3701-84-54 Level II newborn care services specific requirements.

(A) Designation as a level II newborn care service requires that the provider of the newborn service provide care for normal newborns, moderately ill newborns and selected extremely ill newborns.

(B) In addition to the requirements of paragraphs (B)(1) to (B)(5) of rule 3701-84-46 and paragraph (B) of rule 3701-84-50 of the Administrative Code, each level II newborn care service shall:

(1) Provide developmental follow-up of at-risk newborns in the service or refer such newborns at-risk to appropriate programs; and

(2) Conduct risk assessments of newborns to ensure identification of appropriate consultation requirements or referrals.

(1) Provide a neonatologist, or a pediatrician in consultation with a staff neonatologist, to manage the care of the newborn; or

(2) Transfer the newborn to a newborn care service that can provide the required management.

(D) In addition to the requirements of paragraphs (D) and (E) of rule 3701-84-51 of the Administrative Code, each level II newborn care service shall provide the necessary support services including:

(1) Diagnostic radiologic services, including computed tomography, magnetic resonance imaging and fluoroscopy available in the building in which the newborn care service is located or available by referral to another newborn care service;

(2) Respiratory therapy services and pulmonary support services, and the staff necessary to provide the support service, available in the building in which the newborn care service is located, on a twenty-four hour basis, when newborns are present that require ventilatory support; and

(3) Biomedical engineering services.

(E) Each level II newborn care service shall have qualified staff as appropriate for the services provided including:

(1) A full-time nurse manager/director who is a registered nurse responsible for the organization and supervision of nursing services in the newborn care service.

(2) RNs with the appropriate education and demonstrated competence, commensurate with the acuity and volume of newborns served, to provide direct supervision of newborns. An RN shall be on duty twenty-four hours per day for newborn care;

(3) At least one staff member in attendance for newborns when they are not with the mother or her designee;

(4) A physician or certified neonatal nurse practitioner with experience in newborn airway management and diagnosis and management of air leaks shall be in the building in which the service is located on a twenty-four hour basis if a newborn is on mechanical ventilation;

(5) A director of anesthesia services who is a board certified anesthesiologist;

(6) An multidisciplinary team of staff, two of which have successfully completed the American heart association/American academy of pediatrics (AHA/AAP) neonatal resuscitation program, or an equivalent program accepted by the director, available in the newborn area;

(7) An RN on staff to provide clinical nursing expertise commensurate with the patient acuity and services provided. Expertise may be demonstrated through education, certification, or a minimum of five years experience;

(8) A licensed social worker to provide psychosocial assessments and family support services;

(9) Medical, surgical, radiology and pathology specialists available for consultation;

(10) A board certified pediatrician who shall serve as director of the newborn care service and maintain a consultative relationship with a neonatologist;

(11) A neonatologist with the responsibility to integrate and coordinate the following:

(a) A system for consultation and referral;

(b) Continuing education programs;

(c) Communication and coordination with an obstetric care service in collaboration with other members of the obstetric care service team; and

(d) The defining and establishing of appropriate policies, protocols and procedures for the nursery and neonatal follow-up; and

(12) A licensed dietitian with knowledge of newborn and parenteral/enteral nutrition management of at-risk neonates, or the service shall have the ability to consult with an individual with those qualifications.

(F) Newborn care service staff requirements that are identical to obstetric care service staff requirements set forth in paragraph (F) of rule 3701-84-51 of the Administrative Code do not need to be duplicated.

(G) Each level II newborn care service shall provide an intermediate care nursery.

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