AN ACT Relating to surgical technologists; reenacting and amending RCW 18.120.020; adding a new chapter to Title 18 RCW; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. (1) "Surgical technologist" means a person who has satisfactorily completed a board-approved training program designed to prepare persons to practice as surgical technologists, or who has otherwise satisfied the requirements of this chapter to practice as a surgical technologist in this state.

(2) "Board" means the Washington state board of surgical technology.

(3) "Practice medicine" shall have the meaning defined in RCW 18.71.011.

NEW SECTION. Sec. 2. The Washington state board of surgical technology is hereby created. The initial members of the board shall be appointed by the governor as follows:

(1) One certified surgical technologist for a term of five years;

(2) One surgical technologist for a term of three years;

(3) One certified surgical technologist instructor of surgical technology for a term of three years;

(4) One fellow of the American college of surgeons licensed in the state of Washington for a term of four years;

(5) One certified nurse operating room or surgical physician's assistant for a term of two years;

(6) One hospital administrator for a term of two years; and

(7) One public member for a term of one year.

Thereafter all appointments shall be for five-year terms. Vacancies shall be filled for the unexpired term by appointment of the governor, who also may remove any member for neglect of duty required by law or for incompetency or unprofessional conduct.

Each board member shall be compensated in accordance with RCW 43.03.240 and shall be paid travel expenses while away from home in accordance with RCW 43.03.050 and 43.03.060. The members of the board shall elect a chairperson and a secretary from among themselves, who shall serve until a successor is elected by the board.

NEW SECTION. Sec. 3. (1) The board shall adopt rules establishing the qualifications and the educational and training requirements for persons who may practice as surgical technologists under this chapter. The board shall approve such programs as it finds meet the minimum requirements established by the board.

(2) The board shall also adopt rules governing the extent to which surgical technologists may practice surgical technology during training and after successful completion of a training course. The rules shall provide that surgical technologists may perform in the following roles and duties:

(a) Surgical technologist scrub: Surgical technology practice incorporates both behavioral and technical components of surgical technology. The activities of the role of the scrub person are considered an integral part of surgical technology practice. Therefore, the surgical technologist who performs the role of the scrub person is practicing surgical technology. The duties of the surgical technologist scrub include, but are not limited to:

(i) Check supplies and equipment needed for surgical procedure, have knowledge of surgical preference;

(ii) Scrub, gown, and glove;

(iii) Set up sterile table with instruments, sutures, blades, electrosurgical equipment, suction, prosthesis, and solutions needed for procedure;

(iv) Count sponges, needles, and instruments with circulator prior to procedure and before incision is closed;

(v) Gown and glove surgeons, assistants, and others;

(vi) Help in draping sterile field;

(vii) Pass instruments and other supplies to surgeon during procedure;

(viii) Prepare sterile dressings and similar procedures;

(ix) Maintain highest standard of sterile technique during procedure;

(x) Clean and prepare instruments for terminal sterilization; and

(xi) Assist other members of team with terminal cleaning of room in readiness for next patient.

(b) Surgical technologist circulator: The surgical technologist may be assigned circulating functions according to the experience, scope of educational preparation of the individual surgical technologist, and applicable legal guidelines and employer policies. The duties of the surgical technologist circulator include, but are not limited to:

(i) Open the sterile field;

(ii) Have the knowledge and ability to communicate on all levels;

(iii) Able to check patient's chart, identify patient, and bring patient to the assigned operating room, ensuring confidence of patient;

(iv) Transfer patient to operating table;

(v) Correctly position patient after securing the proper equipment;

(vi) Prep the patient prior to draping by surgical team;

(vii) Apply electrosurgical grounding pads and tourniquets before procedure begins;

(viii) Supply sterile field with anything necessary during procedure;

(ix) Keep accurate records throughout the procedure;

(x) Take sponge, needle, and instrument count with scrub prior to operation and before incision is closed;

(xi) Make sure dressings are secure after surgery;

(xii) Help transport patient to recovery room;

(xiii) Assist in cleaning of room in readiness for next patient;

(xiv) Properly care for and handle specimens; and

(xv) Assist anesthesia personnel.

(c) Surgical technologist first assistant: The surgical technologist first assistant provides aid in exposure, hemostasis, and other technical functions that will help the surgeon carry out a safe operation with optimal results for the patient. This role will vary considerably with the surgical operation, specialty area, and type of facility.

Surgical technologist first assistant and scrub roles are differentiated by education. First surgical assistants must have additional specialized education or training in the use of surgical instruments on tissues versus the handling of instruments.

Practice privileges of surgical technologist first assistants shall be based upon verified credentials reviewed and approved by the appropriate credentialing committee.

The surgical technologist first assistant practices under the direct supervision and in the physical presence of the surgeon during the intraoperative phase of the surgical procedure. Duties of the surgical technologist first assistant include:

(i) Tissue handling;

(ii) Providing exposure;

(iii) Using instruments;

(iv) Suturing; and

(v) Providing hemostasis.

(3) The board may grant licensure to persons (a) who have passed a certifying examination that is recognized by the national commission on health certifying agencies and is approved by the board; and (b) who maintain currency in that credential by meeting the established requirements of that credential. Only individuals who have passed the board-approved certifying examination may use the title "certified surgical technologist (CST)." The board may also grant licensure to persons who, on or before the effective date of this act: (i) Have graduated from or are enrolled in and later graduate from a surgical technology program recognized by the board; and (ii) have been employed in the practice of surgical technology as defined in this section, if the board determines that the person meets commonly accepted standards of education and experience. Although licensed, these individuals will not be permitted to use the title "certified surgical technologist (CST)."

