reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4105 - NURSING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Level I and
				  Level II emergency services shall have one or more registered nurses assigned
				  and on duty within the emergency service area at all times.
(b) A Level III emergency service shall have
				  a registered nurse available on at least an on-call, in-house basis at all
				  times.
(c) The facility shall
				  document that all emergency services nursing personnel shall have orientation,
				  training and continuing education in the reception and care of emergency
				  patients.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4106 - POLICIES AND PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
Each emergency department shall establish written policies
					 and procedures that specify the scope and conduct of patient care to be
					 provided in the emergency areas. They shall include the following:
(1) the location, storage, and procurement of
				  medications, blood, supplies, equipment, and the procedures to be followed in
				  the event of equipment failure;
(2)
				  the initial management of patients with burns, hand injuries, head injuries,
				  fractures, multiple injuries, poisoning, animal bites, gunshot or stab wounds,
				  and other acute problems;
(3) the
				  provision of care to an unemancipated minor not accompanied by a parent or
				  guardian, or to an unaccompanied unconscious patient;
(4) management of alleged or suspected child,
				  elder, or adult abuse;
(5) the
				  management of pediatric emergencies;
(6) the initial management of patients with
				  actual or suspected exposure to radiation;
(7) management of alleged or suspected rape
				  victims;
(8) the reporting of
				  individuals dead on arrival to the proper authorities;
(9) the use of standing orders;
(10) tetanus and rabies prevention or
				  prophylaxis; and
(11) the
				  dispensing of medications in accordance with State and federal laws.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4107 - EMERGENCY RECORDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall require all levels of emergency departments to maintain a continuous
				  control register on each patient seen for services which shall include at least
				  the name, age, sex, date, time, and means of arrival, nature of complaint,
				  disposition, and time of discharge.
(b) The facility shall maintain a record for
				  each patient seeking emergency care. This shall include:
(1) patient identification, time and means of
				  arrival;
(2) pertinent history and
				  physical findings and patient vital signs;
(3) diagnostic and therapeutic
				  orders;
(4) clinical observations
				  including results of treatment;
(5)
				  reports of procedures, tests and results;
(6) diagnostic impression; and
(7) discharge or transfer summary of
				  treatment including final disposition, the patient's condition, and any
				  instructions given to the patient and or family for follow-up care.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4108 - OBSERVATION BEDS

Current through Register Vol. 39, No. 2, July 15, 2024
When observation beds are used, the facility shall
					 implement written policies and procedures that address the type of patient use,
					 the mechanism for providing appropriate clinical monitoring, the length of time
					 services may be provided in this setting and documentation
					 requirements.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4109 - TRANSFER

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall establish and implement protocols for stabilization and transportation of
				  emergency patients.
(b) A facility
				  with specialized capabilities, such as burn units, shock-trauma units and
				  neonatal intensive care units, shall not refuse to accept an appropriate
				  transfer for those services if the hospital has the capacity to treat the
				  individual.
(c) The facility shall
				  not transfer a patient until the receiving organization has consented to accept
				  the patient and the patient is sufficiently stable for transport.
(d) If the patient or the person acting on
				  the patient's behalf refuses transfer, the facility staff shall:
(1) explain to the individual or his
				  representative the risks and benefits of transfer; and
(2) shall request the patient's or his
				  representative's refusal of transfer in writing.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4100 - EMERGENCY SERVICES › Section 13B .4110 - DISASTER AND MASS CASUALTY PROGRAM

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  facility shall describe:
(1) the level of
				  emergency services available during an external disaster;
(2) the emergency department's role in the
				  facility's external disaster plan;
(3) procedures to be followed in the event of
				  an internal disaster; and
(4) the
				  facility's connection to other community services such as fire, police and the
				  American Red Cross.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4200 - SPECIAL CARE UNITS › Section 13B .4201 - ORGANIZATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body shall approve the type and scope of special care units.
(b) The facility shall document the
				  relationship of the special care units to the other departments within the
				  hospital, including channels of responsibility and authority.
(c) The facility shall provide necessary
				  equipment and supplies for delivery of nursing care specific to the unit
				  population for each special care unit.
(d) The facility shall provide sufficient
				  emergency drugs and equipment to meet anticipated needs as determined by the
				  medical staff.
(e) The governing
				  body shall delegate to the medical and nursing staff the responsibility to
				  develop policies and procedures concerning the scope and provision of safe care
				  in each unit.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4200 - SPECIAL CARE UNITS › Section 13B .4202 - MEDICAL STAFF

