reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 136 - OPEN HEART SURGICAL SERVICES › PROGRAM, SERVICE AND PERSONNEL REQUIREMENTS › Section 136.20 - Pediatric heart surgery-supplementary criteria

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A hospital which provides pediatric heart
					 surgery shall meet the standards in this chapter for a cardiovascular surgery
					 program for adults.
(b) In
					 addition, the following criteria shall be met by a pediatric heart surgery
					 program:
(1) The facility shall be capable of
					 providing definitive diagnostic and therapeutic services for children with all
					 types of cardiovascular disease.
(2) A diagnostic laboratory with radiographic
					 and cardiac catheterization equipment generally similar to that for adults.
					 Bi-plane cineangiography shall be readily available 24 hours per day, and
					 laboratories (both catheterization and general chemical) shall be equipped for
					 small volume samples.
(3) Surgical
					 equipment appropriate for newborns, infants and children.
(4) Intensive care facilities for newborns
					 (as defined by current American Academy of Pediatrics/American College of
					 Obstetrics and Gynecology Guidelines for Perinatal Care), infants and
					 children.
(5) All staff responsible
					 for care of the pediatric patient shall have experience and training in
					 pediatrics including both physiological and psychosocial needs of the
					 patient.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 136 - OPEN HEART SURGICAL SERVICES › PROGRAM, SERVICE AND PERSONNEL REQUIREMENTS › Section 136.21 - Quality management and improvement

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A hospital performing open heart surgery
					 shall maintain patient data on the following:
(1) Mortality/morbidity.
(2) Infections and complications.
(3) Patient risk factors.
(4) Volume of procedures performed.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › GENERAL PROVISIONS › Section 137.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
Where a hospital provides obstetrical services, they
						shall be provided in a manner sufficient to meet the medical needs of the
						patients.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › GENERAL PROVISIONS › Section 137.2 - Organization and staffing

Current through Register Vol. 54, No. 28, July 13, 2024
The obstetrics service shall be organized in a manner
						that will ensure appropriate, effective care of maternity
						patients.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › GENERAL PROVISIONS › Section 137.3 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The director of
					 the obstetrical services must be a member of the medical staff who is certified
					 by the American Board of Obstetrics and Gynecology or an equivalent Board or
					 who is eligible for Board certification or has successfully completed an
					 approved residency training program in obstetrics-gynecology. The director of
					 the obstetrical service, in cooperation with a committee of staff physicians,
					 nurses, administrators, and other relevant personnel, shall establish policies
					 for the proper conduct of the service.
(b) A designated physician who is experienced
					 in the practice of obstetrics shall be on call at all times for consultation
					 and obstetrical emergencies.
(c) A
					 designated physician who is experienced in the practice of anesthesiology shall
					 be on call at all times for consultation and anesthesia emergencies.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › GENERAL PROVISIONS › Section 137.4 - Obstetrical nursing service

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Obstetrical nursing services shall be provided in accordance with Chapter 109
					 (relating to nursing services) in addition to this section.
(b) The obstetrical nursing service shall be
					 under the direction and supervision of a professional registered nurse who is
					 qualified by training and experience in obstetrics and care of the
					 newborn.
(c) There shall be at
					 least one professional nurse on each tour of duty and other nursing personnel
					 as needed. A professional nurse shall be available to supervise persons
					 monitoring all occupied labor rooms.
(d) Recovery rooms, when occupied, shall have
					 continuous coverage by nursing personnel qualified by training and experience
					 in postobstetrical care.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › FACILITIES › Section 137.11 - Facilities and equipment

Current through Register Vol. 54, No. 28, July 13, 2024
The obstetrics service shall be contained within a unit
						that shall include a labor and delivery unit and maternity unit, all of which
						shall be located and arranged to preclude unrelated traffic through the suite.
						Clean gynecological patients may be housed on the obstetrical
						unit.
The provisions of this § 137.11 issued under
						  67 Pa.C.S. §§
														6101-6104; and Reorganization Plan No. 2 of
						  1973 (71 P.S. §
														755-2).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › FACILITIES › Section 137.12 - Delivery suite

