North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1910 - NURSING/HEALTH CARE ADMINISTRATION AND SUPERVISION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  licensed facility shall have a director of nursing service who shall be
				  responsible for the overall organization and management of all nursing services
				  and shall be currently licensed to practice as a registered nurse by the North
				  Carolina Board of Nursing in accordance with G.S. 90, Article 9A.
(b) The Director of Nursing shall not serve
				  as administrator or assistant administrator.
(c) A licensed facility with nursing
				  facilities shall provide a full-time director of nursing on duty at least eight
				  hours per day, five days a week. A registered nurse shall relieve the Director
				  of Nursing (be in charge of nursing) during the Director's absence.
(d) A licensed facility shall employ and
				  assign registered nurses, licensed practical nurses, nurse aides and nurse aide
				  trainees for duties in accordance with G.S. 90, Article 9A.
(e) The Director of Nursing shall cause the
				  following to be accomplished:
(1)
				  establishment and implementation of nursing policies and procedures which shall
				  include, but shall not be limited to the following:
(A) assessment of and planning for patients'
				  nursing care or health care needs, and implementation of nursing or health care
				  plans;
(B) daily charting of any
				  unusual occurrences or acute episodes related to patient care, and progress
				  notes written monthly reporting each patient's performance in accordance with
				  identified goals and objectives and each patient's progress toward
				  rehabilitative nursing goals;
(C)
				  assurance of the delivery of nursing services in accordance with physicians'
				  orders, nursing care plans and the facility's policies and
				  procedures;
(D) notification of
				  emergency physicians or on-call physicians;
(E) infection control to prevent
				  cross-infection among patients and staff;
(F) reporting of deaths;
(G) emergency reporting of fire, patient and
				  staff accidents or incidents, or other emergency situations;
(H) use of protective devices or restraints
				  to assure that each patient or resident is restrained in accordance with
				  physician orders and the facility's policies, and that the restrained patient
				  or resident is appropriately evaluated and released at a minimum of every two
				  hours;
(I) special skin care and
				  decubiti care;
(J) bowel and
				  bladder training;
(K) maintenance
				  of proper body alignment and restorative nursing care;
(L) supervision of and assisting patients
				  with feeding;
(M) intake and output
				  observation and reporting for those patients whose condition warrants
				  monitoring of their fluid balance. This will include those patients on
				  intravenous fluids or tube feedings, and patients with kidney failure and
				  temperatures elevated to 102 degrees Fahrenheit or above;
(N) catheter care; and
(O) procedures used in caring for patients in
				  the facility;