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body shall provide that each special care unit or group of similar units be
				  directed by qualified members of the medical staff whose clinical and
				  administrative privileges have been approved by the governing board.
(b) The governing body shall designate the
				  director to be responsible for making decisions in consultation with the
				  physician responsible for the patient, for the disposition of a patient when
				  patient load exceeds optimal operation capacity.
(c) The governing body shall require that the
				  medical staff provide medical staff coverage sufficient to meet the specific
				  needs of the patients on a 24-hour basis.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4200 - SPECIAL CARE UNITS › Section 13B .4203 - NURSING STAFF

Current through Register Vol. 39, No. 2, July 15, 2024
The supervision of nursing care for each special care unit
					 shall be provided by a qualified registered nurse and shall include the
					 following:
(1) unit-specific
				  orientation and competency evaluation for each staff member;
(2) a staffing plan based upon the needs of
				  the patient population which is implemented to ensure a sufficient number of
				  qualified Registered Nurses are on duty when patients are in the
				  unit;
(3) assessment, planning,
				  implementation and evaluation of nursing care which is documented according to
				  policy; and
(4) delivery of nursing
				  care in accordance with the North Carolina Nurse Practice Act.
Authority
					 G.S.
					 131E-79;
RRC objection due to
					 lack of statutory authority Eff. July 13, 1995;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4200 - SPECIAL CARE UNITS › Section 13B .4204 - POLICIES AND PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility in
				  conjunction with the medical and nursing staff shall develop written policies
				  and procedures which guide the provision of care in a special care unit. These
				  policies and procedures shall be approved by the medical staff and include:
(1) patient admission and discharge
				  criteria;
(2) notification of
				  appropriate medical staff for changes in the condition of the
				  patient;
(3) use of standing orders
				  and emergency protocols;
(4)
				  designation of staff members authorized to perform special procedures and
				  special circumstances requiring such authorization;
(5) patient care procedures, including
				  medication administration;
(6)
				  infection control;
(7) pertinent
				  safety practices;
(8) use of
				  equipment and procedures to be followed in the event of equipment
				  failure;
(9) regulations governing
				  visitors and traffic control; and
(10) role of special care unit in internal
				  and external disaster plans.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4301 - ORGANIZATION MATERNAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  governing body shall approve the scope of obstetric services offered based upon
				  the level of patient need, qualifications of the credentialed staff, and
				  resources of the facility.
(b) The
				  following capabilities and minimum services shall be made available when
				  obstetric services are provided:
(1)
				  identification of high-risk mothers and fetuses;
(2) continuous electronic fetal
				  monitoring;
(3) cesarean delivery
				  capability within 30 minutes of decision;
(4) blood or fresh frozen plasma for
				  transfusion;
(5) anesthesia on a
				  24-hour or on-call basis;
(6)
				  radiology and ultrasound examination;
(7) stabilization of unexpectedly small or
				  sick neonates before transfer;
(8)
				  neonatal resuscitation;
(9)
				  laboratory services on a 24-hour or on-call basis;
(10) consultation and transfer
				  agreements;
(11) assessment and
				  care for the neonates; and
(12)
				  nursery or other appropriate space for care of the neonates.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4302 - MEDICAL STAFF MATERNAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The medical
				  staff shall require that each birth be attended by a physician or certified
				  nurse midwife who has documented evidence of current competence and appropriate
				  privileges.
(b) At all times
				  medical staff with obstetrical privileges shall be available within 30 minutes
				  to provide services and attend deliveries. An on-call schedule shall be
				  available to the Division for review.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4303 - NURSING SERVICES MATERNAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The nurse
				  executive or the decentralized nursing management staff shall designate a
				  registered nurse who has education, training, and experience in obstetrical
				  care as supervisor of obstetrical services.
(b) A registered nurse shall be responsible
				  for providing the type and amount of nursing care needed by each patient. A
				  staffing plan shall be available to the Division for review.
Authority
					 G.S.
					 131E-79;
RRC objection due to
					 lack of statutory authority Eff. July 13, 1995;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4304 - POLICIES AND PROCEDURES MATERNAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  provision of patient care shall be guided by written policies and procedures
				  developed by the medical and nursing staff and approved by the medical
				  staff.
(b) Written policies shall
				  relate to at least the following:
(1) a system
				  for informing the physician or certified nurse midwife responsible for a
				  patient of the following:
(A) the patient's
				  admission;
(B) the onset of labor;
				  and
(C) pertinent information about
				  progress of labor or changes in patient's condition.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4305 - ORGANIZATION OF NEONATAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  governing body shall approve the scope of all neonatal services and the
