b . for outpatients only , in lieu of an H & P , a Hospital department specific pre-procedure evaluation which :
( 1 ) includes a Medical Staff member pre-sedation assessment and plan , and
( 2 ) has been approved by the Medical Staff Executive Committee following input from the appropriate Medical Staff Departments and / or Sections .
B . 3 .
An Emergency Department ( ED ) Medical Staff note containing the required H & P elements noted above may be considered an H & P for the purposes of procedures performed while the patient is in the ED . When a patient is transferred or admitted to another area of the Hospital , another H & P must be performed and documented by the responsible Medical Staff member .
B . 4 .
For the purposes of these Rules and Regulations , anesthesia services include the following :
a . general anesthesia ; b . regional anesthesia ; c . monitored anesthesia care ( MAC ); and d . deep ( level 5 ) sedation .
1 . An H & P update should , at a minimum , include the following : a statement that the H & P was reviewed , a statement that the patient was interviewed , a statement describing pertinent changes or their absence , the date and time of the update , and the signature of the responsible Medical Staff Member .
2 . Responsibility for updating the H & P prior to a surgery or procedure :
( i ) If the surgery or procedure itself requires an H & P , a written update documented in a progress note by a licensed practitioner who is credentialed and privileged by the Medical Staff to perform H & Ps is required .
( ii ) If an H & P is required for a surgery or procedure solely because the patient is receiving anesthesia services ( i . e ., outpatient MRI , pediatric dental , etc .), the responsible
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