reglab/statecodes huggingface dataset:
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-4.3.1 - Emergency Department

Current through June 25, 2024
1. The facility
					 must have an emergency department, division, service, or section staffed so
					 trauma patients are assured immediate and appropriate initial care. The
					 emergency physician must be in-house 24 hours/day and immediately available at
					 all times. The emergency department medical director must meet the recommended
					 requirements related to commitment, experience, continuing education, ongoing
					 credentialing, and current or previous board certification in emergency
					 medicine.
2. The director of the
					 emergency department, along with the Trauma Medical Director (TMD), will
					 establish trauma-specific credentials that should exceed those that are
					 required for general hospital privileges. Examples of credentialing
					 requirements would include skill proficiency, training requirements, conference
					 attendance, education requirements, ATLS verification, and specialty board
					 certification.
3. The emergency
					 medicine physician or designee will be responsible for activating the trauma
					 team based on predetermined response protocols. He will provide team leadership
					 and care for the trauma patient until the arrival of the surgeon in the
					 resuscitation area. The emergency department must have established standards
					 and procedures to ensure immediate and appropriate care for the adult and
					 pediatric trauma patient. The emergency department medical director, or his/her
					 designee, must act as a liaison and participate with the Multidisciplinary
					 Trauma Committee and the trauma PI process.
4. There should be an adequate number of RN's
					 staffed for the trauma resuscitation area in-house 24 hours/day. Emergency
					 nurses staffing the trauma resuscitation area must be a current provider of
					 Trauma Nurse Core Curriculum (TNCC), or Advanced Trauma Care for Nurses (ATCN),
					 and participate in the ongoing PI process of the trauma program. Nurses must
					 obtain TNCC or ATCN within 18 months of assignment to the ER.
5. The list of required equipment necessary
					 for the ED can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-4.3.2 - Surgical Suites/Anesthesia

Current through June 25, 2024
1. An operating
					 room must be adequately staffed and available within 30 minutes of time of
					 notification, Availability of the operating room personnel and timeliness of
					 starting operations must be continuously evaluated by the trauma performance
					 improvement process, and measures must be implemented to ensure optimal care.
2. If the staff is not in-house,
					 hospital policy must be written to assure notification and prompt response.
3. The OR nurses should
					 participate in the care of the trauma patient and be competent in the surgical
					 stabilization of the major trauma patient.
4. The surgical nurses are an integral member
					 of the trauma team and must participate in the ongoing PI process of the trauma
					 program and must be represented on the Multidisciplinary Trauma
					 Committee.
5. The OR supervisor
					 must be able to demonstrate a prioritization scheme to assure the availability
					 of an operating room for the emergent trauma patient during a busy operative
					 schedule. There must be an on-call system for additional personnel for multiple
					 patient admissions.
6. The
					 anesthesia department in a Level II trauma center must be organized and run by
					 an anesthesiologist who is experienced and devoted to the care of the injured
					 patient.
7. A Licensed Anesthesia
					 Provider must be immediately available with a mechanism established to ensure
					 early notification of the on-call provider. Anesthesiologists or Certified
					 Registered Nurse Anesthetist (CRNAs) may fill this requirement. Hospital policy
					 must be established to determine when the Licensed Anesthesia Provider must be
					 immediately available for airway control and assisting with resuscitation. The
					 availability of the Licensed Anesthesia Provider and the absence of delays in
					 airway control or operative anesthesia must be documented and monitored by the
					 PI process. The maximum response time for all trauma patients is 30 minutes
					 from the time notified to respond.
8. The list of required equipment for Surgery
					 and Anesthesia can be found on the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-4.3.3 - Post Anesthesia Care Unit (PACU)

Current through June 25, 2024
1. It is essential
					 to have a PACU staffed 24 hours/day and available to the postoperative trauma
					 patient. If the staff is not in-house, hospital policy must be written to
					 assure early notification and prompt response. If this availability requirement
					 is met with a team on call from outside the hospital, the availability of the
					 PACU nurses and compliance with this requirement must be documented.
2. PACU staffing should be in sufficient
					 numbers to meet the critical needs of the trauma patient.
3. The list of required equipment necessary
					 for the PACU can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-4.3.4 - Intensive Care Unit (ICU)

