WSR 00-23-119

PERMANENT RULES

DEPARTMENT OF HEALTH


(Surgical Technologist Program)

[ Filed November 22, 2000, 10:05 a.m. ]

Date of Adoption: September 19, 2000.

Purpose: WAC 246-939-010 Who can delegate to a surgical technologist?, 246-939-030 Who needs to be registered as a surgical technologist?, and 246-939-050 Are there tasks a surgical technologist is not allowed to do? The rules define who can delegate to a surgical technologist; give examples of typical tasks to identify who needs to register and to protect public safety since there is no advisory committee relating to surgical technologists; lists activities that are prohibited so that surgical technologists can be informed.

Statutory Authority for Adoption: Chapter 18.215 RCW.

Other Authority: RCW 18.130.050.

Adopted under notice filed as WSR 00-11-167 on May 24, 2000.

Changes Other than Editing from Proposed to Adopted Version: A change has been made to WAC 246-939-030 to clarify that stapling is allowed only for "skin stapling" and not "deep tissue" stapling. This is because, when directed by the surgeon by placing the stapler or approximating the skin, skin stapling does not need the use of judgment on the part of the surgical technologist. The law relating to surgical technologists does not require education or examination. Also clarified the definition of surgical setting so that it would be clear who really needs to register under this law.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 3, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 3, Amended 0, Repealed 0. Effective Date of Rule: Thirty-one days after filing.

November 15, 2000

M. C. Selecky

Secretary

OTS-3978.4


NEW SECTION
WAC 246-939-010
Who can delegate to a surgical technologist?

Health care practitioners who may delegate as referenced in RCW 18.215.010 and include:

     (1) Physicians licensed under chapter 18.71 RCW.

     (2) Registered nurses and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

     (3) Osteopathic physicians licensed under chapter 18.57 RCW.

     (4) Osteopathic physician assistants licensed under chapter 18.57A RCW.

     (5) Podiatric physicians licensed under chapter 18.22 RCW.

     (6) Dentists licensed under chapter 18.32 RCW.

     (7) Physician's assistants and physician's assistant surgical assistants licensed under chapter 18.71A RCW.

     (8) Naturopathic physicians as licensed under chapter 18.36A RCW.

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NEW SECTION
WAC 246-939-030
Who needs to be registered as a surgical technologist?

(1) Anyone representing themselves as a surgical technologist by title or by description as a person who performs tasks in the surgical setting under the delegation of authority of a licensed health care practitioner.

     (2) For the purposes of this chapter "surgical setting" means any place surgery takes place where the patient is placed in a sterile field.

     (3) Surgical technologists perform tasks that typically consist of, but are not limited to, the following tasks in a surgical setting:

     (a) Prepare basic sterile packs and trays.

     (b) Assist with the physical preparation of the operating room, creating the sterile field, and maintaining sterile technique during operative procedure.

     (c) Identify and select appropriate packs, trays and accessory/specialty equipment for each surgery.

     (d) Prepare supplies and instruments for sterile field.

     (e) Assists with the count of instruments, sponges, needles and other surgical items. Surgical technologists are not accountable for the final count of surgical instrumentation.

     (f) Pass correct instruments, supplies and sutures as needed by the surgeon.

     (g) Sponge or suction the operative site, retract tissue for exposure at the operative site and assist with irrigation under immediate supervision of the licensed health care practitioner.

     (h) Cut sutures placed by the authorized health care practitioner.

     (i) Prepare specimens for submission for pathological analysis.

     (j) Fire automatic staple gun as directed by the licensed health care practitioner for skin stapling. Deep tissue stapling is not allowed.

     (k) Move drugs to the sterile field.

     (4) Registered nurses, practical nurses and other credentialed providers acting within their scope do not need to register.

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NEW SECTION
WAC 246-939-050
Are there tasks a surgical technologist is not allowed to do?

Tasks that shall not be performed by a surgical technologist include:

     (1) Activities that constitute the practice of medicine under the Medical Practice Act in RCW 18.71.011 including: Prescribing or administering; penetrating or severing tissue, including, but not limited to, suturing and cutting/incisions, regardless of instrumentality.

     (2) Dispensing medications, as defined in RCW 18.64.011 and 69.41.010.

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