				  facility shall classify its capability in providing a range of neonatal
				  services using the following criteria:
(1)
				  LEVEL I: Full-term and pre-term neonates that are stable without complications.
				  This may include infants who are small for gestational age or neonates who are
				  large for gestational age.
(2)
				  LEVEL II: Neonates or infants that are stable without complications but require
				  special care and frequent feedings; infants of any weight who no longer require
				  LEVEL III or LEVEL IV neonatal services, but who still require more nursing
				  hours than normal infant. This may include infants who require close
				  observation in a licensed acute care bed.
(3) LEVEL III: Neonates or infants that are
				  high-risk, small or approximately 32 and less than 36 completed weeks of
				  gestational age but otherwise healthy, or sick with a moderate degree of
				  illness that are admitted from within the hospital or transferred from another
				  facility requiring intermediate care services for sick infants, but not
				  requiring intensive care. The beds in this level may serve as a "step-down"
				  unit from Level IV. Level III neonates or infants require less constant nursing
				  care, but care does not exclude respiratory support.
(4) LEVEL IV (Neonatal Intensive Care
				  Services): High-risk, medically unstable, or critically ill neonates under 32
				  weeks of gestational age, or infants, requiring constant nursing care or
				  supervision that includes continuous cardiopulmonary or respiratory support,
				  complicated surgical procedures, or other intensive supportive
				  interventions.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4306 - MEDICAL STAFF OF NEONATAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
The medical staff shall require that the director or other
					 designated physician in charge of the neonatal special or intensive care unit
					 has training and experience in care of the neonate.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4307 - NURSING STAFF OF NEONATAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The nurse
				  executive or the decentralized nursing management staff shall designate a
				  registered nurse who has training and experience in the care of neonates as
				  supervisor of neonatal services.
(b) A registered nurse shall be responsible
				  for providing the type and amount of nursing care needed by each patient. A
				  staffing plan shall be available to the Division for review.
(c) The nursing staff shall provide
				  educational opportunities for parents of neonates on routine care and
				  procedures needed by the neonate.
(d) The nursing staff shall provide
				  opportunities for parental participation in care of the neonate to facilitate
				  bonding and family adjustment to the neonate's needs.
Authority
					 G.S.
					 131E-79;
RRC objection due to
					 lack of statutory authority Eff. July 13, 1995;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4300 - MATERNAL - NEONATAL SERVICES › Section 13B .4308 - POLICIES AND PROCEDURES OF NEONATAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  provision of neonatal care at all levels shall be guided by written policies
				  and procedures developed and approved by the medical and nursing
				  staffs.
(b) The policies and
				  procedures shall include but are not limited to:
(1) emergency resuscitation and stabilization
				  of the neonate;
(2) equipment for
				  routine and emergency care of the neonate;
(3) continuous oxygen supply and means of
				  administration including ventilators;
(4) administration of medications;
(5) insertion and care of invasive
				  lines;
(6) prevention of infectious
				  diseases or processes; and
(7)
				  family involvement in care of the neonate.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4400 - RESPIRATORY CARE SERVICES › Section 13B .4401 - ORGANIZATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body shall appoint a medical director of the respiratory care service who is an
				  anesthesiologist, pulmonologist or other qualified physician.
(b) The facility shall appoint a qualified
				  individual as the director of respiratory care services.
(c) When the facility is without a distinct
				  respiratory care service, the facility shall:
(1) designate the department responsible for
				  the delivery of respiratory care services;
(2) designate a person to supervise the
				  delivery of respiratory care services; and
(3) establish and maintain policies and
				  procedures for the delivery of respiratory care services offered.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4400 - RESPIRATORY CARE SERVICES › Section 13B .4402 - STAFFING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Staffing
				  numbers shall be determined by the types and complexities of the services
				  offered.
(b) The director of the
				  service shall provide for the availability of trained respiratory technicians,
				  Certified Respiratory Therapy Technicians, registry eligible or Registered
				  Respiratory Therapist needed for the scope of services offered.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4400 - RESPIRATORY CARE SERVICES › Section 13B .4403 - POLICIES AND PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
The facility shall establish and maintain written policies
					 and procedures for the services offered. These shall include but are not
					 limited to:
(1) scope of services and
				  treatment offered;
(2) medication
				  administration;
(3) cleaning,
				  assembly and storage of equipment;
(4) safety;
(5) infection control;
(6) documentation of delivered care or
				  treatments; and
(7) care and
				  supervision of all ventilated patients.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4501 - PROVISION OF SERVICE