Current through June 25, 2024
1. Level II trauma
					 centers must have an Intensive Care Unit (ICU) that meets the needs of the
					 adult trauma patient.
2. The
					 surgical director or co-director must be the TMD, or general surgeon taking
					 trauma call. The director is responsible for the quality of care and
					 administration of the ICU and will set policy and establish standards of care
					 to meet the unique needs of the trauma patient.
3. The trauma surgeon assumes and maintains
					 responsibility for the care of the serious or multiple injured patients. A
					 surgically directed ICU physician team is desirable. The team will provide
					 in-house physician coverage for all ICU trauma patients at all times. This
					 service can be staffed by appropriately trained physicians from different
					 specialties, but must be led by a qualified surgeon consistent with the medical
					 staff privileging process of the institution. The trauma surgeon must maintain
					 control over all aspects of care, including but not limited to respiratory care
					 and management of mechanical ventilation; placement and use of pulmonary
					 catheters; management of fluid and electrolytes, antimicrobials, and enteral
					 and parenteral nutrition.
4. There
					 must be physician coverage for the ICU at all times. A physician credentialed
					 by the facility must be promptly available to the trauma patient in the ICU 24
					 hours/day. This coverage is for emergencies only and is not intended to replace
					 the primary surgeon but rather is intended to ensure that the patient's
					 immediate needs are met while the surgeon is contacted.
5. Level II trauma centers must provide
					 staffing in sufficient numbers to meet the critical needs of the trauma
					 patient. Critical care nurses must be available 24 hours per day. ICU nurses
					 are an integral part of the trauma team and as such, shall be represented on
					 the Multidisciplinary Trauma Committee and participate in the PI process of the
					 trauma program at least 50% of the time.
6. The list of required equipment necessary
					 for the ICU can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.1 - Respiratory Therapy Service

Current through June 25, 2024
The service must be staffed with qualified personnel
						in-house 24 hours/day to provide the necessary treatments for the injured
						patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.2 - Radiological Service

Current through June 25, 2024
1. A radiological
					 service must have a certified radiological technician in-house 24 hours/day and
					 immediately available at all times for general radiological procedures. A
					 technician must be in-house and immediately available for computerized
					 tomography (CT) for both head and body.
2. Specialty procedures such as Sonography
					 and Angiography must be available to the trauma team. It is desirable that MRI
					 services be available to the trauma team.
3. The radiologist liaison must attend at
					 least 50 percent of committee meetings and should educate and guide the entire
					 trauma team in the appropriate use of radiologic services. A staff radiologist
					 must be promptly available, when requested, for the interpretation of
					 radiographs, performance of complex imaging studies or interventional
					 procedures. The radiologist must ensure the preliminary interpretations are
					 promptly reported to the trauma team and radiology services must monitor the
					 interpretation.
4. Written policy
					 must exist delineating the prioritization/availability of the CT scanner for
					 trauma patients. The trauma center must have policies designed to ensure that
					 trauma patients who may require resuscitation and monitoring are accompanied by
					 appropriately trained providers during transportation to, and while in, the
					 radiology department.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.3 - Clinical Laboratory Service

Current through June 25, 2024
1. A clinical
					 laboratory service must have the following services available in-house 24
					 hours/day:
a. Access to a blood bank and
					 adequate storage facilities. Sufficient quantities of blood and blood products
					 must be maintained at all times. Blood typing and cross-match capabilities must
					 be readily available.
b. Standard
					 analysis of blood, urine, and other body fluids including micro sampling when
					 appropriate.
c. Blood gas and pH
					 determinations (this function may be performed by services other than the
					 clinical laboratory service, when applicable).
d. Alcohol and drug screening.
e. Coagulation studies
f. Microbiology
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.4 - Acute Hemodialysis

Current through June 25, 2024
There must be a written protocol to transfer the patient
						to a facility that provides this service if this service is not available at
						the Level II Trauma Center.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.5 - Burn Care

