Nevada Administrative Code

NAC 449.5745 Written list concerning knowledge and skills. (NRS 449.0302) The supervising nurse or a registered nurse of a facility who qualifies as an instructor for the facility shall complete a written list to determine the knowledge and skills of each dialysis technician in p…

NAC 449.576 Peritoneal dialysis: Additional activities required. (NRS 449.0302) In addition to the written list required pursuant to the provisions of NAC 449.5745, if a dialysis technician who is enrolled in a course of training pursuant to the provisions of NAC 449.571 intends …

NAC 449.5765 Cannulation or administration of normal saline or heparin: Additional activities required. (NRS 449.0302) In addition to the written list required pursuant to the provisions of NAC 449.5745, if a dialysis technician who is enrolled in a course of training pursuant to…

NAC 449.577 Cannulation or administration of normal saline, heparin or lidocaine: Verification and documentation of competency required. (NRS 449.0302) If a dialysis technician intends to cannulate a dialysis access during the treatment of a patient of the facility or administer …

NAC 449.5775 Documentation of successful completion of program of training; employment by another facility. (NRS 449.0302) 1. A facility shall issue to each dialysis technician who successfully completes a program of training and receives an evaluation of his or her competency pr…

NAC 449.579 Patient care: Technicians must demonstrate certain knowledge and competency. (NRS 449.0302) A dialysis technician who provides care directly to a patient of a facility must demonstrate knowledge of and competency to carry out the responsibilities specified in NAC 449.…

NAC 449.5795 Prohibited acts. (NRS 449.0302) A dialysis technician of a facility shall not: 1. Initiate the provision of education for any patient of the facility; 2. Alter any treatment that is ordered for a patient of the facility, including shortening the period for providing …

NAC 449.612 Definitions. (NRS 449.0302) As used in NAC 449.612 to 449.61256, inclusive, unless the context otherwise requires, the words and terms defined in NAC 449.612011 to 449.612017, inclusive, have the meanings ascribed to them in those sections. (Added to NAC by Bd. of Hea…

NAC 449.612011 “Approval” defined. (NRS 449.0302) “Approval” means the approval granted by the Division to a hospital authorizing the hospital to perform open-heart surgery. (Added to NAC by Bd. of Health by R107-98, eff. 3-18-99)

NAC 449.612012 “Approved hospital” defined. (NRS 449.0302) “Approved hospital” means a hospital that has obtained approval from the Division to perform open-heart surgery. (Added to NAC by Bd. of Health by R107-98, eff. 3-18-99)

NAC 449.612014 “Cardiac surgery” defined. (NRS 449.0302) “Cardiac surgery” means an operation performed on the heart or on the blood vessels connected to the heart in which access to the area of interest is provided by means of an incision in the wall of the thorax or for which t…

NAC 449.612017 “Open-heart surgery” defined. (NRS 449.0302) “Open-heart surgery” means any cardiac surgery requiring the use of a heart-lung bypass machine. (Added to NAC by Bd. of Health by R107-98, eff. 3-18-99)

NAC 449.61202 Prerequisites to initial provision of service. (NRS 449.0302) A hospital that desires to provide a new service for the performance of open-heart surgery must make application to the Division requesting approval of the service. A hospital shall not provide such a ser…

NAC 449.61204 Form and contents of application for approval to provide service. (NRS 449.0302) 1. The application for approval must include a statement describing: (a) The qualifications of the personnel of the hospital to perform open-heart surgery; (b) The facilities and equipm…

NAC 449.61206 Notification of applicant upon review of application; site inspection required. (NRS 449.0302) 1. Within 10 days after it receives an application for approval from a hospital, the Division shall notify the hospital, in writing, whether the application is complete. I…

NAC 449.61208 Composition and duties of site inspection team. (NRS 449.0302) The site inspection team: 1. Must be composed of: (a) A cardiothoracic surgeon; (b) A cardiologist; (c) A cardiac intensive care nurse; (d) An administrator of a hospital at which open-heart surgery is c…

