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Ohio Laws and Rules
(A) Each provider of a service shall develop and follow a written service plan for the care of women and newborns from birth through the physiologic transition period. The plan shall include protocols based on the current American academy of pediatrics and American college of obstetricians and gynecologists guidelines for perinatal care for the following:
(1) The selected complicating and high-risk conditions for which the obstetric and newborn care service will provide care;
(2) Resuscitation;
(3) Newborn screening and testing;
(4) Physical exam;
(5) Enteral nutrition;
(6) Cord blood for Rh negative women and women with type O or unknown blood;
(7) Vitamin K administration; and
(8) Thermoregulation of the newborn.
(B) Each provider of a service shall develop and follow a written service plan for the discharge and follow-up care of patients. The plan shall include provisions for:
(1) Education on the use of medical equipment;
(2) Parent/support person education for special needs;
(3) Information on hearing loss in accordance with section 3701.506 of the Revised Code;
(4) Home care activities;
(5) Referrals; and
(6) Stabilization for transport.
(C) Each provider of a service shall develop and follow a written service plan for inter-service transfers. The plan shall include provisions for:
(1) The transfer of complicated and high-risk patients that are not managed by the service;
(2) Continuity of care;
(3) Evaluation and communication of patient acuity and risk assessment criteria;
(4) Equipment, type of transport vehicle, and team composition;
(5) Reverse transfer of convalescing patients to services with lower level classifications; and
(6) Communication between referring and receiving services from initiation to completion of transfer.
(D) Each provider of a service shall develop and follow a written service plan for the administration of blood and blood products, including protocols for the administration of blood and blood products to newborns requiring intervention. The service shall provide the appropriate equipment and supplies necessary to administer blood and blood products. At a minimum:
(1) Services providing blood transfusions shall have a blood pressure monitor, infusion pump, and appropriate intravenous equipment;
(2) Services providing partial exchange transfusions shall meet the requirements of paragraph (D)(1) of this rule and have umbilical catheter trays, umbilical catheters, a blood drainage system, and intravenous fluids or volume expanders; and
(3) Services providing exchange transfusions shall meet the requirements of paragraphs (D)(1) and (D)(2) of this rule and have a blood warmer and pulse oximeter.
(E) Each provider of a service shall develop and follow a written service plan for phototherapy and shall maintain the equipment and supplies to provide phototherapy.
(F) Each provider of a service shall develop and follow a written service plan for the preparation, administration, maintenance and management of complications of respiratory therapy. The provider of a service shall maintain the necessary equipment, supplies and support services for the administration of oxygen. At a minimum:
(1) Equipment required for the administration of oxygen shall include a flow-meter, bag and mask set-up, humidification, pulse oximeter, and suction equipment. A cardiorespiratory monitor shall be maintained if a newborn requires oxygen therapy for more than stabilization;
(2) Services shall have the capability of providing blood gas analysis and portable x-ray;
(3) Services providing oxygen administration by nasal cannula shall have a low flow meter;
(4) Services providing oxygen administration using an oxygen hood shall have an oxygen analyzer, a heat source, and a thermometer;
(5) Services providing incubator oxygen shall have appropriate tubing and an oxygen analyzer; and
(6) Services providing oxygen by a continuous positive airway pressure/ventilator shall have intubation equipment, endotracheal tubes, nasal prongs, and an oxygen analyzer.
(7) Services shall have the capability of performing the insertion of chest tubes in the event of pneumothorax.
(G) Each provider of a service shall develop and follow a written service plan of care for unit-based surgeries and surgical suite-based surgeries. The plan shall include the type of surgical procedures authorized to be performed on the unit and in surgical suites. The provider of a service shall maintain equipment appropriate to patient size.
(H) Each provider of a service that provides parenteral nutrition shall develop and follow a written service plan for the preparation and administration of parenteral nutrition. The service shall provide the appropriate staff, equipment, space, and supplies necessary to prepare and administer parenteral nutrition including a laminar flow hood. The laminar flow hood does not need to be located in the obstetric and newborn care services. The service shall provide the necessary support to assess and monitor the patient receiving parenteral nutrition.
(I) Each provider of a service shall develop and follow a written service plan for the maintenance of newborn nutrition services to ensure that newborn nutritional needs are met at all times.
(J) Each provider of a service shall develop and follow a written service plan of care for the insertion, maintenance, monitoring and complication management of peripheral, central, and arterial lines. Each provider of a service shall provide the appropriate staff, equipment, supplies, and support services for the insertion, maintenance, and monitoring of lines in accordance with the written service plan. The written plan shall require that infusion pumps regulating flow to newborns be capable of regulating flow to one-tenth cubic centimeter.
Effective: 05/15/2008
R.C. 119.032 review dates: 02/29/2008 and 03/01/2013
Promulgated Under: 119.03
Statutory Authority: 3702.11, 3702.13
Rule Amplifies: 3702.11, 3702.12, 3702.13, 3702.14, 3702.141, 3702.15, 3702.16, 3702.18, 3702.19, 3702.20
Prior Effective Dates: 3/1/1997, 3/24/03