Current through June 25, 2024
There must be a written protocol to transfer the patient
						to a Burn Center that provides this service if this service if it is not
						available at the Level II Trauma Center. Policies and procedures shall be in
						place to assure that the appropriate care is rendered during the initial
						resuscitation and transfer of the patient.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.6 - Rehabilitation/Social Services

Current through June 25, 2024
1. The
					 rehabilitation of the trauma patient and the continued support of the family
					 members are an important part of the trauma system. Each facility will be
					 required to address a plan for integration of rehabilitation into the acute and
					 primary care of the trauma patient, at the earliest stage possible after
					 admission to the trauma center. Hospitals will be required to identify a
					 mechanism to initiate rehabilitation services and/or consultation in a timely
					 manner as well as policies regarding coordination of the Multidisciplinary
					 Rehabilitation Team. The rehabilitation services must minimally include;
a. Occupational Therapy
b. Physical Therapy
c. Speech Pathology
d. Social Work
e. Psychological Therapy
f. Nutritional support
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.7 - Prevention/Public Outreach

Current through June 25, 2024
1. Level II Trauma
					 Centers will be responsible for participating with appropriate agencies,
					 professional groups and hospitals in their geographic area to develop a
					 strategic plan for public awareness. This plan must take into consideration
					 public awareness of the trauma system, access to the system, public support for
					 the system, as well as specific prevention strategies. Prevention programs must
					 be specific to the needs of the geographic area. A trauma center's prevention
					 program must include and track partnerships with other community organizations.
					 At a minimum, the trauma registry data must be utilized to identify injury
					 trends and focus prevention needs.
2. Outreach is the act of providing resources
					 to individuals and institutions that do not have the opportunities to maintain
					 current knowledge and skills. Staff members at the Level II trauma center
					 should provide consultation to staff members at other facilities in the
					 geographic area. Advanced Trauma Life Support (ATLS), Pre Hospital Trauma Life
					 Support (PHTLS), Trauma Nurse Curriculum Course (TNCC), and Transport Nurse
					 Advanced Trauma Course (TNATC) courses for example can be coordinated by the
					 trauma center. Trauma physicians should provide a formal follow up to referring
					 physicians/designee about specific patients to educate the practitioner for the
					 benefit of further injured patients.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.8 - Transfer Guidelines

Current through June 25, 2024
Level II Trauma Centers shall work in collaboration with
						the referral trauma facilities in the system and develop interfacility transfer
						guidelines. These guidelines must address criteria to identify high-risk trauma
						patients that could benefit from a higher level of trauma care. All designated
						facilities will agree to provide services to the trauma victim regardless of
						his/her ability to pay.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 4 - Level II Trauma Centers › Subchapter 4 - Clinical Support Services › Rule 15-3-1-4.4.9 - Education

Current through June 25, 2024
1. Level II Trauma Centers must have internal
					 trauma education programs including training in trauma for physicians, nurses,
					 ancillary staff, and prehospital providers.
2. Level II Trauma centers must have a
					 written trauma education plan.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.1 - General

Current through June 25, 2024
A Level III trauma center is an acute care facility with
						the commitment, medical staff, personnel and specialty training necessary to
						provide initial resuscitation of the trauma patient. Generally, a Level III
						trauma center is expected to provide initial resuscitation of the trauma
						patient and immediate operative intervention to control hemorrhage and to
						assure maximal stabilization prior to referral to a higher level of care. In
						many instances, patients will remain in the Level III Trauma Center unless the
						medical needs of the patient require secondary transfer. The decision to
						transfer a patient is the responsibility of the physician attending the trauma
						patient. All Level III Trauma Centers will work collaboratively with other
						trauma facilities to develop transfer protocols and a well-defined transfer
						sequence. The trauma center shall participate in hospital and statewide
						performance improvement activities
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.2 - Hospital Departments/Divisions/Sections

Current through June 25, 2024
The Level III Trauma Center must have the following
						departments, divisions, or sections:
1. Emergency Medicine
2. Trauma/General Surgery
3. Orthopedic Surgery
4. Anesthesia
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.3 - Trauma Program

