BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                  AB 2561|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  AB 2561
          Author:   Roger Hernández (D)
          Amended:  8/6/12 in Senate
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  9-0, 
            6/25/12
          AYES:  Price, Emmerson, Corbett, Correa, Hernandez, Negrete 
            McLeod, Strickland, Vargas, Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8
           
          ASSEMBLY FLOOR  :  70-2, 5/17/12 - See last page for vote


          SUBJECT  :    Certified surgical technologists

           SOURCE  :     California State Assembly of the Association of 
          Surgical 
                      Technologists 


           DIGEST  :    This bill establishes the Certified Surgical 
          Technologist Act and specifies educational and 
          certification requirements, and specific patient care 
          activities of surgical technologists.

           ANALYSIS  :    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.
                                                           CONTINUED





                                                               AB 2561
                                                                Page 
          2


          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:

                  (1)        At the direction of, or subject to 
                     supervision by, a physician and surgeon, or 
                     registered nurse, preparing the operating 
                     room for surgical procedures by ensuring that 
                     surgical equipment is functioning properly 
                     and safely.

                  (2)        At the direction of, or subject to 
                     supervision by, a physician and surgeon, or 
                     registered nurse, preparing the operating 
                     room and the sterile field for surgical 
                     procedures by preparing sterile supplies, 
                     instruments, and equipment using sterile 
                     technique.

                  (3)        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.

                  (4)        As directed in an operating room 
                     setting, performing the following tasks at 
                     the sterile field:

                      (a)            Passing supplies, 
                         equipment, or instruments.

                                                           CONTINUED





                                                               AB 2561
                                                                Page 
          3


                      (b)            Sponging or suctioning an 
                         operative site.

                      (c)            Preparing and cutting 
                         suture material.

                      (d)            Transferring and pouring 
                         irrigation fluids.

                      (e)            Transferring but not 
                         administering drugs within the sterile 
                         field.

                      (f)            Handling specimens.

                      (g)            Holding retractors and 
                         other instruments.

                      (h)            Applying electrocautery to 
                         clamps on bleeders.

                      (i)            Connecting drains to 
                         suction apparatus.

                      (j)            Applying dressings to 
                         closed wounds.

                      (k)            Assisting in counting 
                         sponges, needles, supplies, and 
                         instruments with the registered nurse 
                         circulator.

                      (l)            Cleaning and preparing 
                         instruments for sterilization on 
                         completion of the surgery.

                      (m)            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 

                                                           CONTINUED





                                                               AB 2561
                                                                Page 
          4

              certification by a specified entity. 

           4.  Specifies that healthcare practitioners, as defined, 
              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.

           Background
           
           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 eight percent of 
          hospital acquired infections that were associated with 
          deaths in the United States were surgical site infections 
          (Klevens et al., 2007).

           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 

           Current Oversight  .  The National Board of Surgical 
          Technology and Surgical Assisting (NBSTSA) was established 
          in 1974 as the certifying agency for surgical 
          technologists.  NBSTSA is solely responsible for all 

                                                           CONTINUED





                                                               AB 2561
                                                                Page 
          5

          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.
          
          FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  8/6/12)

          California State Assembly of the Association of Surgical 
          Technologists 
             (source)



           ASSEMBLY FLOOR  :  70-2, 5/17/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Blumenfield, Bonilla, Bradford, Brownley, 
            Buchanan, Butler, Charles Calderon, Campos, Carter, 
            Cedillo, Chesbro, Conway, Cook, Davis, Dickinson, Eng, 
            Feuer, Fong, Fuentes, Furutani, Beth Gaines, Garrick, 
            Gatto, Gordon, Gorell, Grove, Hagman, Halderman, Hall, 
            Harkey, Hayashi, Roger Hernández, Hill, Huber, Hueso, 
            Huffman, Jeffries, Jones, Knight, Lara, Logue, Ma, 
            Mansoor, Mendoza, Miller, Mitchell, Monning, Morrell, 
            Nestande, Nielsen, Olsen, V. Manuel Pérez, Portantino, 
            Silva, Smyth, Solorio, Swanson, Torres, Valadao, Wagner, 
            Wieckowski, Williams, John A. Pérez

                                                           CONTINUED





                                                               AB 2561
                                                                Page 
          6

          NOES:  Donnelly, Galgiani
          NO VOTE RECORDED:  Block, Fletcher, Bonnie Lowenthal, 
            Norby, Pan, Perea, Skinner, Yamada


          JJA:d  8/7/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****
          


































                                                           CONTINUED