(A) The provider of a PICU service shall have a medical director whose appointment, acceptance and responsibilities shall be in writing and on file in the PICU.
(B) The PICU medical director shall be board certified in pediatrics and pediatric critical care, or anesthesiology with practice limited to infants and children and with special qualifications in critical care medicine, or in pediatric surgery with added qualifications in surgical critical care medicine. The medical director shall be an active service provider in the PICU where he or she is the medical director.
(C) The PICU medical director shall:
(1) Participate in development, review and implementation of PICU policies;
(2) Participate in budget preparation;
(3) Coordinate staff education;
(4) Maintain a data base and/or vital statistics that describe unit experience and performance;
(5) Supervise resuscitation techniques, including educational component;
(6) Supervise quality control, assessment and improvement activities, including morbidity and mortality reviews;
(7) Coordinate research;
(8) Have the authority to consult on any PICU patient; and
(9) Name qualified designees to fulfill his or her duties during absences.
(D) Other individuals may supervise the activities required in paragraph (C) of this rule, but the PICU director shall participate in each.
(E) The provider of a PICU service shall have a licensed physician assigned to the PICU twenty-four hours per day. The provider of a PICU service shall also have a licensed physician specializing in pediatrics, anesthesia, or internal medicine/pediatrics in-house and available to the PICU twenty-four hours per day.
(F) The provider of a PICU service shall have a nurse manager dedicated to the PICU who shall be supervised by the director of pediatric nursing or equivalent. The PICU nurse manager shall have specific training and experience in pediatric critical care. Pediatric critical care registered nurse (CCRN) certification is recommended for the nurse manager but not required.
(G) The nurse manager shall:
(1) Participate in the development and implementation of written policies and procedures for the PICU;
(2) Participate in the coordination of staff education and/or research;
(H) Nursing to patient ratios in the PICU service shall be sufficient to accommodate the acuity level and volume of patients, usually ranging from two nurses to one patient to one nurse to three patients.
(I) Required nursing skills for PICU nurses shall include:
(1) Recognition, interpretation and recording of various physiologic variables;
(2) Drug and fluid administration;
(3) Cardio-pulmonary resuscitation (CPR) certification;
(4) Respiratory care techniques including chest physiotherapy, endotracheal suctioning and management, and tracheostomy care;
(5) Preparation and maintenance of patient monitors; and
(6) Psychosocial skills to meet the needs of both patient and family.
(J) PICU nurses should have pediatric advanced life support certification (PALS).
(K) The provider of a PICU service shall provide for in-service education on pediatric critical care.
(L) The provider of a PICU service shall have respiratory therapy staff assigned to the unit in-house twenty-four hours per day.
(M) Other PICU staff shall include:
(1) Biomedical technicians (in-house or available within one hour twenty-four hours per day);
(2) A social worker;
(3) A pharmacist in-house twenty-four hours per day;
(4) A radiology technician;
(5) A registered dietitian;
(6) A physical therapist;
(7) An occupational therapist;
(8) A child life specialist; and
(9) A unit clerk.
(N) As part of a continuing education program, the provider of a PICU service shall:
(1) Have staff participate in regional pediatric critical care education programs; and
(2) Provide regularly scheduled resuscitation practice sessions.
(O) Staffing requirements of this rule may be met by individuals with equivalent or greater qualifications if the replacement's scope of practice encompasses the duties of the required staff.
119.032 review dates:
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: 3/20/1997, 3/24/03, 5/15/08