Publish Date: November 4, 2014
New laws effective January 1, 2015 require certification and annual continuing education for surgical technologists and central service technicians working in New York hospitals and ambulatory surgery centers. Both bills were signed by Governor Andrew Cuomo on August 1, 2013, leaving hospitals, ASCs and allied health care personnel plenty of time to prepare for the new requirements.
Certification Mandate: New York is the seventh state to require certification of surgical technologists, joining Indiana, Massachusetts, New Jersey, South Carolina, Tennessee and Texas. The new law defines "surgical technologists" and sets forth the tasks and functions surgical technologists will be allowed to perform – all functions of the scrub role – including assisting licensed health care professionals to prepare the operating room and sterile field, setting up sterile supplies, instruments, and equipment, assisting licensed health care professionals to perform non-invasive prepping of the skin’s surface, holding a retractor after placement by a licensed health care professional, and anticipating instrument needs of the surgeon. In addition to operating room technicians, OB technicians who perform these tasks listed in the law during a cesarean section, hysterectomy, tubal ligation or D&C are also subject to the certification requirements.
Surgical technologists may not retract tissue to expose the operating field, administer medication by any route, place hemostatic instruments or devices or apply cautery to tied off bleeders, apply sutures or assist with or perform wound closure, assist the surgeon in identifying structures that should not be ligated, or apply wound dressings.
Hospitals and ambulatory surgery centers in New York will not be allowed to employ or contract for the services of a surgical technologist unless the individual has completed an accredited surgical technologist educational program and is certified.
Exemptions: Surgical technologists who are trained in the U.S. military, work for the federal government, or who worked as a surgical technologist for one of the past four years are exempt from the certification requirement. These “grandfathered” surgical technologists who have worked as a surgical technologist for a cumulative period of at least one year between January 1, 2011 and December 31, 2014 need not obtain certification in the future. Employers of surgical technologists must provide to their surgical technologist employees written confirmation of their dates of employment as of January 1, 2015, which will become proof for future employers of a surgical technologist’s grandfathered status.
Continuing Education: All surgical technologists employed by licensed hospitals and ASCs must meet the new continuing education requirement of fifteen hours per year going forward, including the grandfathered and military-trained surgical technologists who are exempt from the certification requirement. Only surgical technologists employed by the federal government or on medical leave or active duty are excused from the CE requirement. It is the employer’s responsibility to verify that its employed surgical technologists are meeting the annual CE requirement. New York has not yet issued regulations addressing this CE requirement. For now, employers may decide what qualifies as quality continuing education hours for the surgical technologist.
“HR and OR managers have a responsibility to ask their employees for a list how the employee is meeting the CE requirements each year, and keep that list in the employee’s personnel file,” advises Deborah Spratt, MPA BSN RN CNOR NEA, Director Surgical Services at United Memorial Medical Center in Batavia, New York, and AORN past president. “While the law does not specifiy accreditation requirements for the CEs, employers should ensure their employees are receiving quality education.”
Waiver Option: If a facility is unable to employ a sufficient number of surgical technologists who meet the certification (or exemption) requirements, it can contract or employ an individual who does not meet the requirements if the facility makes a written record of its attempts and the individual meets the requirements within two years of the start of employment. In addition, new graduates from accredited programs have 12 months to obtain certification.
SUPERVISION AND FIRST ASSISTING
Under the new law, surgical technologists may only perform tasks and functions under the direction and supervision of an appropriately licensed heath care professional participating in the surgery, such as the registered nurse circulator. Existing New York and federal regulations also confirm that the surgical technologist works under the supervision of the registered nurse.
New York perioperative nurses must work within their facilities to ensure appropriate policies and procedures are in place concerning surgical technologists. Facility policies need to guarantee the registered nurse circulator’s supervisory authority over surgical technologists performing in the scrub role, and should make it clear the surgical technologist works under the supervision of the registered nurse circulator in the room.
In addition, the new certification mandate for surgical technologists should not be interpreted to allow for certified surgical technologists to function as the first assistant at surgery. Certification is not akin to licensure. The New York State Education Department has confirmed by letter that under Section 6512 of the New York Education Law, unlicensed persons may not perform first assistant tasks. Only licensed professionals may properly perform the first assistant at surgery role in New York.
CENTRAL SERVICE TECHNICIANS
Beginning in 2015, central service technicians must pass a nationally accredited central service exam and hold and maintain certification. All central service technicians are also required to complete ten hours of continuing education annually. Employers are responsible for tracking employees’ compliance with the CE requirement.
Similar to the surgical technologist requirements, students and central service technicians who were employed as a central service technician for one of the past four years are exempted from the certification requirement (i.e., grandfathered). Unlike the surgical technologist requirements, health care facilities may hire uncertified central service technicians who also do not meet the grandfathering exception, and those individuals have 18 months to become certified.
For central service supply, in addition to the updates addressing certification and continuing education, facility policy and procedures should require collaboration between sterile processing departments, nursing staff in surgical services and infection control, and the department of surgery.
Spratt adds, “In addition to an opportunity to refresh supervision policies, these new laws also present a perfect opportunity for facilities to update continuing education policies and find ways for central service, surgical technologists, and perioperative nurses to work together to provide meaningful continuing education for everyone.”