THE FLORIDA BOARD OF MEDICINE

4052 BALD CYPRESS WAY BIN #C03

TALLAHASSEE FL 32399-1753

This protocol is required to be filed for each nurse anesthetist. It only needs signed by one physician.

In the past, protocols were required to be submitted on a yearly basis and every time there was a change in the protocols. Effective May 6, 2013, a change in Rule 64B8-35.002, FAC will require the protocols to be submitted within thirty days of renewal of the ARNPs’s license and upon any change, including termination of the protocol. This change makes the rule consistent with the Board of Nursing requirements for protocols. Both the physician and the ARNP must maintain a copy of the protocol for a minimum of four years.

A form, ARNP/EMT/Paramedic Protocol Form, is available at the Board of Medicine’s website at www.FLBoardofMedicine.gov, Resources. If you have any questions, feel free to contact the Board

The following is an example – There is also a form available at http://www.doh.state.fl.us/mqa/medical/frm_ARNPprotocol.pdf

The highlighted information was updated 7/12/13

1. The first page is for hospital CRNA’s.

2. The second page is for CRNA’s that work at locations outside of the hospital.

Note - Pursuant to Florida Board of Medicine, effective April 15, 2002 all level III office surgeries must have the anesthesia provided by an anesthesiologist or by an anesthesia provider under the direct supervision of a licensed M.D. or D.O. anesthesiologist other than the surgeon.

ENTER NAME AND ADDRESS OF GROUP

A.R.N.P. Protocol

April 19, 2001

Re: Name of CRNA

License #

Certificate #

The above-referenced is certified as an Advanced Registered Nurse Practitioner and may perform duties as an anesthetist at all (insert hospital name) locations. These duties will be performed as outlined in the bylaws and the rules and regulations of these facilities.

Specifically:

1) A sponsoring anesthesiologist shall, at all times during the course of any anesthetic administered by the Certified Registered Nurse Anesthetist, be physically present in the facility and shall not administer anesthesia at the same time as that of the supervised anesthetist, except in case of emergency, administering an epidural or caudal anesthetic to a patient in labor, or performing periodic, rather than continuous, monitoring of an obstetrical patient.

2) No more than four registered nurse anesthetists shall be supervised at one time by the anesthesiologist, except in case of emergency.

3) The anesthesiologist will make a pre-operative evaluation of every patient and the registered nurse anesthetist will administer the anesthetic as directed by the anesthesiologist. The registered nurse anesthetist may be designated to make a post-operative evaluation of the patient.

4) (Insert name of group practice) has designated (Insert name of physician) M.D., President, as the affirming physician that the undersigned nurse anesthetist is our employee and abides by the above protocol.

CRNA Signature (Insert name), M.D., President

ENTER NAME AND ADDRESS OF GROUP

A.R.N.P. Protocol

April 19, 2001

Re: Name of CRNA

License #

Certificate #

The above-referenced is certified as an Advanced Registered Nurse Practitioner and may perform duties as an anesthetist at all (insert hospital name) locations. These duties will be performed as outlined in the bylaws and the rules and regulations of these facilities.

Specifically:

1) A sponsoring anesthesiologist or Florida-licensed medical doctor shall, at all times during the course of any anesthetic administered by the Certified Registered Nurse Anesthetist, be physically present in the facility and shall not administer anesthesia at the same time as that of the supervised anesthetist, except in case of emergency, administering an epidural or caudal anesthetic to a patient in labor, or performing periodic, rather than continuous, monitoring of an obstetrical patient.

2) No more than four registered nurse anesthetists shall be supervised at one time by the anesthesiologist, except in case of emergency.

3) The anesthesiologist will make a pre-operative evaluation of every patient and the registered nurse anesthetist will administer the anesthetic as directed by the anesthesiologist. The registered nurse anesthetist may be designated to make a post-operative evaluation of the patient.

4)  (Insert name of group practice ) has designated (insert name), M.D., President, as the affirming physician that the undersigned nurse anesthetist is our employee and abides by the above protocol.

CRNA Signature (Insert name), M.D., President