Current through Register Vol. 39, No. 2, July 15, 2024
The facility shall provide for pharmaceutical services
					 which are administered in accordance with the pharmacy laws of North Carolina
					 including but not limited to G.S. 90 and G.S. 106.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4502 - PHARMACIST

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The pharmacy
				  service shall be directed by a pharmacist licensed by the State of North
				  Carolina. If a facility has a limited service as defined by the N.C. Board of
				  Pharmacy, a part-time director of pharmacy shall have responsibility for
				  control and dispensing of drugs.
(b) The director of pharmacy shall be
				  responsible to the chief executive officer or his designee for developing,
				  supervising, and coordinating all the activities of pharmacy services
				  throughout the facility.
(c) The
				  director of pharmacy shall require that the pharmacists are trained in the
				  specialized functions of facility pharmacy.
(d) The dispensing of drugs in the absence of
				  a pharmacist shall be done by facility staff under the direct supervision of
				  staff approved by the pharmacy committee and who are responsible for following
				  policies established by the pharmacy committee.
Authority
					 G.S.
					 131E-79;
RRC objection due to
					 lack of statutory authority Eff. July 13, 1995;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4503 - STAFF

Current through Register Vol. 39, No. 2, July 15, 2024
The director of pharmacy shall be assisted by additional
					 pharmacists and such other personnel as the activities of the pharmacy may
					 require to meet the pharmaceutical needs of the patients
					 served.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4504 - PHARMACY COMMITTEE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A pharmacy
				  committee or its equivalent, to include physicians, registered nurses,
				  pharmacists and the administrator or designee shall be established.
(b) The committee shall meet at least
				  quarterly, record its proceedings and report to the medical staff. It shall
				  assist in the formulation of broad professional policies regarding the
				  evaluation, appraisal, selection, procurement, storage, distribution, use and
				  safety procedures, and all other matters relating to drugs in the facility.
				  This shall include a mechanism to review and evaluate adverse drug reactions
				  and drug usage evaluations, offering appropriate recommendations, actions, and
				  follow-up if necessary. The committee shall:
(1) serve as an advisory group to the medical
				  staff and the pharmacy director on matters pertaining to drug
				  selection;
(2) develop an ongoing
				  mechanism to review a formulary or drug list for use in the hospital;
(3) recommend and develop policies regarding
				  the use and control of investigational drugs and research in the use of U.S.
				  Food and Drug Administration approved drugs;
(4) evaluate clinical data concerning new
				  drugs or preparations requested for use in the facility;
(5) make recommendations concerning drugs to
				  be stocked on the nursing units and by other services;
(6) establish mechanisms which will prevent
				  formulary duplication;
(7)
				  establish policies and procedures that address therapeutic drug
				  substitution;
(8) establish a
				  policy describing the duration of drug therapy or number of doses for all
				  medication orders; and
(9) make
				  recommendations regarding medication administration policies and
				  procedures.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4505 - PHARMACY FACILITIES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall provide sufficient space for the pharmaceutical service to carry out its
				  professional and administrative functions.
(b) Equipment shall be provided for the
				  storage, preparation, dispensing, distributing and safeguarding of drugs
				  throughout the hospital.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4506 - SUPPLIES

