N.J. Admin. Code § 13:35-6.20A

Current through Register Vol. 56, No. 11, June 3, 2024

Section 13:35-6.20A - Radiologist assistant performing procedures

(a) The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:

"Direct supervision" means that a licensed radiologist must be present in the office suite or department and immediately available to furnish assistance and direction throughout the performance of a procedure, but the licensed radiologist is not required to be present in the room when the procedure is performed.

"General supervision" means that a procedure is performed under a licensed radiologist's direction and control, but the licensed radiologist's presence in the office suite or department is not required during the performance of the procedure.

"Licensed radiologist" means a radiologist as the term is defined at N.J.S.A. 26:2D-26.

"Personal supervision" means that the licensed radiologist must be present in the room during the performance of a procedure.

"Radiologist assistant" means a radiologic technologist licensed by the New Jersey Radiologic Technology Board of Examiners who is certified and registered with a national radiologic certifying body approved by the New Jersey Radiologic Technology Board of Examiners and is credentialed to provide primary advanced-level radiology health care under the supervision of a licensed radiologist.

(b) A licensed radiologist may direct a radiologist assistant to perform the tasks set forth at (c) below provided that:

1. The licensed radiologist has personally certified and documented the radiologist assistant's training and competency to perform the task. The documents shall be preserved in the personnel record and retained for at least the duration of such radiologist assistant's employment by or for that licensed radiologist or licensed health care facility;

2. The licensed radiologist is responsible for the choice and ordering of all pharmaceuticals and contrast materials and for the determination of dosage and route of administration;

3. For pediatric patients, the licensed radiologist shall have experience in the performance of the pertinent procedures with such patients; and

4. The licensed radiologist is currently certified in and has verified that the radiologist assistant is currently certified in Advanced Cardiovascular Life Support (ACLS) by the American Heart Association.

(c) A licensed radiologist may direct a radiologist assistant to:

1. Under general supervision, obtain the clinical history and physical examination of the patient by:

i. Reviewing the patient's medical record to verify the appropriateness of a specific exam or procedure;

ii. Interviewing the patient to obtain, verify, or update medical history;

iii. Explaining a procedure to the patient or significant other of the patient, including a description of the risks, benefits, alternatives, and follow-up care;

iv. Obtaining informed consent, as long as the patient is provided the opportunity to communicate with the licensed radiologist if the patient has any questions;

v. Determining if the patient has followed instructions in preparation for the exam, such as diet and pre-medications;

vi. Assessing risk factors that may be contraindications to the procedure, such as health history, medications, pregnancy, psychological indicators, and alternative medicines and informing the licensed radiologist of the findings;

vii. Obtaining and evaluating vital signs;

viii. Performing the physical examination of the patient and analyzing data, such as signs and symptoms, laboratory values, and significant abnormalities, provided that the licensed radiologist reviews all reported data prior to a procedure being performed; and

ix. Participating in quality improvement activities;

2. Under general supervision, perform the following general procedures:

i. Applying electrocardiography (ECG) leads and recognizing life threating ECG abnormalities;

ii. Performing urinary catheterization, except for instances where there is a known anatomic anomaly or recent surgery to this area;

iii. Performing venipuncture;

iv. Monitoring intravenous (IV) for flow rate and complications;

v. Positioning patient to perform required procedures, using immobilization devices and modifying technique, as necessary;

vi. Assessing patient's vital signs, levels of anxiety, and pain, informing the licensed radiologist, when appropriate, and bringing to the patient's physician any issues of concern;

vii. Recognizing and responding to medical emergencies, such as drug reactions, cardiac arrest, and hypoglycemia, and activating emergency response systems, including notification of the licensed radiologist;

viii. Administering oxygen, as prescribed;

ix. Operating a fixed or mobile fluoroscopic unit;

x. Assuring documentation of fluoroscopy time; and

xi. Explaining the effects and potential side effects to the patient of pharmaceuticals required for the examination;

xii. -xiii. (Reserved)

3. Under general supervision, perform the following post-imaging activities:

i. Reviewing imaging procedures, making initial observations, and communicating observations only to the licensed radiologist;

ii. Communicating the licensed radiologist's report to referring physician;

iii. Providing licensed radiologist-prescribed post-care instructions to patients;

iv. Performing follow-up patient evaluation and communicating findings to the licensed radiologist;

v. Documenting the procedure in appropriate record and documenting exceptions from established protocol or procedure;

vi. Writing patient discharge summary for review and co-signature by licensed radiologist;

vii. Participating in quality improvement activities within the licensed radiologist's practice; and

viii. Assisting with data collection and review for clinical trials or other research;

4. Under direct supervision, perform the following general procedures:

i. Monitoring intravenous (IV) therapy for flow rate and complications;

ii. Administering oral medications;

iii. Monitoring patient for side effects or complications of the pharmaceuticals; and

iv. Administering radiopharmaceuticals as prescribed by the licensed radiologist;

5. Under personal supervision, perform urinary catheterization when there is a known anatomic anomaly or recent surgery to this area;

6. Under direct supervision, perform the following examinations and procedures, including contrast media administration, placement of needle or catheter, and operation of imaging equipment:

i. Upper GI;

ii. Esophagus;

iii. Small bowel studies;

iv. Barium enema;

v. Injection of contrast material into percutaneous gastric and enteric tubes;

vi. Cystogram, except that a radiologist assistant shall not place a suprapubic catheter;

vii. T-Tube cholangiogram, except that a radiologist assistant shall not place a catheter;

viii. (Reserved)

ix. Port injections;

x. (Reserved)

xi. Loopogram;

xii. Swallowing study;

xiii. Peripherally Inserted Central Catheter (PICC) placement; and

xiv. Monitoring of paracentesis and thoracentesis with appropriate image guidance after catheter has been placed by a radiologist; and

7. Under personal supervision, perform the following examinations and procedures, including contrast media administration, placement of needle or catheter, and operation of imaging equipment:

i. Joint injection and aspiration; and

ii. Arthrogram, including conventional, computerized tomography (CT), and magnetic resonance imaging (MRI).

(d) -(e) (Reserved)

N.J. Admin. Code § 13:35-6.20A

Adopted by 55 N.J.R. 67(a), effective 1/3/2023