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Each delivery
					 room shall be maintained and supplied as a separate unit which contains the
					 equipment and supplies necessary for normal delivery, including examination and
					 care of infants, and for the immediate management of complications in mother
					 and infant. The obstetrical delivery suite shall be in an area which does not
					 have traffic-bearing corridors to other parts of the hospital and which is
					 physically separated from other departments.
(b) Each delivery room shall be equipped for
					 administration of inhalation and regional anesthesia.
(c) Each delivery room shall have a
					 functioning source of emergency electrical power.
(d) Caesarean sections may be performed in an
					 operating room on the surgical service or in an operating room within the labor
					 and delivery unit. At least one delivery room should be equipped for the
					 performance of emergency Caesarean sections.
(e) Each delivery room shall have an
					 emergency call or intercommunication system.
(f) Oxygen and suction equipment which can be
					 accurately regulated shall be available for both mother and infant in each
					 delivery room.
(g) Equipment for
					 examination, identification and care of infants shall be readily available to
					 each delivery room.
(h) The
					 delivery room and equipment shall be cleaned after each patient's delivery is
					 completed.
(i) A movable heated
					 bassinet, transport incubator, or similar device should be made available to
					 transport an infant from the delivery room. Oxygen shall be available for use
					 during transit in cases of neonatal distress. Elevators, when used to transport
					 infants from the delivery room shall be kept free of other passengers. The
					 medical record of the infant shall accompany him to the nursery.
(j) Scrub sinks, equipped with elbow, knee or
					 foot controls; hot and cold running water with mixer; and hand scrubbing
					 accessories shall be available adjacent to or within all delivery
					 rooms.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › FACILITIES › Section 137.13 - Labor rooms

Current through Register Vol. 54, No. 28, July 13, 2024
The labor and delivery unit shall be considered a
						semirestricted area. The hospital shall establish and post appropriate
						restrictions to limit entry into this unit to authorized persons only. There
						shall be at least one labor room, properly equipped, for each delivery room. It
						shall provide privacy and be convenient to the delivery room. In an emergency,
						a properly equipped labor room may be used as a delivery room. The number of
						beds in a labor room or other rooms used for this purpose shall not exceed two.
						Beds used by patients in labor shall be equipped with protective
						sides.
The provisions of this § 137.13 issued under
						  67 Pa.C.S. §§
														6101-6104; and Reorganization Plan No. 2 of
						  1973 (71 P. S. §
														755-2).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.21 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Written policies and procedures for obstetrical services shall be maintained
					 and made available to medical and nursing staff members. They shall be reviewed
					 by the medical staff, revised as necessary, and dated to indicate the time of
					 last review.
(b) Obstetrical
					 services policies and procedures shall include:
(1) A current roster of physicians with a
					 delineation of their obstetrical privileges which shall be properly maintained
					 and made available to nursing personnel.
(2) An on-call schedule established to ensure
					 that a physician with obstetrical privileges is readily available at all
					 hours.
(3) Provisions to ensure
					 that spontaneous deliveries of patients in the final stages of labor shall not
					 be delayed.
(4) Policies for
					 intervention where patients demonstrate evidence of maternal, fetal, or
					 neonatal distress.
(5) Criteria
					 established by the medical staff to govern the administration of oxytocic
					 agents, when used for induction or stimulation of labor. These criteria shall
					 include a requirement for the immediate presence of a physician.
(6) A program to prevent isoimmunization of
					 RH-negative mothers.
(7) A program
					 for immediate blood transfusion services, as necessary.
(8) Procedures in accordance with Chapters 27
					 and 29 (relating to communicable and noncommunicable diseases; and
					 miscellaneous health provisions) governing the reporting of metabolic diseases
					 in the newborn and screening for phenylketonuria. All hospitals with
					 obstetrical services must comply with the act of September 9, 1965 (P. L. 497,
					 No. 251) (35 P. S. §
													621) which
					 provides for the testing of all newborns for phenylketonuria.
(9) Clean gynecology patients may be housed
					 on maternity units at the discretion of the chief of service. A maternity
					 patient shall not be denied a bed because of the presence of gynecological
					 patients.
(10) Policies for
					 visitors.
(11) Policies and
					 procedures governing the presence of fathers or other supportive persons in the
					 delivery room, if the hospital allows this practice.
(12) Policies and procedures for the care and
					 treatments of drug-dependent newborns.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.22 - Infection control

