reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › POLICIES › Section 129.23 - Radiation safety committee

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 radiation safety committee shall be established in hospitals providing nuclear
					 medicine services. At least one member of this committee shall be a physician
					 experienced in the safe handling of radioisotopes, in the measurement of
					 radioactivity, and in determining radioisotope dosage for various patient
					 studies and treatments. Representatives of various fields of specialization
					 should be included on the committee, as determined by the nature of the program
					 conducted in the hospital.
(b) The
					 radiation safety committee shall be responsible for all of the following:
(1) Reviewing all proposals for diagnostic
					 and therapeutic uses for radionuclides.
(2) Recommending to the medical staff medical
					 practitioners having suitable training and experience to perform nuclear
					 medicine procedures.
(3) Developing
					 rules governing the use, removal, handling and storage of radioactive materials
					 used in nuclear medicine procedures.
(4) Recommending corrective and appropriate
					 disciplinary action where there is a failure to observe safety rules and
					 procedures.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › POLICIES › Section 129.24 - Written orders

Current through Register Vol. 54, No. 28, July 13, 2024
Nuclear medicine therapeutic and diagnostic services,
						when provided within the hospital, shall be performed only upon written request
						of the responsible physician or member of the house staff and shall be subject
						to the regulations otherwise governing written medical orders or exceptions
						thereto.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.31 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be quality control procedures governing
						nuclear medicine services that ensure diagnostic reliability and patient
						safety.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.32 - Radioisotopes

Current through Register Vol. 54, No. 28, July 13, 2024
All radioisotopes shall be prepared, stored, and
						periodically checked to ensure accuracy, patient safety and precision of
						results. All radioisotopes shall be labeled to indicate identity, date of
						preparation and concentration assay.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.33 - Instrument calibration procedures

Current through Register Vol. 54, No. 28, July 13, 2024
Instrument calibration procedures designed to affirm
						proper performance shall be conducted periodically as required by the nature of
						the instrument. The results of these calibration procedures shall be recorded
						as provided in §
											129.35 (relating to instrument log
						book).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.34 - Radionuclides and radiopharmaceutical records

Current through Register Vol. 54, No. 28, July 13, 2024
The following records shall be maintained for
						radionuclides and radiopharmaceuticals:
(1) Dates, amounts and methods of receipt and
					 disposal.
(2) Supplier and lot
					 number.
(3) The use, date, amount
					 and identity of any recipient, where applicable.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.35 - Instrument log books

Current through Register Vol. 54, No. 28, July 13, 2024
Instrument log books shall be maintained for the life of
						each instrument with at least the following information:
(1) Calibration records of equipment and
					 monitors showing dates, names of technologists and sources of reference
					 standards.
(2) Maintenance and
					 repair records showing dates and source of service.
This section cited in 28 Pa. Code §
													129.33 (relating to instrument
						  calibration procedures).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.36 - Personnel monitoring

Current through Register Vol. 54, No. 28, July 13, 2024
The radiation exposure of nuclear medicine employes shall
						be monitored by means of film badges or other similar personnel monitoring
						devices. A record of the annual accumulation shall be maintained as part of the
						personnel file of the employe, and a copy given to the employe upon
						termination. The employe shall have access to these records during time of
						employment.
The provisions of this §
													129.36 issued under section
						  2021(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 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.37 - Patient records

Current through Register Vol. 54, No. 28, July 13, 2024
Reports of nuclear medicine interpretations,
						consultations, and therapy shall be included in each patient's medical record.
						Duplicate reports shall be kept on file in the nuclear medicine department. The
						patient's medical record should show the identity, date and amount of
						radiopharmaceutical used, as well as any specific patient preparation
						performed. These records shall conform in other respects, with Chapter 115
						(relating to medical records).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 129 - NUCLEAR MEDICINE SERVICES › QUALITY CONTROL PROCEDURES › Section 129.38 - Compliance with other law

Current through Register Vol. 54, No. 28, July 13, 2024
All applicable provisions of the Department of
						Environmental Protection and the United States Nuclear Regulatory Commission
						shall be complied with. A copy of the most recent inspection and approval
						letter by the Department of Environmental Protection shall be available for
						review by survey team members.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
Rehabilitation services shall be available to meet the
						needs of the patients. These may include physical medicine, physical therapy,
						occupational therapy and other related programs.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.2 - Organization and staffing