Current through June 25, 2024
1. There must be a
					 written commitment on behalf of the entire facility to the organization of
					 trauma care. The written commitment shall be in the form of a resolution at the
					 time of application passed by an appropriate quorum of the members of the
					 governing authority. Should the business organization be other than a
					 corporation, a letter explaining such together with a written commitment of the
					 hospital's chief executive officer to the establishment of a trauma care
					 program may be sufficient. The trauma program must be established and
					 recognized by the medical staff and hospital administration. The trauma program
					 must come under the direction of a surgeon with current or previous board
					 certification in General Surgery. An identified hospital administrative leader
					 must work closely with the trauma medical director to establish and maintain
					 the components of the trauma program including appropriate financial support.
					 The trauma program location in the organizational structure of the hospital
					 must be placed so that it may interact effectively with at least equal
					 authority with other departments providing patient care. An administrative
					 structure must minimally include an administrator, trauma medical director
					 (TMD), trauma program manager (TPM), trauma registrar and other appropriate
					 support staff Administrative support includes human resources, educational
					 activities, community outreach activities, and research. The trauma program
					 must be multidisciplinary in nature and the performance improvement evaluation
					 of this care must extend to all the involved departments.
2. Compliance with the above will be
					 evidenced by but not limited to:
a. Governing
					 authority and medical staff letter of commitment in the form of a
					 resolution;
b. Written policies and
					 procedures and guidelines for care of the trauma patient;
c. Defined trauma team and written roles and
					 responsibilities;
d. Appointed
					 Trauma Medical Director with a written job description;
e. Appointed Trauma Program Manager with a
					 written job description;
f. A
					 written Trauma Performance Improvement plan.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.4 - Trauma Service

Current through June 25, 2024
The Trauma Service must be established and recognized by
						the medical staff and be responsible for the overall coordination and
						management of the system of care rendered to the injured patient. The trauma
						service will vary in each organization depending on the needs of the patient
						and the resources available. The trauma service must come under the
						organization and direction of the TMD. All patients with multiple system trauma
						or serious injury must be evaluated and/or admitted by the trauma surgeon. The
						surgeon responsible for the overall care of the patient must be
						identified.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.5 - Trauma Medical Director (TMD)

Current through June 25, 2024
1. Level III Trauma
					 Centers must have a physician director of the trauma program with current or
					 previous Board Certification in General Surgery and may not direct more than
					 one trauma center. The TMD plays an important administrative role. The TMD will
					 be responsible for developing a performance improvement process and will have
					 overall accountability and administrative authority for the trauma program. The
					 TMD must be given administrative support to implement the requirements
					 specified by the State trauma plan. The TMD is responsible for working with the
					 credentialing process of the hospital and, in consultation with the appropriate
					 service chiefs, recommending appointment and removal of physicians from the
					 trauma team. She/he must cooperate with nursing administration to support the
					 nursing needs of the trauma patient and develop treatment protocols for the
					 trauma patients. The TMD in collaboration with the Trauma Program Manager (TPM)
					 must coordinate the budgetary process for the trauma program.
2. The TMD must be currently certified in
					 Advanced Trauma Life Support (ATLS), maintain personal involvement in care of
					 the injured, maintain education in trauma care, and maintain involvement in
					 professional organizations. The TMD, or his designee, must be actively involved
					 with the trauma system development at the community and state level. The TMD
					 must perform an annual assessment of general surgeons and mid-level providers
					 assigned to the trauma service using a formal documented process.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.6 - Trauma Program Manager (TPM)

Current through June 25, 2024
1. Level III trauma
					 centers must have a registered nurse working in the role of Trauma Program
					 Manager (TPM). Working in conjunction with the TMD, the TPM is responsible for
					 organization of the program and all systems necessary for the multidisciplinary
					 approach throughout the continuum of trauma care. The TPM is responsible for
					 working with the trauma team to assure optimal patient care. There are many
					 requirements for data coordination and performance improvement, education and
					 prevention activities incumbent upon this position. The TPM must
					 obtain/maintain 4 hours of trauma related education per year. TNCC may be used
					 to meet this requirement.
2. The
					 TPM or his/her designee must offer or coordinate services for trauma education.
					 The TPM must liaison with local EMS personnel, the Department, Trauma Care
					 Regions(s) and other trauma centers.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.7 - Trauma Team

