BILL ANALYSIS Ó
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|Hearing Date:June 25, 2012 |Bill No:AB |
| |2561 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: AB 2561Author:Roger Hernández
As Amended:April 26, 2012 Fiscal:Yes
SUBJECT: Certified surgical technologists.
SUMMARY: Establishes the Certified Surgical Technologist Act and
specifies educational and certification requirements, and specific
patient care activities of surgical technologists.
Existing law: Provides for the licensure and regulation of healing
arts licensees by boards within the Department of Consumer Affairs,
including the licensure and regulation of physicians and surgeons by
the Medical Board of California.
This bill:
1)Establishes the Certified Surgical Technologist Act.
2)Defines the following:
a) "Certified surgical technologist" means a person who
practices surgical technology and who has successfully completed
a nationally accredited education program for surgical
technologists and holds and maintains certification as a surgical
technologist.
b) "Surgical technology" means intra-operative surgical patient
care including:
i) Preparing the operating room for surgical procedures by
ensuring that surgical equipment is functioning properly and
safely.
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ii) Preparing the operating room and the sterile field for
surgical procedures by preparing sterile supplies, instruments,
and equipment using sterile technique.
iii)Anticipating the needs of the surgical team based on
knowledge of human anatomy and pathophysiology and how they
relate to the surgical patient and the patient's surgical
procedure.
iv)As directed in an operating room setting, performing the
following tasks at the sterile field:
(1) Passing supplies, equipment, or instruments.
(2) Sponging or suctioning an operative site.
(3) Preparing and cutting suture material.
(4) Transferring and pouring irrigation fluids.
(5) Transferring but not administering drugs within the
sterile field.
(6) Handling specimens.
(7) Holding retractors and other instruments.
(8) Applying electrocautery to clamps on bleeders.
(9) Connecting drains to suction apparatus.
(10) Applying dressings to closed wounds.
(11) Assisting in counting sponges, needles, supplies,
and instruments with the registered nurse circulator.
(12) Cleaning and preparing instruments for
sterilization on completion of the surgery.
(13) Assisting the surgical team with cleaning of the
operating room on completion of
the surgery.
3)Makes it unlawful for a person to use the title "certified surgical
technologist" unless the person meets certain educational
requirements and holds a certification by a specified entity.
4)Specifies that healing arts licensees are not prohibited from
performing a task or function within their licensure scope, and that
this bill does not apply to licensed registered nurses, licensed
vocational nurses, or persons responsible for cleaning or
sterilization of supplies, instruments, equipment, or operating
rooms.
FISCAL EFFECT: According to the Assembly Appropriations Committee
analysis dated May 9, 2012, this bill will result in negligible direct
state costs. Previous versions of this bill established registration
fees, a Surgical Technologist Fund, and oversight by a Certified
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Surgical Technologist Committee within the Medical Board of California
for purposes of this title act. Recent amendments removed these
provisions. This bill no longer specifies a role for an oversight and
enforcement entity or fee collection; however, putting this title
protection in statute could result in pressure to establish state
oversight. Such oversight could cost in the range of $200,000-$500,000
per year.
COMMENTS:
1)Purpose. This bill is sponsored by the California State Assembly
Association of Surgical Technologists (CSA-AST). According to the
Author, this bill would provide state title recognition for
Certified Surgical Technologists who hold nationally recognized
credentials in surgical technology and work to prevent surgical site
infections.
2)Background.
a) Surgical Site Infections. In a 2007 report from the Joint
Commission on Quality and Safety, surgical site infections were
listed as the second most common hospital-acquired infections in
the United States. According to a 2001 report, three of every
100 operations performed in the United States are complicated by
surgical site infections (Gaynes, et al. 2001). Additionally
over 8% of hospital acquired infections that were associated with
deaths in the United States were surgical site infections
(Klevens et al., 2007).
b) Surgical Technologists. California is home to an estimated
5000 of the nation's 90,000 surgical technologists. Surgical
technologists are allied health professionals who are part of the
team of medical practitioners who provide surgical care to
patients. They work under the supervision of a surgeon to
facilitate safe surgical procedures by ensuring that the
operating room environment is safe, equipment functions a
properly, and the operative procedures are conducted under
conditions that maximize patient safety. Surgical technologists
possess training in the theory and application of sterile and
aseptic technique in order to assist a physician in their
performance of invasive therapeutic and diagnostic procedures.
Surgical technologists graduate from surgical technology programs
accredited by the Accreditation Review Committee on Education in
Surgical Technology (ARC-ST).
c) Current Oversight. The National Board of Surgical Technology
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and Surgical Assisting (NBSTSA) was established in 1974 as the
certifying agency for surgical technologists. NBSTSA is solely
responsible for all decisions regarding certification; from
determining eligibility to maintaining, denying, granting and
renewing the designation. The NBSTSA determines, through
examination, if an individual has acquired both theoretical and
practical knowledge of surgical technology or surgical first
assisting.
According to the NBSTSA, "?because certification is voluntary, the
choice to become certified exhibits pride in the profession, the
desire to be recognized for mastery of scientific principles, as
well as an ongoing commitment to quality patient care."
Certification is a means for upward mobility, a condition for
employment, a route to higher pay, and a source of recognition
nationwide. Approved candidates who take and pass the Certified
Surgical Technician examination are authorized to use the
initials "CST" as long as they maintain certification currency.
In California, there are approximately 1400 surgical
technologists who are certified.
3)Arguments in Support. According to the Sponsor, surgical
technologists are the only health care professionals engaged in
surgical suite activity without state recognition of their
profession and the attendant standards of care which their work in
such settings warrant. The Sponsor states that a key purpose of the
bill is to encourage the education, training and utilization of
certified surgical technologists in California given their important
work in surgical settings.
4)Proposed Author's Amendments. The Author has proposed the following
amendment:
§2525.22(a) "Certified surgical technologist" means a person who
practices surgical technology, and who has successfully completed a
nationally accredited educational program for surgical technologists
and holds and maintains certification as a surgical technologist by
any of the entities described in Section 2525.24."
§ 2525.31. "This article does not prohibit or limit any healing arts
licensee or any other health care practitioner described in this
division from performing a task or function within the his or her
scope of the healing art licensee's license , nor shall it be
construed as such."
SUPPORT AND OPPOSITION:
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Support: California State Assembly Association of Surgical
Technologists (Sponsor)
Opposition: None on file as of June 20, 2012.
Consultant:Le Ondra Clark