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The hospital
					 shall designate a committee which shall formulate specific policies for
					 prevention, reporting, and control of infections on the obstetrical service.
					 These policies shall be in written form, readily available to all appropriate
					 personnel, and reviewed at least once every year for possible revision. One
					 member of the committee or other individual shall be delegated to receive
					 reports of infections and to assist in interpretation and implementation of
					 established policies.
(b) The
					 policies established in accordance with subsection (a) shall provide at a
					 minimum:
(1) that, if a patient is admitted
					 to the labor and delivery area with suspected or confirmed transmissible
					 infection, isolation precautions or other appropriate precautions shall be
					 instituted and followed.
(2)
					 written policies governing the use of delivery rooms by patients with diagnosed
					 or suspected infection and establishing techniques for cleaning delivery rooms
					 following use by such patients. If a regular delivery room is used for such a
					 patient, it shall be thoroughly cleaned following use in accordance with
					 hospital policies and in a manner adequate to control the
					 contamination.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.23 - Labor room procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Medical and licensed nursing staff shall be present in the labor and delivery
					 unit in sufficient numbers for the proper observation and care of patients in
					 labor whenever a labor room is occupied.
(b) The director of obstetrical services or
					 the appropriate medical staff committee shall establish written policies, which
					 shall be available in the labor and delivery unit, concerning the use of
					 oxytocic drugs during each of the three stages of labor.
(c) The director of obstetrical services or
					 the appropriate medical staff committee shall establish written policies, which
					 shall be available on the labor and delivery unit, regarding the use and
					 administration of anesthetics, sedatives, analgesics, and other
					 drugs.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.24 - Delivery room procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Every patient in a delivery room shall be under the immediate care of a
					 physician, house staff, registered nurse, licensed practical nurse or licensed
					 midwife at all times.
(b) Aseptic
					 surgical techniques shall be used in all delivery rooms.
(c) Each obstetric patient shall be kept
					 under close observation by competent professional personnel during the period
					 of recovery after delivery, whether in the delivery room or in a recovery area
					 until she is transferred to the maternity unit.
(d) All persons present in a delivery room in
					 which explosive anesthetics are stored or in use shall observe necessary
					 precautions against explosion and electric shock hazards and shall wear
					 appropriate antistatic apparel and non-conductive footwear.
(e) Identification shall be attached to the
					 mother and newborn infant before they are removed from the delivery room.
					 Reference should be made to the act of April 20, 1925 (P. L. 358)
					 (35
					 P. S. §§
												351-353).
(f) The eyes of newborn infants shall have
					 instilled medication under §
											27.98 (relating to prophylactic
					 treatment of newborns) by the physician or his designee as soon as the
					 condition of the infant permits. Procedures for prophylaxis shall be in
					 accordance with §
											27.98 (relating to prophylactic
					 treatment of newborns).
The provisions of this §
													137.24 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); section 16 of the
						  Disease Prevention and Control Law of 1955 (35 P. S. §
														521.16); and section 803 of the Health Care
						  Facilities Act (35 P. S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.25 - Radiologic examination