Current through June 25, 2024
The team approach is optimal in the care of the severely
						or multiple injured patient. There must be identified members of the trauma
						team. Policies must be in place describing the roles of all personnel on the
						trauma team. The composition of the trauma team in any hospital will depend on
						the characteristics of that hospital and its staff. All physicians and
						mid-level providers (Physician Assistant/Nurse Practitioner) on the trauma team
						responsible for directing the initial resuscitation of the trauma patient must
						be currently certified in The American College of Surgeons Advanced Trauma Life
						Support (ATLS). ATLS requirements are waived for Board Certified Emergency
						Medicine and Board Certified General Surgery Physicians. Minimum composition of
						the trauma team for severely injured patients includes:
1. General/Trauma Surgeons*
2. Emergency Physicians and/or mid-level
					 providers (Physician Assistant/Nurse Practitioner)*
3. Nursing: ED*
4. Laboratory Technicians
5. Respiratory Therapists
6. Radiology Technician
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 1 - Hospital Organization › Rule 15-3-1-5.1.8 - Multidisciplinary Trauma Committee

Current through June 25, 2024
1. The purpose of
					 the committee is to provide oversight and leadership to the entire trauma
					 program. The exact format will be hospital specific and may be accomplished by
					 collaboration with another designated trauma center in the region. Each trauma
					 center may choose to have one or more committees to accomplish the tasks
					 necessary. One committee must be multidisciplinary and focus on program
					 oversight and leadership. The major focus will be on PI activities, policy
					 development, communication among all team members, development of standards of
					 care, education and outreach programs, and injury prevention. The committee has
					 administrative and systematic control and oversees the implementation of all
					 program related services, meets regularly, takes attendance, maintains minutes
					 and works to correct overall program deficiencies to optimize patient care.
					 Membership for the committee includes representatives from:
a. Trauma Medical Director (Chairman; must be
					 present greater than 50% of the meetings)
b. Emergency Medicine
c. General Surgery
d. Orthopedics
e. Anesthesia
f. Operating Room
g. Intensive Care
h. Respiratory Therapy
i. Radiology
j. Laboratory
k. Rehabilitation
l. Pre-hospital Care Providers
m. Administration
n. Pediatrics
o. Nursing
p. Trauma Program Manager
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-3-1-5.2.1 - Required Components

Current through June 25, 2024
Level III Trauma Centers must maintain published call
						schedules and have the following physician coverage immediately available 24
						hours/day:
1. Emergency Medicine
					 (In-house 24 hours/day). Emergency Physician and/or mid-level provider
					 (Physician Assistant/Nurse Practitioner) must be in the specified trauma
					 resuscitation area upon patient arrival.
2. Trauma/General Surgery. It is desirable
					 that a backup surgeon schedule is published. It is desirable that the surgeon
					 on-call is dedicated to the trauma center and not on-call to any other hospital
					 while on trauma call. Hospital policy must be established to define conditions
					 requiring the trauma surgeon's presence with the clear requirement on the part
					 of the hospital and surgeon that the surgeon will participate in the early care
					 of the patient. The trauma surgeon's participation in major therapeutic
					 decisions, presence in the emergency department for major resuscitation and
					 presence at operative procedures is mandatory. A system must be developed to
					 assure notification of the on-call surgeon and compliance with these criteria
					 and their appropriateness must be documented and monitored by the PI process.
					 Response time for Alpha Activations is 30 minutes and starts at patient arrival
					 or EMS notification, whichever is sooner. Response time for Bravo Activations
					 is 45 minutes from the time notified to respond.
3. Orthopedic Surgery. It is desirable to
					 have the orthopedists dedicated to the trauma center solely while on-call. The
					 maximum response time for all trauma patients is 60 minutes from the time
					 notified to respond.
4. It is
					 desirable the following specialist be on-call and available 24 hours/day:
a. Critical Care Medicine
b. Obstetrics/Gynecology Surgery
c. Critical Care Medicine
d. Thoracic Surgery*
*A trauma surgeon is presumed to be qualified and have
						privileges to provide emergency thoracic surgical care to patients with
						thoracic injuries. If this is not the case, the facility must have a
						board-certified thoracic surgeon immediately available (within 30 minutes of
						the time notified to respond).
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-3-1-5.2.2 - Qualifications of Surgeons on the Trauma Team