Current through Register Vol. 54, No. 28, July 13, 2024
Organized rehabilitation services within the hospital
						shall be provided by a qualified staff of adequate size to meet patient needs
						and under qualified medical direction.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.3 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
A hospital which provides rehabilitation services shall
						organize those services under the direction and supervision of: a phychiatrist
						who is a member of the medical staff; a physician who is a member of the
						medical staff and who, on the basis of training and experience, is
						knowledgeable in physical medicine; or a medical staff committee whose chairman
						directs the program with committee guidance.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.4 - Personnel

Current through Register Vol. 54, No. 28, July 13, 2024
Rehabilitation programs such as physical therapy and
						occupational therapy shall be under the direction of persons licensed or
						registered in their respective fields and employed either full time or part
						time to implement the programs and carry out treatments as ordered by the
						medical staff. Designated procedures may be performed insofar as is consistent
						with law by supportive personnel who have completed an organized training or
						on-the-job training program to qualify them for the performance of their
						duties.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.5 - Nursing services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Restorative
					 nursing services shall be coordinated with rehabilitation programs.
(b) If specialized nursing services are
					 provided, they shall be governed by Chapter 109 (relating to nursing services)
					 and by the following provisions:
(1)
					 Restorative nursing services shall be under the direction and supervision of a
					 registered nurse qualified by training and experience in rehabilitation and
					 restorative nursing.
(2) There
					 shall be an active restorative nursing care program to carry out, between
					 visits of the physical therapist, those procedures which are consistent with
					 the qualifications of the restorative nursing staff.
(3) Restorative nursing care shall include
					 the following measures, among others:
(i)
					 Maintaining good body alignment.
(ii) Proper positioning of bedfast
					 patients.
(iii) Keeping patients
					 active.
(iv) Helping patients stay
					 out of bed in accordance with prescribed orders.
(v) Developing independence in activities of
					 daily living.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.6 - Organizational plan

Current through Register Vol. 54, No. 28, July 13, 2024
Rehabilitation services and other physical restorative
						and maintenance programs shall be identified in a current written
						organizational plan which defines the responsibility, authority, and
						relationship of all personnel within each service and
						program.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › GENERAL PROVISIONS › Section 131.7 - Services provided outside the hospital

Current through Register Vol. 54, No. 28, July 13, 2024
When rehabilitation services required by an inpatient are
						not provided within the hospital, such services must be arranged for, upon
						prescription by a practitioner from appropriate community resources. These
						services must be in accordance with standards outlined in this
						chapter.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › FACILITIES AND EQUIPMENT › Section 131.11 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
When rehabilitation services are provided within the
						hospital, there shall be adequate space, facilities, and equipment to fulfill
						the professional, educational, and administrative needs of the services. Each
						rehabilitation service area should be easily accessible to patients by means of
						transportation ordinarily available to patients requiring rehabilitation
						services. Equipment shall be provided to meet the needs of patients served,
						shall be calibrated according to the directions of the manufacturer, and shall
						be serviced periodically as part of a preventive maintenance program. Records
						of equipment servicing shall be maintained and retained for the life of the
						equipment.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › POLICIES › Section 131.21 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
Policies and procedures for rehabilitation services shall
						be developed by the director of rehabilitation or by the designated medical
						staff committee in cooperation with representatives from the medical staff, the
						administration, the nursing service and other appropriate services. Policies
						and procedures shall be reviewed periodically, revised if necessary, and dated
						to indicate the time of the last review.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › POLICIES › Section 131.23 - Plan of care

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be a current written plan of care for each
						patient receiving treatment, based on the direction of the attending physician
						and on the rehabilitation potential of the patient. The plan of care shall
						state the needs and limitations of the patient as well as the goals of the
						treatment program for that patient. Because the patient should be an active
						participant in his treatment program, the prescribing physician or the person
						providing the service, or both, should discuss the treatment goals and the
						capabilities of the rehabilitative service with the patient or his family, or
						both. The prescribing physician, or the person providing the service, or both,
						should participate in planning for the discharge and followup care of the
						patient, whenever indicated. The patient or his family, or both, should receive
						the written instructions that are necessary for the appropriate aftercare of
						the patient.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 131 - REHABILITATION SERVICES › POLICIES › Section 131.24 - Patients' medical records

