1. (a) The delegating physician must ensure the individual performing these medical acts:

   1. (1) has appropriate training regarding:

      1. (A) techniques for the delegated act including pre-procedural care, post-procedural care, and infectious disease control;
      2. (B) contraindications for the delegated act; and
      3. (C) recognition and acute management of potential complications; and
   2. (2) signs and dates a written protocol.
2. (b) A physician must either be appropriately trained or be familiar with and able to perform the delegated medical act according to the standard of care;

3. (c) Prior to performance of the delegated act, a physician, or a physician assistant or advanced practice registered nurse acting under the delegation of a physician, must:

   1. (1) establish a practitioner-patient relationship;
   2. (2) complete and maintain an adequate medical record in accordance with Chapter 163 of this title;
   3. (3) disclose the identity and title of the individual who will perform the delegated act; and
   4. (4) ensure at least one person trained in basic life support is present while the patient is onsite.

4. (d) A physician or physician assistant or advanced practice registered nurse must either:

   1. (1) be onsite during the procedure; or
   2. (2) be immediately available for emergency consultation in the event of an adverse outcome; and
   3. (3) if necessary, the physician must be able to conduct an emergency appointment with the patient.

Source Note:The provisions of this §169.26 adopted to be effective January 9, 2025, 50 TexReg 342.