NAC 449.6121 Hospital to pay costs of inspection. (NRS 449.0302) The costs incurred in connection with any inspection required by the provisions of NAC 449.612 to 449.61256, inclusive, must be paid by the hospital affected. (Added to NAC by Bd. of Health, eff. 8-31-89)

NAC 449.61212 Approval or denial of application; period of validity of approval; cessation of performance of surgeries. (NRS 449.0302) 1. Within 15 working days after it receives the findings of the site inspection team, the Division shall approve or notify the hospital of its in…

NAC 449.61214 Amount of surgery required following approval. (NRS 449.0302) After approval of a service for open-heart surgery is granted, such surgeries must be performed in an approved hospital at the following rates: 1. Not less than 80 operations during the first 12 months af…

NAC 449.61216 Provision of patient with preoperative instruction. (NRS 449.0302) On specific orders from the patient’s physician, a cardiac surgical nurse shall provide each nonemergent cardiac surgical patient with preoperative instruction concerning the proposed surgical proced…

NAC 449.61218 Surgical team: Composition; privileges and qualifications of members; participation of qualified nurses. (NRS 449.0302) 1. A surgical team assigned to each open-heart surgery at an approved hospital must be composed of a cardiovascular surgeon who will be the primar…

NAC 449.6122 Qualifications of anesthesiologist. (NRS 449.0302) Anesthesia during open-heart surgery at an approved hospital must be administered by an anesthesiologist who: 1. Is certified by or who is eligible for certification by the American Board of Anesthesiologists; and 2.…

NAC 449.61222 Qualifications of nurse in charge of service. (NRS 449.0302) The registered nurse in charge of the service for open-heart surgery at an approved hospital must: 1. Have not less than 2 years of operating room nursing experience and not less than 1 year of current exp…

NAC 449.61224 Perfusion team: Use required; qualifications; approval of members by surgeon of record. (NRS 449.0302) 1. An approved hospital shall use a perfusion team, which must include a senior perfusionist who is responsible for the supervision of all perfusion services provi…

NAC 449.61226 Operating rooms: General requirements. (NRS 449.0302) 1. An approved hospital shall maintain two fully equipped operating rooms, one dedicated to and another available for services for open-heart surgery. Each operating room must have a minimum clearance of 400 squa…

NAC 449.61228 Operating rooms: Equipment and staff. (NRS 449.0302) 1. Each operating room designated or available for open-heart surgery must be equipped with: (a) A heart-lung bypass machine. (b) Proper suction and plumbing outlets for heat exchangers for the heart-lung bypass m…

NAC 449.6123 Intensive care facility: General requirements. (NRS 449.0302) 1. An approved hospital shall maintain an intensive care facility within the hospital. The facility must: (a) Have accommodations which can isolate patients; (b) Have a sufficient system for controlling te…

NAC 449.61232 Intensive care facility: Staff. (NRS 449.0302) 1. The administration of intensive care units in an approved hospital for patients recovering from or awaiting open-heart surgery must be under the direction of a qualified physician approved by the cardiac surgeon. 2. …

NAC 449.61234 Intensive care facility: Equipment and supplies. (NRS 449.0302) 1. The following equipment must be immediately available to the intensive care facility: (a) A laryngoscope. (b) Endotracheal tubes. (c) Respirators. (d) Hypothermia equipment. (e) Tracheostomy sets. (f…

NAC 449.61236 Orientation and continuing education of personnel. (NRS 449.0302) An approved hospital shall provide, under the direction of the cardiac surgeon, an orientation program and a program of continuing education for surgical nurses, technicians and any personnel who part…

NAC 449.61238 Maintenance of blood bank. (NRS 449.0302) An approved hospital shall maintain a blood bank which operates 24 hours a day under the direction of qualified specialists. These persons must be able to supply blood and blood derivatives to surgical teams assigned to open…

