AN ACT establishing standards for surgical technology care in hospitals and ambulatory surgical facilities.

The General Assembly of North Carolina enacts:

SECTION 1.  Part 2 of Article 5 of Chapter 131E of the General Statutes is amended by adding a new section to read:

§ 131E‑79.3.  Hospital standards for surgical technology care.

(a)        Definitions. – The following definitions apply in this section:

(1)        Surgical technologist. – An individual who is employed or contracted by a hospital to perform surgical technology tasks and functions.

(2)        Surgical technology. – Surgical patient care that includes, but is not limited to, the following perioperative tasks or functions, as directed by the surgeon:

a.         Preparing the operating room and the sterile field for surgical procedures by ensuring that surgical equipment is functioning properly and safely and preparing sterile supplies, instruments, and equipment using sterile technique.

b.         Assisting the surgeon with placing sterile drapes on the patient to establish the sterile operating field.

c.         Anticipating the needs of the surgeon by preparing and passing instruments and supplies during surgical procedures.

d.         Sponging or suctioning an operative site.

e.         Preparing and cutting suture material.

f.          Preparing and pouring irrigation solutions during procedures.

g.         Preparing and passing medications and hemostatic agents during procedures, but not administering drugs.

h.         Preparing and passing off specimens.

i.          Holding retractors and other instruments.

j.          Applying electrocautery to clamps or forceps on bleeding vessels.

k.         Connecting drains to suction apparatus.

l.          Preparing and applying sterile dressings to closed wounds.

m.        Performing counts of sponges, needles, supplies, and instruments with the registered nurse circulator.

n.         Assisting with transferring patients and positioning patients on the operating table.

o.         Maintaining the highest standard of sterile technique, including identifying and correcting breaks in the sterile operating field.

(b)        Qualifications for Employment or Contract. – Except as provided by subsection (e) of this section, a hospital shall not employ or otherwise contract for the services of a surgical technologist in that hospital unless the individual meets, at a minimum, one of the following qualifications:

(1)        Provides evidence of successfully completing an accredited educational program for surgical technology and holds and maintains an accredited surgical technologist certification credential.

(2)        Provides evidence of successfully completing an appropriate training program for surgical technology in the United States Army, Navy, Air Force, Marine Corps, or Coast Guard or in the United States Public Health Service.

(3)        Provides evidence that satisfies one of the following requirements:

a.         Documentation of employment to practice surgical technology in a hospital licensed under this Part or an ambulatory surgical facility licensed under Part 4 of Article 6 of this Chapter on December 31, 2021.

b.         Documentation of employment to practice surgical technology during the three years immediately preceding December 31, 2021.

(c)        Probationary Practice. – A hospital may employ or contract with an individual to practice surgical technology during the 12‑month period that immediately follows the successful completion of a surgical technology program as described in subdivision (1) of subsection (b) of this section. However, the hospital may not continue to employ or contract with that individual beyond the 12‑month period without documentation that the individual has obtained the credential described in subdivision (1) of subsection (b) of this section.

(d)       Continuing Education. – A surgical technician employed by or contracted with a hospital shall comply with one of the following:

(1)        A surgical technologist who is certified by the credentialing organization specified in subdivision (1) of subsection (b) of this section shall comply with the continuing education requirements set forth by the credentialing organization, as necessary to keep the certification current, and shall provide proof of compliance upon employer's request.

(2)        A surgical technologist who is not certified according to subdivision (1) of subsection (b) of this section shall complete 30 hours of relevant continuing education every two years and shall provide proof of compliance upon employer's request.

(e)        Exception. – A hospital may employ or otherwise contract with an individual who does not meet any of the qualifications specified in subsection (b) of this section if all of the following requirements are met:

(1)        The hospital makes a diligent and thorough effort, and after such an effort is completed, the hospital is unable to employ or contract with a sufficient number of qualified surgical technologists who satisfy the requirements of this section.

(2)        The hospital documents and retains records of its efforts made pursuant to subdivision (1) of this subsection.

(3)        The hospital ensures that any noncertified surgical technologist employed or contracted by the hospital complies with the continuing education requirements of subsection (d) of this section.

(f)        Scope of Practice. – Nothing in this section shall be construed to prohibit a licensed practitioner from performing surgical technology tasks or functions if the practitioner is acting within the scope of his or her license.

(g)        Adverse Action. – The Department of Health and Human Services may take adverse action against a hospital under G.S. 131E‑78 for a violation of this section. A hospital may restrict an employee's eligibility to practice surgical technology, as deemed appropriate by the hospital, in the event the employee does not comply with the requirements of this section.

SECTION 2.  Part 4 of Article 6 of Chapter 131E of the General Statutes is amended by adding a new section to read:

§ 131E‑147.2.  Ambulatory surgical facility standards for surgical technology care.

