Senate Bill 462 (2026) — Autonomous practice by a certified registered nurse anesthetist
SB 462
Florida Bills
Florida Senate - 2026 SB 462 By Senator Rodriguez 40-00540-26 2026462__ Page 1 of 5 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1
An act relating to autonomous practice by a certified 2 registered nurse anesthetist; amending s. 395.0191, 3 F.S.; revising requirements for clinical privileges 4 for certain certified registered nurse anesthetists; 5 amending s. 464.012, F.S.; authorizing certain 6 certified registered nurse anesthetists to perform 7 specified acts under certain circumstances; amending 8 s. 464.0123, F.S.; authorizing certain autonomous 9 advanced practice registered nurses to perform 10 specified acts as part of their autonomous practice; 11 providing an effective date. 12 13 Be It Enacted by the Legislature of the State of Florida: 14 15
Section 1. Paragraph (
b) of subsection (2) of
section 16 395.0191, Florida Statutes, is amended to read: 17 395.0191 Staff membership and clinical privileges.— 18 (2) 19 (
b) An advanced practice registered nurse who is certified 20 as a registered nurse anesthetist licensed under
part I of 21
chapter 464 shall administer anesthesia under the onsite medical 22 direction of a professional licensed under
chapter 458,
chapter 23 459, or
chapter 466, and in accordance with an established 24 protocol approved by the medical staff. The medical direction 25 shall specifically address the needs of the individual patient. 26 This paragraph does not apply to an autonomous advanced practice 27 registered nurse registered under s. 464.0123 who is certified 28 as a registered nurse anesthetist licensed under
part I of 29
Florida Senate - 2026 SB 462 40-00540-26 2026462__ Page 2 of 5 CODING: Words stricken are deletions; words underlined are additions.
chapter 464; however, a facility may require a certified 30 registered nurse anesthetist who is registered and practicing 31 under s. 464.0123 to perform acts under an established protocol 32 approved by the medical staff or the governing board of the 33 facility. 34
Section 2. Paragraph (
b) of subsection (4) of
section 35 464.012, Florida Statutes, is amended to read: 36 464.012 Licensure of advanced practice registered nurses; 37 fees; controlled substance prescribing.— 38
(4) In addition to the general functions specified in 39 subsection (3), an advanced practice registered nurse may 40 perform the following acts within his or her specialty: 41 (
b) A The certified registered nurse anesthetist may, to 42 the extent authorized by an established protocol approved by the 43 medical staff of the facility in which the anesthetic service is 44 performed, or a certified registered nurse anesthetist who is 45 registered and practicing under s. 464.0123 without an 46 established protocol, may perform any or all of the following: 47 1. Determine the health status of the patient as it relates 48 to the risk factors and to the anesthetic management of the 49 patient through the performance of the general functions. 50 2.
Based on history, physical assessment, and supplemental 51 laboratory results, determine, with the consent of the 52 responsible physician, the appropriate type of anesthesia under 53 within the framework of the protocol, unless the certified 54 registered nurse anesthetist is registered and practicing under 55 s. 464.0123 without an established protocol. 56 3. Order under the protocol preanesthetic medication under 57 the protocol, unless the certified registered nurse anesthetist 58
Florida Senate - 2026 SB 462 40-00540-26 2026462__ Page 3 of 5 CODING: Words stricken are deletions; words underlined are additions. is registered and practicing under s. 464.0123 without an 59 established protocol. 60 4. Perform under the protocol procedures commonly used to 61 render the patient insensible to pain during the performance of 62 surgical, obstetrical, therapeutic, or diagnostic clinical 63 procedures under the protocol, unless the certified registered 64 nurse anesthetist is registered and practicing under s. 464.0123 65 without an established protocol.
These procedures include 66 ordering and administering regional, spinal, and general 67 anesthesia; inhalation agents and techniques; intravenous agents 68 and techniques; and techniques of hypnosis. 69 5. Order or perform monitoring procedures indicated as 70 pertinent to the anesthetic health care management of the 71 patient. 72 6. Support life functions during anesthesia health care, 73 including induction and intubation procedures, the use of 74 appropriate mechanical supportive devices, and the management of 75 fluid, electrolyte, and blood component balances. 76 7.
Recognize and take appropriate corrective action for 77 abnormal patient responses to anesthesia, adjunctive medication, 78 or other forms of therapy. 79 8. Recognize and treat a cardiac arrhythmia while the 80 patient is under anesthetic care. 81 9. Participate in management of the patient while in the 82 postanesthesia recovery area, including ordering the 83 administration of fluids and drugs. 84 10. Place special peripheral and central venous and 85 arterial lines for blood sampling and monitoring as appropriate. 86 87
Florida Senate - 2026 SB 462 40-00540-26 2026462__ Page 4 of 5 CODING: Words stricken are deletions; words underlined are additions. A certified registered nurse anesthetist registered and 88 practicing under s. 464.0123 without an established protocol may 89 perform acts only authorized under
part I of this chapter. 90
Section 3. Paragraph (
a) of subsection (3) of
section 91 464.0123, Florida Statutes, is amended to read: 92 464.0123 Autonomous practice by an advanced practice 93 registered nurse.— 94
(3) PRACTICE REQUIREMENTS.— 95 (
a) An advanced practice registered nurse who is registered 96 under this
section may: 97 1. Engage in autonomous practice only in primary care 98 practice, including family medicine, general pediatrics, and 99 general internal medicine, as defined by board rule. 100 2. For certified nurse midwives, engage in autonomous 101 practice in the performance of the acts listed in s. 102 464.012(4)(c). 103 3. Perform the general functions of an advanced practice 104 registered nurse under s. 464.012(3) related to primary care. 105 4. For certified registered nurse anesthetists registered 106 and practicing under this section, perform the acts listed in s. 107 464.012(4)(b). 108 5.
For a patient who requires the services of a health care 109 facility, as defined in s. 408.032(8): 110 a. Admit the patient to the facility. 111 b. Manage the care received by the patient in the facility. 112 c. Discharge the patient from the facility, unless 113 prohibited by federal law or rule. 114 6.5. Provide a signature, certification, stamp, 115 verification, affidavit, or endorsement that is otherwise 116
Florida Senate - 2026 SB 462 40-00540-26 2026462__ Page 5 of 5 CODING: Words stricken are deletions; words underlined are additions. required by law to be provided by a physician, except an 117 advanced practice registered nurse registered under this