Current through Register Vol. 39, No. 2, July 15, 2024
The director of pharmacy shall maintain an inventory of
					 drugs and pharmaceutical devices to meet the needs of the patients as described
					 in the facility's formulary.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4507 - STORAGE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) All drugs and
				  related pharmaceutical supplies located throughout the facility shall be under
				  the control of the pharmacy service.
(b) All areas where drugs and related
				  pharmaceutical supplies are stored shall be monitored at least monthly by the
				  pharmacy service.
(c) The director
				  of pharmacy shall require that corresponding records are maintained of drug
				  inventory variances and the corrective action taken.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4509 - SECURITY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The director of
				  pharmacy shall require that all drugs and related pharmaceutical supplies be
				  stored in a lockable environment except when under the direct supervision of
				  personnel authorized by the pharmacy committee to handle drugs.
(b) Controlled substances and other drugs the
				  facility deems subject to abuse shall be stored as outlined in the U.S.
				  Controlled Substance Act, 21
				  CFR 1301.41 and the N.C. Controlled
				  Substances Act, G.S. 90, Article 5. These rules are available from the N.C.
				  Drug Control Unit of the N.C. Division of Mental health, Development
				  Disabilities & Substance Abuse Services, 3008 Mail Service Center, Raleigh,
				  NC 27699-3008 (919-733-1765) without charge to current registrants.
(c) All keys and other locking devices to the
				  pharmacy and controlled substances throughout the facility shall be under the
				  control of the director of pharmacy and the facility management.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22, 2017;
Amended Eff.
					 October 1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4510 - RECORDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The director of
				  pharmacy shall provide that all drug transactions of the pharmacy shall be
				  recorded as described in policies approved by the pharmacy committee.
(b) The director of pharmacy shall establish
				  and maintain a system of records and bookkeeping in accordance with the
				  policies of the facility in order to maintain adequate control over the
				  requisitioning and dispensing of all drugs and pharmaceutical supplies and over
				  patient billing for all drugs and pharmaceutical supplies.
(c) The director of pharmacy shall maintain
				  records for all drugs purchased, ordered, dispensed, distributed, returned and
				  disposed of in accordance with the pharmacy laws of North Carolina from the
				  pharmacy.
(d) Verbal orders for
				  drugs shall be subject to medical staff policies.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4511 - MEDICATION ADMINISTRATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  facility shall establish and maintain policies and procedures governing the
				  administration of medications which shall be enforced and implemented by
				  administration and staff. Policies and procedures shall include:
(1) accountability of controlled substances
				  as defined by the G.S. 90, Article 5; and
(2) storage, distribution, administration and
				  monitoring the effects of medications.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4512 - MEDICATIONS DISPENSED

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Except as
				  provided in Paragraph (c) of this Rule, the pharmacy shall dispense only those
				  drugs which are listed in one or more of the references listed in Paragraph (b)
				  of this Rule. No drug which is listed in Paragraph (b) of this Rule shall be
				  used for any purpose which is not approved by the U.S. Food and Drug
				  Administration unless the use has been approved by the facility's pharmacy
				  committee.
(b) References:
(1) United States Pharmacopoeia;
(2) National Drug Formulary;
(3) Evaluations of Drug Interactions by the
				  American Pharmaceutical Association;
(4) American Hospital Formulary Service;
				  and
(5) Other references approved
				  by the Pharmacy Committee.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4513 - DRUG DISTRIBUTION SYSTEMS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  pharmacy committee shall develop written policies and procedures pertaining to
				  the intra-facility drug distribution system. In developing such policies the
				  committee shall utilize representatives of other disciplines within the
				  facility, including nursing services.
(b) The label of each patient's individual
				  medication container shall bear all information required by the Pharmacy Laws
				  of North Carolina.
(c) The
				  pharmacist, with the advice and guidance of the pharmacy committee or its
				  equivalent, shall be responsible for specifications as to quality, quantity and
				  source of supplies of all drugs.
(d) There shall be a formulary or list of
				  drugs accepted for use in the facility which shall be developed and amended as
				  necessary by the pharmacy committee.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4514 - EMERGENCY PHARMACEUTICAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
The director of pharmacy shall be responsible for emergency
					 pharmaceutical services as currently described in the Pharmacy Laws of North
					 Carolina.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4515 - DISPOSITION

