3701-84-61 Pediatric intensive care service standards.

(A) The provisions of rules 3701-84-61 to 3701-84-65 of the Administrative Code are applicable to each provider of PICU services regardless of the date service was initiated.

(B) The provider of a PICU service shall develop and follow written comprehensive and effective patient care policies and procedures that designate the severity of illnesses that may be treated and the types of care that may be provided in the PICU. The PICU shall operate within the scope of this service plan.

(C) The provider of a PICU service shall require that the patient's attending intensivist physician or designee be available in thirty minutes or less, on a twenty-four hour basis.

(D) The following physicians shall be available to the PICU in less than sixty minutes on a twenty-four hour basis:

(1) An anesthesiologist (with demonstrated training and experience in pediatrics);

(2) A general surgeon;

(3) Pediatric subspecialists to include:

(a) An intensivist;

(b) A cardiologist;

(c) A nephrologist;

(d) A hematologist/oncologist; and

(e) A neurologist;

(4) Surgeon subspecialists to include:

(a) A pediatric surgeon;

(b) A neurosurgeon with demonstrated training and experience in pediatrics;

(c) An otolaryngologist with demonstrated training and experience in pediatrics; and

(d) An orthopedist;

(5) A radiologist with demonstrated training and experience in pediatrics;

(6) A pathologist; and

(7) A psychiatrist or psychologist.

(E) The PICU service without an on-site pediatric cardiovascular surgery service shall maintain a written transfer agreement for emergency pediatric cardiovascular surgery services with a provider of pediatric cardiovascular surgery services that can be reached expeditiously from the catheterization service by available emergency vehicle in less than sixty minutes on a twenty-four hour basis and that provides the greatest assurance for patient safety.

(F) The provider of a PICU service shall have available in less than sixty minutes on a twenty-four hour basis, a craniofacial (plastic) surgeon, an oral surgeon, a pediatric pulmonologist, a pediatric endocrinologist, a pediatric gastroenterologist, a pediatric allergist or immunologist, and a pediatric infectious disease specialist.

(G) The provider of a PICU service shall have available at least two operating rooms with the capability, equipment and personnel to perform emergency procedures in less than sixty minutes on a twenty-four hour basis.

(H) The provider of a PICU service shall have access to a blood bank with all blood components available twenty-four hours per day. Unless some unusual antibody is encountered, blood typing and cross matching shall allow for transfusion in less than sixty minutes.

(I) The provider of the PICU service shall have radiology services immediately available to the PICU. Radiology services shall be timely provided to the PICU to meet the needs of the patient and shall include:

(1) Portable radiology;

(2) Fluoroscopy;

(3) Computerized tomography scanning;

(4) Ultrasonography;

(5) Angiography;

(6) Nuclear scanning;

(7) Magnetic resonance imaging; and

(8) Radiation therapy.

(J) The provider of a PICU service shall have the following clinical laboratory capabilities:

(1) Microspecimen capability and one hour turnaround time for clotting studies and measurements of complete blood cell count, differential count, platelet count, urinalysis, electrolytes, blood urea nitrogen, creatinine, glucose, calcium, prothrombin time, partial prothrombin time and cerebrospinal fluid cell counts;

(2) Blood gas values available within fifteen minutes;

(3) Results of drug screening and levels of serum ammonia, serum and urine osmolarity, phosphorus and magnesium all available within three hours; and

(4) Preparation of gram stains and bacteriological cultures available twenty-four hours per day.

(K) The provider of a PICU service shall have a pharmacy and personnel on-site and timely dispenses all necessary medications for pediatric patients of all types and ages, twenty-four hours per day.

(L) Diagnostic cardiac and neurological services shall be available to the provider of a PICU service as needed:

(1) Electrocardiograms, two-dimensional and M-mode echocardiograms and electroencephalograms within thirty minutes of being requested;

(2) A catheterization laboratory or angiography suite shall ; and

(3) Doppler ultrasonograph devices and evoked potential monitoring equipment.

(M) The provider of a PICU service shall timely provide hemodialysis equipment and competent and qualified staff experienced with children available twenty-four hours per day, as needed.

(N) The provider of a PICU service shall have an integrated communication system with local emergency medical transport system.

(O) The provider of a PICU service shall have a secondary emergency communication available twenty-four hours per day into the PICU.

(P) The provider of a PICU service shall have a transportation system and competent and qualified staff for effective transport.

(Q) The provider of a PICU service shall maintain a communication link to a federal, state, or local poison control center.

(R) A PICU shall only be operated in a fully permanent setting within the permanent frame of the building of a registered hospital that is classified as a general hospital or a children's hospital. The hospital shall be fully equipped to meet the needs of the PICU.

Effective: 06/21/2012
R.C. 119.032 review dates: 04/05/2012 and 05/01/2017
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, 5/15/08