Current through June 25, 2024
1. Basic to
					 qualification for trauma care for any surgeon is current or previous Board
					 Certification in a surgical specialty recognized by the American Board of
					 Medical Specialties, the Advisory Board for Osteopathic Specialties, the
					 American Dental Association, the Royal College of Physicians and Surgeons of
					 Canada, or other appropriate foreign board. Many boards require a practice
					 period. Such an individual may be included when recognition by major
					 professional organizations has been received in their specialty. The board
					 certification criteria apply to the general surgeons and orthopedic surgeons.
2. The surgeon is expected to
					 serve as the captain of the resuscitating team and is expected to be in the
					 emergency department upon arrival of the seriously injured patient to make key
					 decisions about the management of the trauma patient's care. The surgeon will
					 coordinate all aspects of treatment, including resuscitation, operation,
					 critical care, recuperation and rehabilitation (as appropriate in a Level III
					 facility) and determine if the patient needs transport to a higher level of
					 care. If transport is required he/she is accountable for coordination of the
					 process with the receiving physician at the receiving facility. If the patient
					 is to be admitted to the Level III trauma center, the surgeon is the admitting
					 physician and will coordinate the patient care while hospitalized. Guidelines
					 must be written at the local level to determine which types of patients should
					 be admitted to the Level III trauma center or which patients should be
					 considered for transfer to a higher level of care. General Surgeons taking
					 trauma call must have eight (8) hours of trauma specific continuing medical
					 education (CME) over three years. This can be met within the 40 hour
					 requirement by licensure.
3. The
					 general surgery and orthopedic liaisons must participate in a
					 multi-disciplinary trauma committee and the PI process. Committee attendance
					 must be at least fifty percent (50%) over a year's period of time.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-3-1-5.2.3 - Qualifications of Emergency Physicians

Current through June 25, 2024
1. For those
					 physicians providing emergency medicine coverage, board certification in
					 Emergency Medicine and/or General Surgery is required or current certification
					 in ATLS. ATLS must be obtained within 18 months of hire.
2. The emergency medicine liaison must
					 participate in a multi-disciplinary trauma committee and the PI process.
					 Committee attendance must be at least fifty percent (50%) over a year's period
					 of time. Emergency physicians must be currently certified in ATLS (ATLS
					 requirements are waived for Board Certified Emergency Medicine and Board
					 Certified General Surgery Physicians), and it is required they be involved in
					 at least eight (8) hours of trauma related continuing education (CME) every 3
					 years.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.1 - Emergency Department