Current through Register Vol. 39, No. 2, July 15, 2024
Drugs, and pharmaceutical devices which are outdated,
					 visibly deteriorated, unlabeled, inadequately labeled, recalled, discontinued
					 or obsolete shall be identified by a pharmacist and shall be disposed of in
					 compliance with applicable state and federal laws and
					 regulations.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4500 - PHARMACY SERVICES AND MEDICATION ADMINISTRATION › Section 13B .4516 - COMMERCIAL PHARMACEUTICAL SERVICE

Current through Register Vol. 39, No. 2, July 15, 2024
A facility using an outside pharmacist or pharmaceutical
					 service must have a contract with that pharmacist or service. As part of the
					 contract, the pharmacist or service shall be required to maintain at least the
					 standards for operation of the pharmaceutical services outlined in this
					 Subchapter.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4600 - SURGICAL AND ANESTHESIA SERVICES › Section 13B .4601 - ORGANIZATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body shall approve the types of surgery and types of anesthesia services to be
				  available throughout the hospital consistent with identified needs and
				  resources.
(b) The facility shall
				  require that surgical or anesthesia procedures are performed only when the
				  necessary equipment and personnel are available.
(c) A facility that provides surgical or
				  obstetric services shall provide anesthesia services on a 24-hour
				  basis.
(d) The requirements and
				  standards identified in this Section apply when any patient, in any setting,
				  receives for any purpose, by any route:
(1)
				  general, spinal or other major regional anesthesia; or
(2) sedation or analgesia that may result in
				  the loss of protective reflexes; or
(3) surgery or other invasive procedure while
				  receiving such anesthesia.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4600 - SURGICAL AND ANESTHESIA SERVICES › Section 13B .4602 - DIRECTOR OF SURGICAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each
				  department or service providing surgical services shall be directed by members
				  of the medical staff whose clinical and administrative privileges have been
				  approved by the governing body.
(b)
				  The medical staff shall establish and maintain a system for monitoring and
				  evaluating the quality and appropriateness of the care and treatment of
				  surgical patients, and for monitoring the clinical performance of all
				  individuals with clinical privileges.
(c) In facilities where there is no
				  anesthesiologist on staff the facility shall:
(1) with review of the medical staff,
				  establish a consultation agreement with a board-certified or board-eligible
				  anesthesiologist for the purpose of establishing policies and procedures that
				  relate to the safe administration of anesthesia in all departments or services
				  of the facility;
(2) assume the
				  responsibility for establishing general policies for anesthesia services;
				  and
(3) establish a line of
				  communication and supervision for staff.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4600 - SURGICAL AND ANESTHESIA SERVICES › Section 13B .4603 - SURGICAL AND ANESTHESIA STAFF

