Section 8-513 - Nurse anesthetist(a) In this section, "perioperative assessment and management" means the assessment and management of a patient preoperatively, intraoperatively, and postoperatively.(b)(1) A nurse anesthetist may perform the following functions: (i) Perioperative assessment and management of patients requiring anesthesia services;(ii) Administration of anesthetic agents;(iii) Management of fluids in intravenous therapy;(iv) Respiratory care; and(v) Subject to paragraph (4) of this subsection, prescription, ordering, and administration of drugs, including a drug that is classified as a controlled dangerous substance under Title 5, Subtitle 4 of the Criminal Law Article.(2) A nurse anesthetist has the right and obligation to refuse to perform a delegated act if in the nurse anesthetist's judgment, the act is:(ii) An invalidly prescribed medical act; or(iii) Beyond the clinical skills of the nurse anesthetist.(3) Paragraph (1) of this subsection may not be construed to authorize a nurse anesthetist to: (i) Diagnose a medical condition;(ii) Provide care that is not consistent with the scope of practice of nurse anesthetists; or(iii) Provide care for which the nurse anesthetist does not have proper education and experience.(4) A nurse anesthetist may prescribe drugs under paragraph (1) of this subsection:(i) Only in an amount that does not exceed a 10-day supply;(ii) Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and(iii) Only in connection with the delivery of anesthesia services.(c) A nurse anesthetist shall collaborate with an anesthesiologist, a licensed physician, or a dentist in the following manner:(1) An anesthesiologist, a licensed physician, or a dentist shall be physically available to the nurse anesthetist for consultation at all times during the administration of, and recovery from, anesthesia;(2) An anesthesiologist shall be available for consultation to the nurse anesthetist for other aspects of the practice of nurse anesthesia; and(3) If an anesthesiologist is not available, a licensed physician or dentist shall be available to provide this type of consultation.(d) The nurse anesthetist shall ensure that a qualified anesthesia provider: (1) Performs a thorough and complete preanesthetic assessment;(2) Obtains informed consent for the planned anesthetic intervention from the patient or an individual responsible for the patient; and(3) Formulates a patient-specific plan for anesthesia care.(e) The nurse anesthetist as part of the standards of practice shall: (1) Implement and adjust an anesthesia care plan as needed to adapt to the patient's response to the anesthesia;(2) Monitor a patient's physiologic condition for untoward identifiable reactions and initiate appropriate corrective actions as required;(3) Enter prompt, complete, and accurate documentation of pertinent information on a patient's record;(4) Transfer responsibility for care of a patient to other qualified providers in a manner that ensures continuity of care and patient safety;(5) Ensure that appropriate safety precautions are taken to minimize the risks of fire, explosion, electrical shock, and equipment malfunction;(6) Maintain appropriate infection control standards;(7) Evaluate anesthesia care to ensure its quality;(8) Maintain continual competence in anesthesia practice; and(9) Respect and maintain the basic rights of patients.(f) This section may not be construed to require a written collaboration agreement between a nurse anesthetist and an anesthesiologist, a physician, or a dentist.Amended by 2022 Md. Laws, Ch. 686, Sec. 1, eff. 10/1/2022.Added by 2018 Md. Laws, Ch. 483, Sec. 2, eff. 10/1/2018.