Current through Register Vol. 54, No. 28, July 13, 2024
Inpatient rehabilitation therapy orders, procedures and
						treatments shall be recorded in the patient's medical record, in accordance
						with Chapter 115 (relating to medical record services). The responsible
						therapist shall make notations in the patient's chart which reflect repeated
						evaluations of the patient's progress. Records shall be reviewed by the medical
						staff at prescribed intervals to evaluate the service and to ascertain means of
						improving the quality of patient care.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › GENERAL PROVISIONS › Section 133.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
Special care units, as appropriate for the hospital,
						shall be developed for patients who require extraordinary
						care.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › GENERAL PROVISIONS › Section 133.2 - Types of special care units

Current through Register Vol. 54, No. 28, July 13, 2024
A special care unit of a hospital is an area set aside
						for the treatment of patients who require extraordinary care on a concentrated
						and continuous basis. There are two kinds of special care units as
						follows:
(1) Multipurpose for the
					 intensive treatment of critically ill patients with a wide variety of
					 diagnoses.
(2) Specific purpose for
					 the continuous care of patients in special diagnostic categories. These
					 categories include but are not limited to:
(i)
					 Burn.
(ii) Coronary care.
(iii) Neonatal care.
(iv) Postobstetric and post operative
					 recovery care.
(v) Pulmonary
					 care.
(vi) Renal
					 dialysis.
(vii) Surgical, including
					 trauma, intensive care units.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › GENERAL PROVISIONS › Section 133.4 - Organization and staffing

Current through Register Vol. 54, No. 28, July 13, 2024
Special care units shall be organized so as to function
						effectively and shall be integrated with other departments or services of the
						hospital.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › GENERAL PROVISIONS › Section 133.5 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Special care
					 units shall be under the direction of a physician who has a special interest in
					 and, preferably, additional experience in providing the type of care supplied
					 by the special care unit. If an experienced physician is not available,
					 direction of the unit may be provided by a medical staff committee.
(b) The special care unit director or
					 committee shall be responsible for the establishment and implementation of
					 written policies governing the following:
(1)
					 Proper utilization of the service.
(2) Staff participation in appropriate
					 training programs for safe and effective use of diagnostic and therapeutic
					 equipment, for cardiopulmonary resuscitation and for other aspects of intensive
					 care.
(3) Supervision of the
					 collection and analysis of clinical data needed for the retrospective
					 evaluation of care provided in the unit.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › GENERAL PROVISIONS › Section 133.6 - Special care unit nursing service

Current through Register Vol. 54, No. 28, July 13, 2024
(a) When a special care unit is occupied,
					 specialized nursing services shall be provided to ensure medically appropriate
					 and effective patient care.
(b)
					 Nursing services shall be provided in accordance with Chapter 109 (relating to
					 nursing services), as well as the following:
(1) At no time may the occupied unit be
					 without a registered professional nurse. Other registered nurses and health
					 care personnel may serve as assistant or backup personnel under the direct
					 supervision of a qualified special care unit nurse.
(2) When a special care unit is occupied, the
					 professional nurse on each tour of duty shall be responsible for the nursing
					 care in the unit. The nurse so assigned shall be qualified by training and
					 experience and shall have demonstrated appropriate competence.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › EDUCATION AND TRAINING › Section 133.11 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
A continuing education program developed especially for
						the personnel of the special care unit shall be provided in order to enable the
						personnel to maintain and improve their skills, as well as to learn new
						techniques. The program may be inside or outside the
						hospital.
The provisions of this § 133.11 issued under
						  67 Pa.C.S. §§
														6101-6104.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › EDUCATION AND TRAINING › Section 133.12 - Special requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Special care unit personnel shall be prepared for their responsibilities
					 through appropriate training and educational programs. Each staff member shall
					 have completed an education course specifically oriented to his level of
					 participation in the care of patients who require extraordinary care.
(b) The educational programs should prepare
					 special care unit personnel to:
(1) Recognize,
					 interpret and record appropriate signs and symptoms in the critically ill
					 patients.
(2) Initiate
					 cardiopulmonary resuscitation.
(3)
					 Administer electrolytes and fluids parenterally.
(4) Use equipment in the unit safely and
					 effectively.
(5) Perform
					 specialized nursing procedures peculiar to the needs of patients in the
					 unit.
(6) Prevent contamination and
					 cross-infection.
(7) Exercise
					 appropriate safety precautions in the use of electrical or electronic
					 equipment.
(8) Recognize and attend
					 to the psychological and social needs of the patients and their
					 families.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › FACILITIES AND EQUIPMENT › Section 133.21 - Facilities