Current through June 25, 2024
1. The facility
					 must have an emergency department, division, service or section staffed so
					 trauma patients are assured immediate and appropriate initial care. The
					 emergency physician and/or mid-level providers must be in-house 24 hours/day,
					 immediately available at all times, and capable of evaluating trauma patients
					 and providing initial resuscitation. The emergency medicine physician will
					 provide team leadership and care for the trauma patient until the arrival of
					 the surgeon in the resuscitation area. The emergency department must have
					 established standards and procedures to ensure immediate and appropriate care
					 for the adult and pediatric trauma patient. The medical director for the
					 department must participate with the Multidisciplinary Trauma Committee and the
					 trauma PI process. The emergency department medical director must meet the
					 recommended requirements related to commitment, experience, continuing
					 education, ongoing credentialing, and initial or current board certified in
					 emergency medicine.
2. The medical
					 director of the emergency department, along with the TMD, will establish
					 trauma-specific credentials that must exceed those that are required for
					 general hospital privileges. Examples of credentialing requirements would
					 include skill proficiency, training requirements, conference attendance,
					 education requirements, ATLS verification, and specialty board certification.
3. The emergency medicine
					 physician or designee will be responsible for activating the trauma team based
					 on predetermined response protocols. He/She will provide team leadership and
					 care for the trauma patient until the arrival of the surgeon in the
					 resuscitation area. The emergency department must have established standards
					 and procedures to ensure immediate and appropriate care for the adult and
					 pediatric trauma patient. The emergency department medical director, or his/her
					 designee, must act as a liaison and participate with the Multidisciplinary
					 Trauma Committee and the trauma PI process.
4. There must be an adequate number of RN's
					 staffed for the trauma resuscitation area in-house 24 hours/day. Emergency
					 nurses staffing the trauma resuscitation area must be a current provider of
					 Trauma Nurse Core Curriculum (TNCC), or Advanced Trauma Care for Nurses (ATCN),
					 and participate in the ongoing PI process of the trauma program. Nurses must
					 obtain TNCC or ATCN within 18 months of assignment to the ER.
5. The list of required equipment necessary
					 for the ED can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.2 - Surgical Suites/Anesthesia

Current through June 25, 2024
1. An operating
					 room must be adequately staffed and available within 30 minutes of time of
					 notification, Availability of the operating room personnel and timeliness of
					 starting operations must be continuously evaluated by the trauma performance
					 improvement process, and measures must be implemented to ensure optimal care.
2. If the staff is not in-house,
					 hospital policy must be written to assure notification and prompt response.
3. The OR nurses should
					 participate in the care of the trauma patient and be competent in the surgical
					 stabilization of the major trauma patient.
4. The OR nurses are integral members of the
					 trauma team and must participate in the ongoing PI process of the trauma
					 program and must be represented on the Multidisciplinary Trauma Committee.
5. The OR supervisor must be able
					 to demonstrate a prioritization scheme to assure the availability of an
					 operating room for the emergent trauma patient during a busy operative
					 schedule. There must be an on-call system for additional personnel for multiple
					 patient admissions.
6. The
					 anesthesia department in a Level III trauma center must be organized and run by
					 an anesthesiologist or physician liaison who is experienced and devoted to the
					 care of the injured patient.
7. A
					 Licensed Anesthesia Provider must be immediately available with a mechanism
					 established to ensure early notification of the on-call provider.
					 Anesthesiologists or Certified Registered Nurse Anesthetist (CRNAs) may fill
					 this requirement. Hospital policy must be established to determine when the
					 Licensed Anesthesia Providers must be immediately available for airway control
					 and assisting with resuscitation. The availability of the Licensed Anesthesia
					 Providers and the absence of delays in airway control or operative anesthesia
					 must be documented and monitored by the PI process. The maximum response time
					 for all trauma patients is 30 minutes from the time notified to respond.
8. The list of required equipment
					 necessary for Surgery and Anesthesia can be found on line at the Department's
					 website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.3 - Post Anesthesia Care Unit (PACU)

Current through June 25, 2024
1. A Level III
					 trauma center must have a PACU staffed and available 24 hours/day to the
					 postoperative trauma patient. Hospital policy must be written to assure early
					 notification and prompt response. If this availability requirement is met with
					 a team on call from outside the hospital, the availability of the PACU nurses
					 and compliance with this requirement must be documented.
2. PACU staffing must be in sufficient
					 numbers to meet the critical need of the trauma patient.
3. The list of required equipment necessary
					 for the PACU can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.4 - Intensive Care Unit (ICU)