Current through Register Vol. 54, No. 28, July 13, 2024
The medical staff shall establish written policies for
						the performance of diagnostic radiologic examinations of known or suspected
						pregnant patients, for the purpose of control of excessive radiation to fetus
						and mother. These policies shall be available to all appropriate personnel and
						shall be reviewed by the medical staff at least once annually for possible
						revision. A written request for a diagnostic radiologic examination of a female
						patient of childbearing age shall be marked in such a way as to clearly
						indicate to the person taking the roentgenogram the date of the patient's last
						menstrual period or the fact that the patient may be
						pregnant.
The provisions of this §
													137.25 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); and section 803 of
						  the Health Care Facilities Act (35 P. S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › POLICIES › Section 137.26 - Adoption procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 hospital providing maternity care shall provide a list, upon request, of
					 available counselors and counseling services, compiled by the court, to
					 maternity patients who are known to be considering relinquishment or
					 termination of parental rights.
(b)
					 Medical history information shall, where practicable, be delivered by the
					 attending physician or other designated person to the intermediary, who shall
					 deliver the information to the adopting parents or their physician. In cases
					 where there is no intermediary, medical history information shall be delivered
					 directly to the adopting parents or their physician. Medical history
					 information shall be construed to be the adoptee's complete medical records as
					 well as other information concerning an adoptee or an adoptee's natural family
					 which are relevant to the adoptee's present or future health care or medical
					 treatment.
(c) In all cases,
					 medical history information shall be edited before delivery so as to remove
					 contents which would identify the adoptee's natural family.
The provisions of this §
													137.26 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); and the Adoption
						  Act,
						  23 Pa.C.S. §
														2909.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › COMBINED OBSTETRICAL-GYNECOLOGICAL SERVICES › Section 137.32 - Director of combined obstetrical-gynecological services

Current through Register Vol. 54, No. 28, July 13, 2024
If the services are combined, the director shall be a
						member of the medical staff who is certified by the American Board of
						Obstetrics and Gynecology or an equivalent board or who is eligible for such
						certification or has successfully completed an approved residency in Obstetrics
						and Gynecology.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › COMBINED OBSTETRICAL-GYNECOLOGICAL SERVICES › Section 137.33 - Obstetrical-gynecological nursing service

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Obstetrical-gynecological nursing service shall be under the direction and
					 supervision of a professional registered nurse who is experienced in
					 maternity-gynecological and newborn nursing. Professional registered nurse
					 supervision shall be provided on each tour of duty.
(b) A separate nursing staff shall be
					 provided for the nursery.
(c) A
					 separate nursing staff shall be provided for delivery and labor
					 rooms.
(d) Bedside nursing care for
					 obstetrical or gynecological patients, or both, may be provided by the same
					 nursing staff.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 137 - OBSTETRICAL SERVICES › COMBINED OBSTETRICAL-GYNECOLOGICAL SERVICES › Section 137.34 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Written policies and procedures for the combined obstetrical and gynecological
					 services shall be available to the medical and nursing staff.
(b) Policies shall state the type of patients
					 admitted, retained and transferred. They shall also include the following:
(1) A current roster of physicians, with a
					 delineation of their obstetrical-gynecological responsibilities, which shall be
					 properly maintained and made available to nursing personnel.
(2) An on-call roster, to ensure that a
					 physician with obstetrical-gynecological privileges is readily available at all
					 hours.
(3) A provision that no
					 maternity patient shall be denied a bed because of the presence of
					 gynecological patients. If necessary, gynecological patients shall be
					 transferred to other areas of the hospital.
(4) A requirement for isolation in a separate
					 room of any patient with an infection or condition inimical to the safety and
					 welfare of other patients.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › GENERAL PROVISIONS › Section 138.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
Cardiac catheterizations shall be performed only in
						hospitals and shall be performed in accordance with accepted and prevailing
						standards of medical practice.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.11 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The director of
					 the cardiac catheterization service shall be Board certified in cardiology or
					 pediatric cardiology, as appropriate.
(b) An interim director may be appointed
					 during the period of time between the departure of the prior director and the
					 selection of a new director. The interim director shall be a physician who is
					 able to demonstrate qualifications acceptable to the medical staff of the
					 hospital and to the Department. The hospital shall apply to the Department for
					 an exception under the procedures in §§
											51.31-51.34 (relating to exceptions). If
					 the exception is granted, the Department will specify the maximum period of
					 time for which the interim director shall be appointed.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.12 - Medical staff

