Read the full stored bill text
Florida Senate
-
2026
SB 462
By
Senator Rodriguez
40-00540-26 2026462__
1 A bill to be entitled
2 An act relating to autonomous practice by a certified
3 registered nurse anesthetist; amending s. 395.0191,
4 F.S.; revising requirements for clinical privileges
5 for certain certified registered nurse anesthetists;
6 amending s. 464.012, F.S.; authorizing certain
7 certified registered nurse anesthetists to perform
8 specified acts under certain circumstances; amending
9 s. 464.0123, F.S.; authorizing certain autonomous
10 advanced practice registered nurses to perform
11 specified acts as part of their autonomous practice;
12 providing an effective date.
13
14 Be It Enacted by the Legislature of the State of Florida:
15
16 Section 1. Paragraph (b) of subsection (2) of section
17 395.0191, Florida Statutes, is amended to read:
18 395.0191 Staff membership and clinical privileges.—
19 (2)
20 (b) An advanced practice registered nurse who is certified
21 as a registered nurse anesthetist licensed under part I of
22 chapter 464 shall administer anesthesia under the onsite medical
23 direction of a professional licensed under chapter 458, chapter
24 459, or chapter 466, and in accordance with an established
25 protocol approved by the medical staff. The medical direction
26 shall specifically address the needs of the individual patient.
27
This paragraph does not apply to an autonomous advanced practice
28
registered nurse registered under s. 464.0123 who is certified
29
as a registered nurse anesthetist licensed under part I of
30
chapter 464; however, a facility may require a certified
31
registered nurse anesthetist who is registered and practicing
32
under s. 464.0123 to perform acts under an established protocol
33
approved by the medical staff or the governing board of the
34
facility.
35 Section 2. Paragraph (b) of subsection (4) of section
36 464.012, Florida Statutes, is amended to read:
37 464.012 Licensure of advanced practice registered nurses;
38 fees; controlled substance prescribing.—
39 (4) In addition to the general functions specified in
40 subsection (3), an advanced practice registered nurse may
41 perform the following acts within his or her specialty:
42 (b)
A
The
certified registered nurse anesthetist
may
, to
43 the extent authorized by
an
established protocol approved by the
44 medical staff of the facility in which the anesthetic service is
45 performed,
or a certified registered nurse anesthetist who is
46
registered and practicing under s. 464.0123 without an
47
established protocol, may
perform
any or
all of the following:
48 1. Determine the health status of the patient as it relates
49 to the risk factors and to the anesthetic management of the
50 patient through the performance of the general functions.
51 2. Based on history, physical assessment, and supplemental
52 laboratory results, determine, with the consent of the
53 responsible physician, the appropriate type of anesthesia
under
54
within the framework of
the protocol
,
unless
the certified
55
registered nurse anesthetist is registered and practicing under
56
s. 464.0123 without an established protocol
.
57 3. Order
under the protocol
preanesthetic medication
under
58
the protocol, unless the certified registered nurse anesthetist
59
is registered and practicing under s. 464.0123 without an
60
established protocol
.
61 4. Perform
under the protocol
procedures commonly used to
62 render the patient insensible to pain during the performance of
63 surgical, obstetrical, therapeutic, or diagnostic clinical
64 procedures
under the protocol, unless the certified registered
65
nurse anesthetist is registered and practicing under s. 464.0123
66
without an established protocol
. These procedures include
67 ordering and administering regional, spinal, and general
68 anesthesia; inhalation agents and techniques; intravenous agents
69 and techniques; and techniques of hypnosis.
70 5. Order or perform monitoring procedures indicated as
71 pertinent to the anesthetic health care management of the
72 patient.
73 6. Support life functions during anesthesia health care,
74 including induction and intubation procedures, the use of
75 appropriate mechanical supportive devices, and the management of
76 fluid, electrolyte, and blood component balances.
77 7. Recognize and take appropriate corrective action for
78 abnormal patient responses to anesthesia, adjunctive medication,
79 or other forms of therapy.
80 8. Recognize and treat a cardiac arrhythmia while the
81 patient is under anesthetic care.
82 9. Participate in management of the patient while in the
83 postanesthesia recovery area, including ordering the
84 administration of fluids and drugs.
85 10. Place special peripheral and central venous and
86 arterial lines for blood sampling and monitoring as appropriate.
87
88
A certified registered nurse anesthetist registered and
89
practicing under s. 464.0123 without an established protocol may
90
perform acts
only
authorized under part I of this chapter.
91 Section 3. Paragraph (a) of subsection (3) of section
92 464.0123, Florida Statutes, is amended to read:
93 464.0123 Autonomous practice by an advanced practice
94 registered nurse.—
95 (3) PRACTICE REQUIREMENTS.—
96 (a) An advanced practice registered nurse who is registered
97 under this section may:
98 1. Engage in autonomous practice only in primary care
99 practice, including family medicine, general pediatrics, and
100 general internal medicine, as defined by board rule.
101 2. For certified nurse midwives, engage in autonomous
102 practice in the performance of the acts listed in s.
103 464.012(4)(c).
104 3. Perform the general functions of an advanced practice
105 registered nurse under s. 464.012(3) related to primary care.
106 4.
For certified registered nurse anesthetists registered
107
and practicing under this section, perform the acts listed in s.
108
464.012(4)(b).
109
5.
For a patient who requires the services of a health care
110 facility, as defined in s. 408.032(8):
111 a. Admit the patient to the facility.
112 b. Manage the care received by the patient in the facility.
113 c. Discharge the patient from the facility, unless
114 prohibited by federal law or rule.
115
6.
5.
Provide a signature, certification, stamp,
116 verification, affidavit, or endorsement that is otherwise
117 required by law to be provided by a physician, except an
118 advanced practice registered nurse registered under this section
119 may not issue a physician certification under s. 381.986.
120 Section 4. This act shall take effect July 1, 2026.