(4) The board shall adopt rules under chapter 34.05 RCW as necessary to carry out this chapter.

NEW SECTION. Sec. 4. The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of licensure and the discipline of persons violating this chapter.

NEW SECTION. Sec. 5. A surgical technologist as defined in this chapter may practice surgical technology in this state only after authorization by the board and only to the extent permitted by the board. A surgical technologist shall be subject to discipline under chapter 18.72 RCW.

Sec. 6. Section 21, chapter 267, Laws of 1988 and section 12, chapter 277, Laws of 1988 and RCW 18.120.020 are each reenacted and amended to read as follows:

The definitions contained in this section shall apply throughout this chapter unless the context clearly requires otherwise.

(1) "Applicant group" includes any health professional group or organization, any individual, or any other interested party which proposes that any health professional group not presently regulated be regulated or which proposes to substantially increase the scope of practice of the profession.

(2) "Certificate" and "certification" mean a voluntary process by which a statutory regulatory entity grants recognition to an individual who (a) has met certain prerequisite qualifications specified by that regulatory entity, and (b) may assume or use "certified" in the title or designation to perform prescribed health professional tasks.

(3) "Grandfather clause" means a provision in a regulatory statute applicable to practitioners actively engaged in the regulated health profession prior to the effective date of the regulatory statute which exempts the practitioners from meeting the prerequisite qualifications set forth in the regulatory statute to perform prescribed occupational tasks.

(4) "Health professions" means and includes the following health and health-related licensed or regulated professions and occupations: Podiatry under chapter 18.22 RCW; chiropractic under chapters 18.25 and 18.26 RCW; dental hygiene under chapter 18.29 RCW; dentistry under chapter 18.32 RCW; dispensing opticians under chapter 18.34 RCW; hearing aids under chapter 18.35 RCW; naturopaths under chapter 18.36A RCW; embalming and funeral directing under chapter 18.39 RCW; midwifery under chapter 18.50 RCW; nursing home administration under chapter 18.52 RCW; optometry under chapters 18.53 and 18.54 RCW; ocularists under chapter 18.55 RCW; osteopathy and osteopathic medicine and surgery under chapters 18.57 and 18.57A RCW; pharmacy under chapters 18.64 and 18.64A RCW; medicine under chapters 18.71, 18.71A, and 18.72 RCW; emergency medicine under chapter 18.73 RCW; physical therapy under chapter 18.74 RCW; practical nurses under chapter 18.78 RCW; psychologists under chapter 18.83 RCW; registered nurses under chapter 18.88 RCW; occupational therapists licensed pursuant to chapter 18.59 RCW; respiratory care practitioners certified under chapter 18.89 RCW; veterinarians and animal technicians under chapter 18.92 RCW; health care assistants under chapter 18.135 RCW; massage practitioners under chapter 18.108 RCW; acupuncturists certified under chapter 18.06 RCW; persons registered or certified under chapter 18.19 RCW; dietitians and nutritionists certified by chapter 18.138 RCW; radiologic technicians under chapter 18.84 RCW; surgical technologists certified under chapter 18.-- RCW (sections 1 through 5 of this act); and nursing assistants registered or certified under chapter 18.52B RCW.

(5) "Inspection" means the periodic examination of practitioners by a state agency in order to ascertain whether the practitioners' occupation is being carried out in a fashion consistent with the public health, safety, and welfare.

(6) "Legislative committees of reference" means the standing legislative committees designated by the respective rules committees of the senate and house of representatives to consider proposed legislation to regulate health professions not previously regulated.

(7) "License," "licensing," and "licensure" mean permission to engage in a health profession which would otherwise be unlawful in the state in the absence of the permission. A license is granted to those individuals who meet prerequisite qualifications to perform prescribed health professional tasks and for the use of a particular title.

(8) "Professional license" means an individual, nontransferable authorization to carry on a health activity based on qualifications which include: (a) Graduation from an accredited or approved program, and (b) acceptable performance on a qualifying examination or series of examinations.

(9) "Practitioner" means an individual who (a) has achieved knowledge and skill by practice, and (b) is actively engaged in a specified health profession.

(10) "Public member" means an individual who is not, and never was, a member of the health profession being regulated or the spouse of a member, or an individual who does not have and never has had a material financial interest in either the rendering of the health professional service being regulated or an activity directly related to the profession being regulated.

(11) "Registration" means the formal notification which, prior to rendering services, a practitioner shall submit to a state agency setting forth the name and address of the practitioner; the location, nature and operation of the health activity to be practiced; and, if required by the regulatory entity, a description of the service to be provided.

(12) "Regulatory entity" means any board, commission, agency, division, or other unit or subunit of state government which regulates one or more professions, occupations, industries, businesses, or other endeavors in this state.

(13) "State agency" includes every state office, department, board, commission, regulatory entity, and agency of the state, and, where provided by law, programs and activities involving less than the full responsibility of a state agency.

NEW SECTION. Sec. 7. Sections 1 through 5 of this act shall constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 8. Section 5 of this act shall take effect on January 1, 1990.