Current through Register Vol. 54, No. 28, July 13, 2024
(a) There shall be
					 at least two physicians staffing the cardiac catheterization laboratory to
					 perform angiographies.
(b) These
					 physicians shall be either Board certified or shall have attained preboard
					 certification status is cardiovascular diseases with specialized training in
					 invasive procedures.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.13 - Nursing staff; other health care personnel

Current through Register Vol. 54, No. 28, July 13, 2024
(a) There shall be at least one registered
					 nurse assigned to provide nursing care for patients in the cardiac
					 catheterization area at all times who shall have intensive care or coronary
					 care experience and knowledge of cardiovascular medications, and experience
					 with cardiac catheterization patients. In pediatric units, this nurse shall
					 also have experience in pediatric cardiac surgery units.
(b) There shall be nursing service goals and
					 objectives, standards of nursing practice, procedure manuals and written job
					 descriptions for each level of personnel which shall include the following:
(1) A means for assessing the nursing care
					 needs of the patients and determining adequate staffing to meet those
					 needs.
(2) Staffing patterns that
					 are adequate to meet the nursing goals, standards of practice and the needs of
					 the patients.
(3) An adequate
					 number of licensed and unlicensed assistive personnel to assure that staffing
					 levels meet the total nursing needs of the patient.
(4) Nursing personnel assigned to duties
					 consistent with their training, experience and scope of practice, where
					 applicable.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.14 - Programs and services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) To perform
					 cardiac catheterizations a hospital shall be an acute care facility that:
(1) Has inpatient medical and surgical
					 services onsite.
(2) Has a coronary
					 care unit onsite with 24-hour per day monitoring capability.
(3) Has a peripheral vascular surgical
					 program available.
(4) Provides
					 noninvasive cardiac diagnostic modalities including exercise and pharmacologic
					 stress testing, echo cardiography and nuclear cardiology.
(5) Has a setting in which ambulatory cardiac
					 catheterization patients can be observed for 4 to 6 hours after the
					 procedure.
(6) Has adequate
					 physician coverage to manage postprocedure complications.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.15 - High-risk cardiac catheterizations

Current through Register Vol. 54, No. 28, July 13, 2024
A hospital may perform high-risk cardiac catheterizations
						only if it has an open heart surgical program onsite.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.16 - Transfer agreements for low-risk cardiac catheterization hospitals

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A hospital that
					 does not have an open heart surgical program onsite may perform low-risk
					 cardiac catheterizations if the hospital has protocols for distinguishing
					 between low and high-risk cardiac catheterization patients and a formal written
					 agreement with at least one hospital that does have an open heart surgical
					 program onsite, which agreement includes the following:
(1) Protocols addressing indications,
					 contraindications and other criteria for the emergency transfer of patients in
					 a timely manner.
(2) Assurance of
					 transfer of patients to an open heart surgery program and initiation of open
					 heart surgery in a timely manner.
(3) Provision for semiannual data exchange on
					 performance between the hospitals party to the agreement.
(4) Specification of mechanisms for continued
					 substantive communication between the hospitals party to the agreement, and
					 between their sending and receiving physicians.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.17 - PTCA

Current through Register Vol. 54, No. 28, July 13, 2024
(a) In a hospital
					 in which elective PTCA is performed, each physician performing PTCAs shall be
					 either Board certified or shall have attained preboard certification status in
					 cardiovascular diseases with specialized and appropriate training in
					 interventional cardiology procedures.
(b) A rigorous mechanism for valid peer
					 review shall be established and ongoing in a hospital offering PTCA
					 services.
(c) If a hospital that
					 does not have an open heart surgery program onsite performs an emergent PTCA,
					 the hospital shall report the circumstances to the Department in writing within
					 72 hours.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.18 - EPS studies

