NAC449.4524. Medical care of patients.

     1. The administrator of a facility shall ensure that:

     (a) Only local anesthesia and oral medication which is administered to a patient to relieve anxiety in the patient, if the medication is not given in a dosage which is sufficient to induce in a patient a controlled state of depressed consciousness or unconsciousness similar to the state produced pursuant to the administration of general anesthesia, deep sedation or conscious sedation, are used at the facility.

     (b) An appropriate and current history, including a list of current medications, dosages, physical examination and pertinent preoperative diagnostic studies, is incorporated into the patient’s medical record before surgery.

     (c) Surgical procedures are performed only by an ophthalmologist licensed pursuant to chapter 630 of NRS or a doctor of osteopathy licensed pursuant to chapter 633 of NRS.

     (d) A preoperative evaluation is conducted immediately before the surgical procedure by the ophthalmologist, licensed pursuant to chapter 630 of NRS, or the doctor of osteopathy, licensed pursuant to chapter 633 of NRS, who will be performing the surgery.

     (e) Emergency equipment and medications as required by the policies and procedures established by the facility pursuant to NAC 449.451 are available, and properly stored and maintained at the facility.

     (f) Outdated medications are destroyed in accordance with the requirements of the laws of this State and federal law.

     (g) Protocols are established and implemented for instructing patients in self-care after surgery, including, without limitation, written instructions to be given at the time of discharge.

     (h) A follow-up examination of a patient is conducted by an ophthalmologist licensed pursuant to chapter 630 of NRS, a doctor of osteopathy licensed pursuant to chapter 633 of NRS or a collaborating optometrist as provided in NRS 636.374 within 24 hours after the procedure. Documentation of the results of this examination must be included as part of the permanent medical record of the patient.

     2. As used in this section:

     (a) “Conscious sedation” means a minimally depressed level of consciousness, produced by a pharmacologic or nonpharmacologic method or a combination thereof, in which the patient retains the ability independently and continuously to maintain an airway and to respond appropriately to physical stimulation and verbal commands.

     (b) “Deep sedation” means a controlled state of depressed consciousness, produced by a pharmacologic or nonpharmacologic method or a combination thereof, and accompanied by a partial loss of protective reflexes and the inability to respond purposefully to verbal commands.

     (Added to NAC by Bd. of Health by R052-02, eff. 7-24-2002)