Florida Administrative Code › 64 - DEPARTMENT OF HEALTH › 64B8 - Board of Medicine › Chapter 64B8-9 - STANDARDS OF PRACTICE FOR MEDICAL DOCTORS › Section 64B8-9.007 - Standards of Practice

Current through Reg. 50, No. 138; July 16, 2024
The Board of Medicine interprets the standard of care
				  requirement of Section
				  458.331(1)(t),
				  F.S., and the delegation of duties restrictions of Section
				  458.331(1)(w),
				  F.S., with regard to surgery as follows:
(1) The ultimate responsibility for
				diagnosing and treating medical and surgical problems is that of the licensed
				doctor of medicine or osteopathy who is to perform the procedure. In addition,
				it is the responsibility of the treating physician or an equivalently trained
				doctor of medicine or osteopathy or a physician practicing within a Board
				approved postgraduate training program to explain the procedure to and obtain
				the informed consent of the patient. It is not necessary, however, that the
				treating physician obtain or witness the signature of the patient on the
				written form evidencing informed consent.
(2) This rule is intended to prevent wrong
				site, wrong side, wrong patient and wrong surgeries/procedures by requiring the
				team to pause prior to the initiation of the surgery/procedure to confirm the
				side, site, patient identity, and surgery/procedure.
(a) Definition of Surgery/Procedure. As used
				herein, "surgery/procedure" means the removal, incision or curettage of tissue
				or an organ, insertion of natural or artificial implants, electro-convulsive
				therapy, endoscopic procedure or other procedure requiring the administration
				of anesthesia or an anesthetic agent. Minor surgeries/procedures such as
				excision of skin lesions, moles, warts, cysts, lipomas and repair of
				lacerations or surgery limited to the skin and subcutaneous tissue performed
				under topical or local anesthesia not involving drug-induced alteration of
				consciousness other than minimal pre-operative tranquilization of the patient
				are exempt from the following requirements. Paracentesis, thoracentesis, ocular
				surgery, liposuction, lipoplasty, and Mohs, are not minor
				surgeries/procedures.
(b) Except in
				life-threatening emergencies requiring immediate resuscitative measures, once
				the patient has been prepared for the elective surgery/procedure and the team
				has been gathered and immediately prior to the initiation of any procedure, the
				team will pause and the physician(s) or physican assistant(s) performing the
				procedure will verbally confirm the patient's identification, the intended
				procedure and the correct surgical/procedure site. The operating physician or
				physican assistant(s) shall not make any incision or perform any surgery or
				procedure prior to performing this required confirmation. If the
				surgery/procedure is performed in a facility licensed pursuant to Chapter 395,
				F.S., or a Level II or III surgery/procedure is performed in an office surgery
				setting, the physician(s) or physican assistant(s) performing the procedure and
				another Florida licensed health care practitioner shall verbally and
				simultaneously confirm the patient's identification, the intended procedure and
				the correct surgical/procedure site prior to making any incision or initiating
				the procedure. The medical record shall specifically reflect when this
				confirmation procedure was completed and which personnel on the team confirmed
				each item.
(c) Confirmation of the
				patient's identity shall be made by using two or more of the following
				corroborating patient identifiers:
1.
				Name.
2. Assigned identification
				number.
3. Telephone
				number.
4. Date of Birth.
5. Social security number.
6. Address.
7. Photograph.
(d) The provisions of paragraph (b), shall be
				applicable to anesthesia providers licensed pursuant to Chapter 458, F.S.,
				prior to administering anesthesia or anesthetic agents, or performing regional
				blocks at any time both within or outside a surgery setting.
(e) At the time after the pause is completed,
				but before the procedure is initiated, if the physician(s) or physican
				assistant(s) leave(s) the room where the procedure is being performed, upon his
				or her return, the pause set forth in subsection (b), above, must be performed
				again.