Current through Register Vol. 54, No. 28, July 13, 2024
(a) In a
					 hospital in which EPS is performed, each physician performing EPS shall be
					 either Board certified or shall have attained preboard certification status in
					 cardiovascular diseases and shall also be either Board certified or have
					 attained preboard certification status in clinical cardiac
					 electrophysiology.
(b) Therapeutic
					 electrophysiology, including ablation and the implantation of automatic
					 implantable cardiovertor defibrillators shall be performed in a hospital with
					 an open heart surgery program, and not in another facility. Implantation of
					 routine permanent pacemakers may be performed in hospitals that do not have an
					 open heart surgery program onsite. Pediatric diagnostic electrophysiology
					 procedures also shall only be performed at a hospital with onsite pediatric
					 cardiovascular surgery.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.19 - Pediatric cardiac catheterizations

Current through Register Vol. 54, No. 28, July 13, 2024
A hospital may perform pediatric cardiac catheterizations
						only if:
(1) It has a pediatric heart
					 surgical program onsite.
(2) The
					 physicians and other staff who participate in the pediatric cardiac
					 catheterizations are trained and experienced in the care of the pediatric
					 cardiac patient.
(3) The equipment
					 used for pediatric cardiac catheterizations is appropriate to meet the needs of
					 the pediatric patient. Bi-plane cineangiography shall be readily available 24
					 hours per day, and laboratories (both catheterization and general chemical)
					 shall be equipped for small volume samples.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 138 - CARDIAC CATHETERIZATION SERVICES › PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS › Section 138.20 - Quality management and improvement

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A hospital providing cardiac
					 catheterization services shall maintain patient data on the following:
(1) Mortality/morbidity.
(2) Infections and complications.
(3) Patient risk factors.
(4) Volume of procedures performed (including
					 separate volumes for diagnostic visualizations, PTCA and electrophysiology
					 procedures).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › GENERAL PROVISIONS › Section 139.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
When a hospital provides neonatal services, they shall be
						provided in a manner that meets the medical needs of the
						neonates.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › GENERAL PROVISIONS › Section 139.2 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
This chapter applies to hospitals which provide
						obstetrical or neonatal infant care, or both. The Department recognizes the
						following levels of neonatal care:
(1)
					 Level I: (Normal Neonatal).
(2)
					 Level II: (Neonatal Intermediate/Intensive Care).
(3) Level III: (Neonatal Intensive
					 Care).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › GENERAL PROVISIONS › Section 139.2a - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter
						have the following meaning, unless the context clearly indicates
						otherwise:
Board certified
-A physician licensed to
						practice medicine in this Commonwealth who has successfully passed an
						examination and has maintained certification in the relevant medical specialty
						area or subspecialty area, or both, recognized by one of the following
						groups:
(i) The American Board of
					 Medical Specialties.
(ii) The
					 American Osteopathic Association.
(iii) The foreign equivalent of either group
					 listed in subparagraph (i) or (ii).
Guidelines
-The term refers to the
						current
Guidelines for Perinatal Care
issued by the American
						Academy of Pediatrics and the American College of Obstetricians and
						Gynecologists.
NICU-Neonatal intensive care unit
-The
						term refers to a unit which is specifically equipped and staffed for the care
						and treatment of high-risk infants and those infants otherwise in need of
						intensive care.
Neonate
-Patients treated in neonatal
						care units. The term is synonymous with baby or infant.
Preboard certification status
-A
						physician licensed to practice medicine in this Commonwealth who has completed
						the requirements necessary to take a certification examination offered by a
						medical specialty board recognized by the American Board of Medical
						Specialties, the American Osteopathic Association, or the foreign equivalent of
						either group, and who has been eligible to take the examination for no longer
						than 3 years.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › GENERAL PROVISIONS › Section 139.3 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A member of the
					 medical staff shall be appointed director of neonatal services. The director
					 shall be certified by the American Board of Pediatrics or an equivalent
					 board.
(b) An interim director may
					 be appointed during the period of time between the departure of the prior
					 director and the selection of a new director. The interim director shall be a
					 physician who is able to demonstrate qualifications acceptable to the medical
					 staff of the hospital and to the Department. The hospital shall apply to the
					 Department for an exception under the procedures in §§
											51.31-51.34 (relating to exceptions). If
					 the exception is granted, the Department will specify the maximum period of
					 time for which the interim director shall be appointed.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › GENERAL PROVISIONS › Section 139.4 - Nursing services; other health care personnel

