Florida Senate - 2025 SB 718
By Senator Rodriguez
40-01588-25 2025718__
1 A bill to be entitled
2 An act relating to autonomous practice by a certified
3 registered nurse anesthetist; amending s. 395.0191,
4 F.S.; revising staff membership and clinical
5 privileges for certain certified registered nurse
6 anesthetists; amending s. 464.012, F.S.; authorizing
7 certain certified registered nurse anesthetists to
8 perform specified acts under certain circumstances;
9 amending s. 464.0123, F.S.; revising practice
10 requirements for autonomous advanced practice
11 registered nurses; authorizing autonomous advanced
12 practice registered nurses to perform certain acts;
13 providing an effective date.
14
15 Be It Enacted by the Legislature of the State of Florida:
16
17 Section 1. Paragraph (b) of subsection (2) of section
18 395.0191, Florida Statutes, is amended to read:
19 395.0191 Staff membership and clinical privileges.—
20 (2)
21 (b) An advanced practice registered nurse who is certified
22 as a registered nurse anesthetist licensed under part I of
23 chapter 464 shall administer anesthesia under the onsite medical
24 direction of a professional licensed under chapter 458, chapter
25 459, or chapter 466, and in accordance with an established
26 protocol approved by the medical staff. The medical direction
27 shall specifically address the needs of the individual patient.
28 This paragraph does not apply to an autonomous advanced practice
29 registered nurse registered under s. 464.0123 who is certified
30 as a registered nurse anesthetist licensed under part I of
31 chapter 464; however, a facility may require a certified
32 registered nurse anesthetist who is registered and practicing
33 under s. 464.0123 to perform acts under an established protocol
34 approved by the medical staff or the governing board of the
35 facility.
36 Section 2. Paragraph (b) of subsection (4) of section
37 464.012, Florida Statutes, is amended to read:
38 464.012 Licensure of advanced practice registered nurses;
39 fees; controlled substance prescribing.—
40 (4) In addition to the general functions specified in
41 subsection (3), an advanced practice registered nurse may
42 perform the following acts within his or her specialty:
43 (b) A The certified registered nurse anesthetist may, to
44 the extent authorized by an established protocol approved by the
45 medical staff of the facility in which the anesthetic service is
46 performed, or a certified registered nurse anesthetist that is
47 registered and practicing under s. 464.0123 without an
48 established protocol, may perform any or all of the following:
49 1. Determine the health status of the patient as it relates
50 to the risk factors and to the anesthetic management of the
51 patient through the performance of the general functions.
52 2. Based on history, physical assessment, and supplemental
53 laboratory results, determine, with the consent of the
54 responsible physician, the appropriate type of anesthesia under
55 within the framework of the protocol unless the certified
56 registered nurse anesthetist is registered and practicing under
57 s. 464.0123 without an established protocol.
58 3. Order under the protocol preanesthetic medication under
59 the protocol unless the certified registered nurse anesthetist
60 is registered and practicing under s. 464.0123 without an
61 established protocol.
62 4. Perform under the protocol procedures commonly used to
63 render the patient insensible to pain during the performance of
64 surgical, obstetrical, therapeutic, or diagnostic clinical
65 procedures under the protocol unless the certified registered
66 nurse anesthetist is registered and practicing under s. 464.0123
67 without an established protocol. These procedures include
68 ordering and administering regional, spinal, and general
69 anesthesia; inhalation agents and techniques; intravenous agents
70 and techniques; and techniques of hypnosis.
71 5. Order or perform monitoring procedures indicated as
72 pertinent to the anesthetic health care management of the
73 patient.
74 6. Support life functions during anesthesia health care,
75 including induction and intubation procedures, the use of
76 appropriate mechanical supportive devices, and the management of
77 fluid, electrolyte, and blood component balances.
78 7. Recognize and take appropriate corrective action for
79 abnormal patient responses to anesthesia, adjunctive medication,
80 or other forms of therapy.
81 8. Recognize and treat a cardiac arrhythmia while the
82 patient is under anesthetic care.
83 9. Participate in management of the patient while in the
84 postanesthesia recovery area, including ordering the
85 administration of fluids and drugs.
86 10. Place special peripheral and central venous and
87 arterial lines for blood sampling and monitoring as appropriate.
88
89 A certified registered nurse anesthetist registered and
90 practicing under s. 464.0123 without an established protocol may
91 only perform acts authorized under part I of this chapter.
92 Section 3. Paragraph (a) of subsection (3) of section
93 464.0123, Florida Statutes, is amended to read:
94 464.0123 Autonomous practice by an advanced practice
95 registered nurse.—
96 (3) PRACTICE REQUIREMENTS.—
97 (a) An advanced practice registered nurse who is registered
98 under this section may:
99 1. Engage in autonomous practice only in primary care
100 practice, including family medicine, general pediatrics, and
101 general internal medicine, as defined by board rule.
102 2. For certified nurse midwives, engage in autonomous
103 practice in the performance of the acts listed in s.
104 464.012(4)(c).
105 3. Perform the general functions of an advanced practice
106 registered nurse under s. 464.012(3) related to primary care.
107 4. For certified registered nurse anesthetists registered
108 and practicing under this section, perform the acts listed in s.
109 464.012(4)(b).
110 5.4. For a patient who requires the services of a health
111 care facility, as defined in s. 408.032(8):
112 a. Admit the patient to the facility.
113 b. Manage the care received by the patient in the facility.
114 c. Discharge the patient from the facility, unless
115 prohibited by federal law or rule.
116 6.5. Provide a signature, certification, stamp,
117 verification, affidavit, or endorsement that is otherwise
118 required by law to be provided by a physician, except an
119 advanced practice registered nurse registered under this section
120 may not issue a physician certification under s. 381.986.
121 Section 4. This act shall take effect July 1, 2025.