Current through Register Vol. 39, No. 2, July 15, 2024
The facility shall develop processes that require each
					 individual provide only those services for which proof of licensure and
					 competency can be demonstrated. The facility shall require that:
(1) when anesthesia is administered, a
				  physician is available in the facility to provide care in the event of a
				  medical emergency;
(2) a roster of
				  practitioners with a delineation of current surgical and anesthesia privileges
				  is available and maintained for the service;
(3) an on-call schedule of surgeons with
				  privileges to be available at all times for emergency surgery and for
				  post-operative clinical management is maintained;
(4) the operating room is supervised by a
				  registered nurse or doctor of medicine or osteopathy; and
(5) an operating room register which shall
				  include date of the operation, name and patient identification number, names of
				  surgeons and surgical assistants, name of anesthetists, type of anesthesia
				  given, pre- and post-operative diagnosis, type and duration of surgical
				  procedure, and the presence or absence of complications in surgery is
				  maintained.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4600 - SURGICAL AND ANESTHESIA SERVICES › Section 13B .4604 - DIRECTION OF ANESTHESIA SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  facility shall be organized, directed and integrated with other related
				  services or departments of the facility.
(b) The department of anesthesia shall
				  require that all anesthetics are administered according to procedures
				  established in medical staff rules. In facilities where there is no department
				  of anesthesia, the medical staff shall assume the responsibility for
				  establishing general policies and for supervising the administration of
				  anesthetics.
(c) The facility shall
				  provide that anesthesia services be directed by a member, or members, of the
				  medical staff whose responsibilities shall be approved by the governing body
				  and shall include:
(1) establishment of
				  criteria and procedures for the evaluation of the quality of all anesthesia
				  care rendered;
(2) review of
				  clinical privileges for all licensed practitioners whose primary clinical
				  activity is the provision of anesthesia services; and
(3) establishment of written policies and
				  procedures for anesthesia services.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4600 - SURGICAL AND ANESTHESIA SERVICES › Section 13B .4605 - POLICIES AND PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The director of
				  surgical services shall develop policies and procedures for surgical and
				  anesthesia services which shall be available to the medical, surgical,
				  anesthesia staff and nursing personnel.
(b) The facility shall require that policies
				  on anesthesia procedures include the delineation of pre-anesthesia and
				  post-anesthesia responsibilities.
(c) The facility shall require that the
				  policies listed in this Paragraph are followed and that each surgical patient's
				  record contain the following documentation:
(1) a complete history and physical
				  documented in the record of every patient prior to surgery, including clinical
				  indications for the surgical procedure;
(2) written evidence of informed consent, in
				  the patient's record before surgery. If prior written consent was not obtained,
				  the record shall contain a written explanation of why prior consent was not
				  obtained;
(3) an evaluation of the
				  patient and anesthesia planned, documented according to medical staff bylaws by
				  an individual qualified to administer anesthesia services. Re-evaluation of the
				  patient immediately prior to the induction of anesthesia shall be performed
				  prior to surgery;
(4) an operative
				  report describing techniques, findings, tissue removed or altered, and pre and
				  post-surgical diagnosis. This report must be written or dictated following
				  surgery and signed by the surgeon in compliance with medical staff
				  rules;
(5) an intraoperative
				  anesthesia record including the dosage of all drugs and agents used, the
				  duration of anesthesia, and the type and amount of all fluids or blood and
				  blood products administered shall be documented;
(6) evaluation and documentation of the
				  postoperative status of the patient on admission to and discharge from the
				  post-anesthesia recovery area.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4700 - NUTRITION AND DIETETIC SERVICES › Section 13B .4701 - PROVISION OF SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
The nutrition and dietetic services shall be organized,
					 directed, staffed and integrated with other facility departments to provide
					 optimal nutritional therapy and quality food service to patients. Nutrition
					 therapy shall apply the principles of the science of nutrition and be
					 administered in accordance with the law and rules including but not limited to
					 G.S. 90, Article 25.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .4700 - NUTRITION AND DIETETIC SERVICES › Section 13B .4702 - ORGANIZATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The nutrition
				  and dietetic services shall be under the full-time direction of a person who is
				  trained or experienced in food services administration and therapeutic diets.
				  The director shall be one of the following:
(1) A qualified dietitian;
(2) Bachelor's degree in Foods and Nutrition
				  or Food Service Management;
(3)
				  Dietetic Technician Registered (DTR); or
(4) Certified Dietary Manager (CDM);
				  or
(5) An individual who is
				  enrolled in a program to complete the minimum qualifications in Paragraph
				  (a)(1)(2)(A)(B)(C) of this Rule.