In light of recent news, state officials in Texas are working closely with the Centers for Disease Control and Prevention (CDC) and local public health departments in monitoring and mitigating the developing outbreak of the novel coronavirus 2019 (COVID-19) to protect public health.
TxANA is actively monitoring state and federal agencies such as the Texas Department of State Health Services (DSHS) and the CDC for any updates related to the virus. TxANA will continue to share the latest guidance related to the outbreak with our members.
The current guidance from DSHS for health care providers regarding COVID-19 is as follows:
TxANA will remain in close communication and coordination with the American Association of Nurse Anesthetists (AANA) and other stakeholders to provide our members with the most up-to-date recommendations and information regarding COVID-19.
The following resources may be helpful to you, your colleagues and your local health care facilities in Texas as we all work together to mitigate the spread of this virus and address cases of COVID-19 in communities:
For Anesthesia Professionals:
Continuing Education During COVID-19:
"The Board of Nursing will consider extenuating circumstances on a case-by-case basis regarding the completion of continuing competency requirements for licensure renewal during the COVID-19 Disaster Declaration Period. For more information about continuing competency requirements, please visit the Board’s Frequently Asked Questions for Continuing Education & Competency at:
If a licensee needs to request a waiver of continuing competency requirements, please email a request to the following address: Mark.Majek@bon.texas.gov
In the request, include your name, date of birth and license number. Once received, the BON will allow an online renewal."
The Centers for Medicare & Medicaid Services (CMS) has temporarily suspended physician supervision requirements for CRNAs providing anesthesia services to Medicare and Medicaid patients. This suspension of burdensome and unnecessary physician supervision requirements means that CRNAs can contribute their skills and expertise when and where they are needed the most.
DSHS is the main state website dedicated to providing the most up-to-date information about COVID-19: https://www.dshs.texas.gov/coronavirus/healthprof.aspx
DSHS has added a communication tools section to their website with a social media tool kit, video and printable materials that are shareable: https://www.dshs.texas.gov/coronavirus/tools.aspx#toolkit
DSHS COVID-19 Call Center:
Hours (call center hours now extended): 7:00 am – 8:00 pm CST, Monday – Friday
Local Health Entities:
For local assistance, see the listing of Coronavirus Disease 2019 (COVID 19) Local Health Entities.
CDC Coronavirus Website:
Take care to wipe down all surfaces with products that have been approved by the U.S. Environmental Protection Agency for use against emerging, enveloped viral pathogens. This is a critical step in keeping individuals protected. A list of appropriate cleaning products is being kept by the Center for Biocide Chemistries, which can be found at https://www.americanchemistry.com/novel-coronavirus-fighting-products-list.pdf
Notice Regarding Testing and Submission of Specimens for COVID-19
As of March 5, 2020, the Texas DSHS Laboratory is accepting specimens per the criteria outlined in the COVID-19 Specimen Collection and Submission Instructions found on the DSHS Laboratory website.
ALL specimens for COVID-19 virus testing require preapproval. Contact your Local Health Department or DSHS Public Health Region to ensure patient meets Person Under Investigation (PUI) criteria for testing and to obtain DSHS approval to test. Specimens MUST meet PUI criteria for testing prior to shipping and WILL NOT be tested without prior approval. Please DO NOT ship specimens prior to receiving this approval.
DSHS Distributes Additional Medical Supplies for COVID-19 Response
“At the request of the Texas Department of State Health Services, Texas has received a share of personal protective equipment from the Strategic National Stockpile. DSHS is distributing the medical supplies to hospitals and health care providers across the state through the state's Hospital Preparedness Program.”
On Friday, April 17, 2020 Texas Governor Greg Abbott announced his office would be lifting its original order banning elective surgeries and procedures. The Governor has created two exceptions to allow elective surgeries provided they meet the below bulleted items effective beginning April 22, 2020.
All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician; provided, however, that this prohibition shall not apply to either of the following:
The Texas Health and Human Services Commission has provided facility administrators additional guidance for those who wish to resume surgeries, provided they meet the necessary criteria to do so during the COVID-19 pandemic.
The Texas Medical Board (TMB) has created an FAQ page to address Governor Greg Abbott’s most recent update on elective surgeries. While the TMB does not regulate CRNAs, they do regulate surgeons. We will continue to monitor the latest updates from the Governor’s office and update this guidance as needed.
How can CRNAs be utilized during the COVID-19 crisis?
TxANA and the American Association of Nurse Anesthetists (AANA) urge hospitals and facilities to utilize CRNAs as Advanced Practice Registered Nurses (APRNs) who can provide life-saving critical care management for patients impacted by the COVID-19 virus.
In their role as APRNs, CRNAs can function in various areas of the hospital, including emergency room and critical care units. CRNAs can be leveraged for their expertise in rapid systems assessment, airway management, ventilatory support, vascular volume resuscitation, triage, emergency preparedness, and resource management to support their facilities.
TxANA and the AANA encourage CRNAs to work directly with their facility administrator to determine how their skills as APRNs can be directly utilized to help address the COVID-19 crisis.
What is the legal liability for CRNAs working in a facility choosing to continue elective procedures despite the executive order from Governor Abbott?
It is not clear whether a CRNA would be held liable for violating the governor’s order. However, CRNAs should ensure that their facility and other providers are aware of the order. If a CRNA is still being asked to perform procedures that they are not comfortable with after discussion with appropriate facility managers, the CRNA should consider invoking Safe Harbor. You can learn more about Safe Harbor here.
What are the reasons for the order to suspend elective surgeries and the penalties for ignoring the Governor’s order?
The COVID-19 pandemic is increasing demands for hospital beds and has created a shortage of personal protective equipment needed to protect health care professionals and stop transmission of the virus. Postponing surgeries and procedures that are not immediately medically necessary will ensure that hospital beds are available for those suffering from COVID-19 and that PPE is available for health care professionals. Failure to comply with an executive order issued by the governor related to the COVID-19 disaster can result in penalties of up to $1,000 and/or 180 days of jail time.
We hope you and your colleagues will utilize TxANA’s online resources to help keep yourself, family and patients safe. Please contact TxANA with any questions.