NAC 449.6124 Maintenance of cardiac catheterization laboratory. (NRS 449.0302) 1. An approved hospital shall maintain a cardiac catheterization laboratory which operates 24 hours a day under the direction of a qualified specialist. 2. The laboratory must be located in the hospita…

NAC 449.61242 Maintenance of medical laboratory. (NRS 449.0302) An approved hospital shall maintain a medical laboratory which operates 24 hours a day. The laboratory must have sufficient equipment to: 1. Perform standard laboratory tests; 2. Make pH determinations; and 3. Analyz…

NAC 449.61244 Maintenance of facilities to perform contrast studies and equipment to review films of operations. (NRS 449.0302) An approved hospital shall maintain: 1. Facilities in which contrast studies of the cardiovascular system may be performed. 2. Film projectors and a pro…

NAC 449.61246 Maintenance of registry to record results for each patient. (NRS 449.0302) A registry must be maintained at an approved hospital and used for recording the results of open-heart surgery for each patient. This registry must include or indicate, for each such patient:…

NAC 449.61248 Maintenance of program to follow recovery of patient. (NRS 449.0302) An approved hospital shall maintain a comprehensive program for following the recovery and progress of the patient toward his or her optimum condition of health. The condition of the patient must b…

NAC 449.6125 Annual review and inspection of hospital. (NRS 449.0302) Unless the hospital has notified the Division that it has ceased to perform open-heart surgeries, a surveyor of health facilities from the Division shall review each approved hospital annually to verify that th…

NAC 449.61252 Annual inspection of hospital: Assessment of rate of mortality. (NRS 449.0302) 1. As a part of the annual inspection of each approved hospital, the Division shall perform a detailed review of the patient files relating to all mortalities at the hospital. 2. In asses…

NAC 449.61254 Further review or on-site inspection for failure to comply with provisions or for excessive rate of mortality; notice; plan for compliance. (NRS 449.0302) 1. If the review conducted pursuant to NAC 449.6125 discloses that the hospital is not in full compliance with …

NAC 449.61256 Denial, suspension or revocation of approval: Grounds; hearing. (NRS 449.0302) 1. The Division may deny, suspend or revoke its approval because of the failure of the hospital affected to comply with any provision of NAC 449.612 to 449.61256, inclusive. 2. The Divisi…

NAC 449.6126 Definitions. (NRS 449.0302) As used in NAC 449.6126 to 449.6127, inclusive, unless the context otherwise requires: 1. “Approval” means the approval granted by the Division to a hospital authorizing it to provide a service for the transplantation of organs. 2. “Transp…

NAC 449.61262 Application for approval to provide services. (NRS 449.0302) An application for approval submitted pursuant to NRS 449.087 must include: 1. A statement of the kinds of organs that are to be transplanted; 2. Proof that the hospital is a member of the United Network f…

NAC 449.61264 Evaluation of application for approval. (NRS 449.0302) 1. The Division will evaluate the application to determine whether it conforms with the requirements of NAC 449.6126 to 449.6127, inclusive. If the Division finds that the application is incomplete, it will info…

NAC 449.61266 Duties of hospital providing services. (NRS 449.0302) A hospital that provides services for the transplantation of organs shall: 1. Supply the Division with the same information from the patient registry that is provided to the United Network for Organ Sharing, at t…

NAC 449.61268 Revocation of approval. (NRS 449.0302) 1. The Division may revoke its approval if: (a) The hospital fails to comply with any provision of NAC 449.6126 to 449.6127, inclusive; (b) The United Network for Organ Sharing suspends or terminates the membership of the hospi…

NAC 449.6127 Notice of intent to deny application or revoke approval; hearing. (NRS 449.0302) 1. If the Division intends to deny an application for approval or to revoke its approval, it shall so advise the hospital affected in writing. 2. The hospital may request a hearing on th…

NAC 449.61302 Limitations on issuance of license. (NRS 449.0302) The Division shall not issue a license to operate an independent center for emergency medical care unless the center: 1. Is located more than 30 minutes by ground transportation from a facility which is licensed to …