(a)        Definitions. – The following definitions apply in this section:

(1)        Surgical technologist. – An individual who is employed or contracted by an ambulatory surgical facility to perform surgical technology tasks and functions.

(2)        Surgical technology. – Surgical patient care that includes, but is not limited to, the following perioperative tasks or functions as directed by the surgeon:

a.         Preparing the operating room and the sterile field for surgical procedures by ensuring that surgical equipment is functioning properly and safely and preparing sterile supplies, instruments, and equipment using sterile technique.

b.         Assisting the surgeon with placing sterile drapes on the patient to establish the sterile operating field.

c.         Anticipating the needs of the surgeon by preparing and passing instruments and supplies during surgical procedures.

d.         Sponging or suctioning the operative site.

e.         Preparing and cutting suture material.

f.          Preparing and pouring irrigation solutions during procedures.

g.         Preparing and passing medications and hemostatic agents during procedures, but not administering drugs.

h.         Preparing and passing off specimens.

i.          Holding retractors and other instruments.

j.          Applying electrocautery to clamps or forceps on bleeding vessels.

k.         Connecting drains to suction apparatus.

l.          Preparing and applying sterile dressings to closed wounds.

m.        Performing counts of sponges, needles, supplies, and instruments with the registered nurse circulator.

n.         Assisting with transferring patients and positioning patients on the operating table.

o.         Maintaining the highest standard of sterile technique, including identifying and correcting breaks in the sterile operating field.

(b)        Qualifications for Employment or Contract. – Except as provided by subsection (e) of this section, an ambulatory surgical facility shall not employ or otherwise contract for the services of a surgical technologist in that ambulatory surgical facility unless the individual meets, at a minimum, one of the following qualifications:

(1)        Provides evidence of successfully completing an accredited educational program for surgical technology and holds and maintains an accredited surgical technologist certification credential.

(2)        Provides evidence of successfully completing an appropriate training program for surgical technology in the United States Army, Navy, Air Force, Marine Corps, or Coast Guard or in the United States Public Health Service.

(3)        Provides evidence that satisfies one of the following requirements:

a.         Documentation of employment to practice surgical technology in an ambulatory surgical facility licensed under this Part or an ambulatory surgical facility licensed under Part 4 of Article 6 of this Chapter on December 31, 2021.

b.         Documentation of employment to practice surgical technology during the three years immediately preceding December 31, 2021.

(c)        Probationary Practice. – An ambulatory surgical facility may employ or contract with an individual to practice surgical technology during the 12‑month period that immediately follows the successful completion of a surgical technology program as described in subdivision (1) of subsection (b) of this section. However, the ambulatory surgical facility may not continue to employ or contract with that individual beyond the 12‑month period without documentation that the individual has obtained the credential described in subdivision (1) of subsection (b) of this section.

(d)       Continuing Education. – A surgical technician employed by or contracted with an ambulatory surgical facility shall comply with one of the following:

(1)        A surgical technologist who is certified by the credentialing organization specified in subdivision (1) of subsection (b) of this section shall comply with the continuing education requirements set forth by the credentialing organization, as necessary to keep the certification current, and shall provide proof of compliance upon employer's request.

(2)        A surgical technologist who is not certified according to subdivision (1) of subsection (b) of this section shall complete 30 hours of relevant continuing education every two years and shall provide proof of compliance upon employer's request.

(e)        Exception. – An ambulatory surgical facility may employ or otherwise contract with an individual who does not meet any of the qualifications specified in subsection (b) of this section if all of the following requirements are met:

(1)        The ambulatory surgical facility makes a diligent and thorough effort, and after such an effort is completed, the ambulatory surgical facility is unable to employ or contract with a sufficient number of qualified surgical technologists who satisfy the requirements of this section.

(2)        The ambulatory surgical facility documents and retains records of its efforts made pursuant to subdivision (1) of this subsection.

(3)        The ambulatory surgical facility ensures that any noncertified surgical technologist employed or contracted by the ambulatory surgical facility complies with the continuing education requirements of subsection (d) of this section.

(f)        Scope of Practice. – Nothing in this section shall be construed to prohibit a licensed practitioner from performing surgical technology tasks or functions if the practitioner is acting within the scope of his or her license.

(g)        Adverse Action. – The Department of Health and Human Services may take adverse action against an ambulatory surgical facility under G.S. 131E‑148 for a violation of this section. An ambulatory surgical facility may restrict an employee's eligibility to practice surgical technology, as deemed appropriate by the ambulatory surgical facility, in the event the employee does not comply with the requirements of this section.

SECTION 3.  This act becomes effective January 1, 2022.