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Neonatal nursing services shall be
					 provided in accordance with Chapter 109 (relating to nursing services) and this
					 section.
(b) A registered
					 professional nurse, especially trained and experienced in the care of normal
					 and high-risk infants, shall be responsible for the neonatal care unit at all
					 times when the unit is occupied. No neonate may be left unattended.
(c) Licensed nursing personnel shall be
					 assigned to duties consistent with their legal scope of practice. Unlicensed
					 assistive personnel shall be assigned duties consistent with standardized
					 training and competency evaluation.
(d) Staffing shall be adequate to meet
					 nursing care goals, standards of nursing practice and nursing care needs of
					 patients. The appropriate number of staff necessary to accomplish these goals,
					 standards and needs shall be established in the written policies of the
					 neonatal service and shall be consistent with the Guidelines.
(e) In addition to the requirements for the
					 nursing staff in subsections (a)-(d), there shall be service goals and
					 objectives, standards of patient care, procedure manuals and written job
					 descriptions for each level of other health care personnel which includes the
					 following:
(1) A means for assessing the needs
					 of patients and determining adequate staffing to meet those needs.
(2) Staffing patterns that are adequate to
					 meet patient care goals, standards of practice and needs of patients.
(3) An adequate number of licensed and
					 unlicensed health care personnel to assure that staffing levels meet the total
					 needs of patients.
(4) Health care
					 personnel in neonatal services shall be assigned to duties consistent with
					 their training, experience and scope of practice when applicable.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.11 - Facilities and equipment

Current through Register Vol. 54, No. 28, July 13, 2024
The maternity and neonatal services shall be separate and
						apart from other hospital services and especially from potential sources of
						infection. Access to each neonatal care unit shall be controlled to insure
						security and safety of all infants.
The provisions of this §
													139.11 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); and section 803 of
						  the Health Care Facilities Act (35 P. S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.12 - Neonatal care units

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Hospitals with
					 maternity services shall provide neonatal care units with areas for neonate
					 recovery, observation and isolation and provisions or arrangements for the care
					 of high-risk infants in a neonatal intensive care unit either at the facility
					 of birth or at a transfer site. Space allocation and total number of bassinets
					 shall be consistent with the Guidelines.
(b) There should be an isolation area for the
					 reception and care of infants exposed to potential sources of infection and
					 infants suspected of or having a communicable disease. Infants may be housed
					 and nursed in the isolation area pending diagnosis, disposition or completion
					 of treatment. This isolation area should be served by nursing personnel and
					 shall meet the standards established in the Guidelines for this type of
					 care.
(c) A neonatal intensive care
					 unit is one which is specifically equipped and staffed for the care and
					 treatment of high-risk infants and those otherwise in need of intensive care.
					 The neonatal intensive care unit shall meet the standards established in the
					 Guidelines for this type of care. If such a service is not provided at the
					 facility of birth, arrangements shall be made with an existing neonatal
					 intensive care unit in the area of appropriate referral. The judgment of the
					 attending physician and the policies of the hospital's neonatal services
					 department shall determine the need for consultation with and referral to the
					 hospital with an existing neonatal intensive care unit. The term "high risk
					 infant" means any infant who, on the basis of socioeconomic, genetic or
					 patho-physiologic history prior to delivery or on the basis of findings in the
					 neonate period, manifests or is likely to manifest persistent and significant
					 signs of distress. This may include:
(1) An
					 infant with a birth weight below 2,000 grams or of less than 34 weeks gestation
					 and any other low birth weight or premature infant who shows any abnormal
					 signs.
(2) An infant showing
					 persistent and significant signs of illness. This includes those with
					 respiratory distress, congenital anomalies, tumors, jaundice, seizures,
					 infections, metabolic distress or other conditions which pose an immediate
					 threat to neonatal survival.
(3) An
					 infant with serious feeding difficulties, excessive lethargy or instability of
					 body temperature.
(4) An infant
					 whose mother is drug addicted or habituated, diabetic, toxemic, isoimmunized,
					 or having any other illness or condition which may affect the fetus.
(5) An infant requiring major surgical
					 procedures.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.13 - Equipment and supplies

