of equipment is to be performed by the physician or a certified registered nurse anesthetist, and prior to each use, an inspection is to be performed and results documented on the anesthesia record.

For a full copy of the regulations, which are free, contact the New Jersey Board of Medical Examiners, 140 E. Front St., Second Floor, Trenton, NJ 08608. Telephone: (609) 826-7100.