Current through June 25, 2024
1. Level III trauma
					 centers must have an Intensive Care Unit (ICU) that meets the needs of the
					 adult trauma patient.
2. There must
					 be physician coverage for the ICU at all times. A physician credentialed by the
					 facility must be promptly available to the trauma patient in the ICU 24
					 hours/day. This coverage is for emergencies only and is not intended to replace
					 the primary surgeon but rather is intended to ensure that the patient's
					 immediate needs are met while the surgeon is contacted.
3. The surgical director or co-director must
					 be the TMD, or general surgeon taking trauma call. The director is responsible
					 for the quality of care and administration of the ICU and will set policy and
					 establish standards of care to meet the unique needs of the trauma
					 patient.
4. The trauma surgeon
					 assumes and maintains responsibility for the care of the serious or multiple
					 injured patient. A surgically directed ICU physician team is desirable. The
					 team will provide in-house physician coverage for all ICU trauma patients at
					 all times. This service can be staff by appropriately trained physicians from
					 different specialties, but must be led by a qualified surgeon as determined by
					 critical care credentials consistent with the medical staff privileging process
					 of the institution. The trauma surgeon, in collaboration with other specialty
					 providers, must maintain control over all aspects of care, including, but not
					 limited to respiratory care and management of mechanical ventilation; placement
					 and use of pulmonary catheters; management of fluid electrolytes,
					 antimicrobials, and enteral and parenteral nutrition.
5. Level III Trauma Center must provide
					 staffing in sufficient numbers to meet the needs of the trauma patient.
					 Critical care nurses must be available 24 hours per day. ICU nurses are an
					 integral part of the trauma team and as such, must be represented on the
					 Multidisciplinary Trauma Committee and participate in the PI process of the
					 trauma program at least 50% of the time.
6. The list of required equipment necessary
					 for the ICU can be found on line at the Department's website.
Miss. Code Ann.
						§
												41-59-5
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.5 - Foundation for Services

Current through June 25, 2024
The Mississippi Poison Control Center shall operate
						under the auspices of a tertiary care center that is associated with a medical
						and pharmacy school. The Medical Director of the poison control center shall
						assume overall responsibility to assure compliance with the regulations, for
						setting policy, appointing medical and other persons to carry out such policies
						and for monitoring the poison control center's total operation. Collaboration
						of services with a medical center/school is important due to expertise and
						resources of that entity in the management of poisonings and its function as an
						educational institution for medical and other health related professions.
Miss. Code Ann.
						§
												41-3-15
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.6 - Operational Requirements

Current through June 25, 2024
In order for apoison control center to be considered
						operational, the center must:
1. Have
					 telecommunications and data resources to assure accessibility 24/7/365;
2. Utilize the national PCC
					 hotline number of 1-800-222- 1222;
3. Have availability of medical and assistive
					 staff to meet the needs of the call volume, educational and training
					 productions and related services;
4. Routinely upload exposure data into the
					 National Poison Control Database.
Miss. Code Ann.
						§
												41-3-15
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.7 - Accreditation Renewal Cycle

Current through June 25, 2024
The accreditation issued for the operation of apoison
						control program, unless sooner suspended or revoked, shall expire automatically
						on June 30 of each third calendar year. Should initial accreditation occur
						prior to the June 30 date, the initial accreditation period shall run from the
						date of determination of compliance with all rules and regulations through June
						30 of the following year post June 30. For example, if compliance is determined
						and initial accreditation is granted on February 28, 2015, the initial
						licensure period shall run from February 28, 2015 thru June 30, 2018. June 30,
						2016, then shall be established on an every three calendar year cycle.
Miss. Code Ann.
						§
												41-3-15
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 3 - Bureau of Acute Care Systems › Subpart 1 - Trauma System of Care › Chapter 5 - Level III Trauma Centers › Subchapter 3 - Facility Standards › Rule 15-3-1-5.3.8 - Accreditation Renewal Process

Current through June 25, 2024
The poison control center seeking renewal of its
						accreditation shall:
1. Request a
					 renewal packet from the Bureau if one is not received within 45 days prior to
					 the expiration of the accreditation date;
2. Complete all forms and return to the
					 Bureau within 30 days prior to the expiration of the renewal;
3. Submit the required accreditation renewal
					 fees with the packet. A renewal packet is not considered complete until the
					 completed packet and all pertinent fees are submitted.
Miss. Code Ann.
						§
												41-3-15