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Required
					 equipment and supplies shall be in accordance with this section, the Guidelines
					 for Design and Construction of Hospital and Health Care Facilities issued by
					 the American Institute of Architects and with written policies of the neonatal
					 service which shall be consistent with the Guidelines.
(b) An individual bassinet and equipment for
					 the exclusive use of the infant to whom it is assigned shall be provided for
					 each infant. All necessary supplies shall be stored in covered containers to
					 permit individualized infant care and minimize risk of infection.
(c) Each neonatal care unit shall have its
					 own sink with hot and cold running water equipped with foot, knee or elbow
					 control so that hand contact with the sink is avoided. A sufficient supply of
					 an antiseptic cleansing agent and disposable towels shall be readily available.
					 Where paper towels are used, a dispenser shall be provided.
(d) Neonatal intensive care units shall be
					 equipped with all equipment and supplies required for other neonatal care
					 units.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.14 - Oxygen control

Current through Register Vol. 54, No. 28, July 13, 2024
Oxygen shall be administered only with proper apparatus
						for its safe administration and control of concentration. Concentration of
						oxygen should not exceed a safe level commensurate with current concepts of
						oxygen therapy as recommended by the Guidelines.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.15 - Temperature control

Current through Register Vol. 54, No. 28, July 13, 2024
A stable year-round temperature and humidity shall be
						maintained in all neonatal care units in accordance with written neonatal
						service policies consistent with the Guidelines.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.16 - Housekeeping and maintenance

Current through Register Vol. 54, No. 28, July 13, 2024
The neonatal care unit shall be maintained in a clean and
						sanitary manner at all times. An environmental services room shall be provided
						for the exclusive use of the neonatal unit and shall be directly accessible
						from the unit.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › FACILITIES › Section 139.17 - Neonatal intensive care units (Levels II and III)

Current through Register Vol. 54, No. 28, July 13, 2024
In addition to the general requirements for the equipment
						of neonatal care units, the following provisions shall be required for all new
						construction, renovation or expansion of neonatal intensive care units and
						shall be available to all present neonatal intensive care units:
(1) The construction and arrangement of the
					 neonatal intensive care unit shall permit personnel to observe the infants and
					 have immediate access to them. Total neonatal care unit space, exclusive of
					 anteroom, shall provide adequate floor space consistent with the
					 Guidelines.
(2) Each infant
					 requiring heat or air control, or both, shall have a separate incubator or
					 other warming device and an individual environment with individualized heat,
					 oxygen, suction and air turnover controls, as appropriate. Any infant whose
					 condition permits may be placed in a bassinet.
(3) At least one oxygen outlet shall be
					 provided for each patient station. Suction apparatus shall be easily available
					 for each infant. A source of medically pure compressed air shall be
					 available.
(4) A double-grounded
					 electrical outlet shall be provided for each incubator or radiant warmer.
					 Sufficient extra outlets should be provided for other electronic patient care
					 equipment. Some electrical outlets in the unit shall be on the emergency
					 electrical circuit of the hospital and shall be so marked.
(5) Resuscitation equipment shall be
					 available within the neonatal intensive care unit. An effective method for
					 preventing heat loss by the infant shall be available while the infant is
					 undergoing any treatment.
(6) Air
					 within neonatal intensive care units may not be recirculated and shall be
					 frequently turned over each hour.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 139 - NEONATAL SERVICES › POLICIES › Section 139.21 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
The director of neonatal services shall be responsible
						for developing written policies and procedures for the provision of medical
						services within the neonatal care unit which shall be available to the medical
						and nursing staff. The policies and procedures shall be reviewed by the
						director once a year and revised as necessary, and dated to indicate the time
						of last review. They shall provide specifications to conform to §§
						139.22-139.29.