Florida Administrative Code › 64 - DEPARTMENT OF HEALTH › 64B15 - Board of Osteopathic Medicine › Chapter 64B15-14 - PRACTICE REQUIREMENTS › Section 64B15-14.006 - Standards of Practice for Surgery/Procedure

Current through Reg. 50, No. 138; July 16, 2024
The Board of Osteopathic Medicine interprets the standard of
				  care requirement of Section
				   459.015(1)(z),
				  F.S., and the delegation of duties restrictions of Section
				   459.015(1)(aa),
				  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
				allopathic or osteopathic physician who is to perform the surgery. In addition,
				it is the responsibility of the treating physician or an equivalently trained
				allopathic or osteopathic 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
				operating surgeon 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 in the surgery/procedure room and immediately prior to the
				initiation of any procedure, the surgery/procedure team will pause and the
				physician(s) performing the procedure will verbally confirm the patient's
				identification, the intended procedure and the correct surgical/procedure site.
				The physician performing the surgery/procedure 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) performing the
				procedure and another Florida licensed health care practitioner shall verbally
				and simultaneously confirm the patient's identification, the intended
				surgery/procedure and the correct surgical/procedure site prior to making any
				incision or initiating the procedure. The notes of the surgery/procedure shall
				specifically reflect when this confirmation procedure was completed and which
				personnel on the surgical 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 prior to administering anesthesia or
				anesthetic agents, or performing regional blocks at any time both within or
				outside a surgery setting.
(e) At
				any time after the pause is completed, but before the procedure is initiated,
				if the physician(s) leave(s) the room where the procedure is being performed,
				upon his or her return, the pause set forth in paragraph (b), above, must be
				performed again.