Current through Register Vol. 54, No. 28, July 13, 2024
Facilities provided for special care units shall be
						specifically designed and equipped for the type of special care to be
						provided.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › FACILITIES AND EQUIPMENT › Section 133.22 - Equipment

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The type and
					 quality of equipment provided in a special care unit shall depend upon the
					 needs of the patient treated.
(b)
					 There shall be a written preventive maintenance program which includes
					 techniques for cleaning and for contamination control as well as for the
					 scheduled periodic testing of equipment with records kept of the results of
					 such testing.
(c) Special safety
					 precautions related to proper grounding, current leakage and device safety
					 shall be observed when electronic devices are used. Potential electrical
					 hazards must be recognized and guarded against in instances where electrically
					 operated beds are used. Documentation of safety testing shall be retained for
					 the life of the equipment.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 133 - SPECIAL CARE UNITS › POLICIES › Section 133.31 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Because of the intensity of care given within the special care unit and of the
					 critical nature of the illnesses of patients cared for in it, written policies
					 and procedures additional to basic hospital policies shall be developed to
					 guide personnel in the management of the unique situations which may occur
					 within the unit. These policies and procedures shall be developed by the
					 medical staff, the nursing staff, other appropriate hospital departments and
					 services and the chief executive officer and shall be approved by the
					 appropriate committee of the medical staff. They shall be reviewed and revised
					 as necessary.
(b) Policies and
					 procedures established in accordance with subsection (a) of this section should
					 give special attention to the following:
(1)
					 Functions and authority of the unit director, with special emphasis on the
					 working relationships that exist between the attending physicians and the
					 director.
(2) Admission and
					 discharge criteria, including priority determinations.
(3) Staff responsibility for special
					 procedures and specifications as to which procedures are to be done, by whom,
					 under what circumstances, and under what degree of supervision. Special
					 procedures, as used in this paragraph, may include cardiopulmonary
					 resuscitation, tracheotomy, ordering of medications, administration of
					 parenteral fluids and other medications, and obtaining of blood and other
					 laboratory specimens.
(4) The
					 assignment of responsibility for a preventive and corrective maintenance
					 program, including procedures to follow in the event of breakdown of essential
					 equipment.
(5) The use and location
					 of special equipment and supplies.
(6) Respiratory care, including assisted
					 ventilation and humidification.
(7)
					 Infection control and isolation procedures.
(8) Procedures for priority orders for
					 laboratory tests.
(9) Standing
					 orders, if any.
(10) Regulations
					 governing visitors and traffic control.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › GENERAL PROVISIONS › Section 135.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
When a hospital provides surgical 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 135 - SURGICAL SERVICES › GENERAL PROVISIONS › Section 135.2 - Director of surgical services

Current through Register Vol. 54, No. 28, July 13, 2024
The director of the surgical services shall be a member
						of the medical staff who is certified by the American Board of Surgery or an
						equivalent board or who is eligible for Board certification or has successfully
						completed an approved residency training program in surgery.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › GENERAL PROVISIONS › Section 135.3 - Surgical staff

Current through Register Vol. 54, No. 28, July 13, 2024
A roster of physicians, dentists and podiatrists with a
						delineation of the surgical privileges of each shall be maintained in the
						surgical suite and available to the surgical nurse
						supervisor.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › GENERAL PROVISIONS › Section 135.4 - Operating room register

Current through Register Vol. 54, No. 28, July 13, 2024
An operating room register shall be provided and
						maintained on a current basis. The operating room log or register shall contain
						date of the operation, name and number of patient, names of surgeons and
						surgical assistants, names of anesthetists, type of anesthesia given, pre- and
						postoperative diagnosis, type of surgical procedure, and the presence or
						absence of complications in surgery. This information may also be maintained in
						an accession file of copies of the operating room record.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › GENERAL PROVISIONS › Section 135.5 - Surgical emergency care

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be an on-call schedule of physicians
						established and posted at each patient unit or other area where surgical
						patients are admitted or the communications center of the hospital to ensure
						that there is 24-hour emergency care or postoperative followup care, or both,
						available.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › POLICIES › Section 135.11 - Policies and procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 surgical division of the medical staff, shall develop written policies and
					 procedures for surgical services. These policies shall be made available to the
					 medical staff and surgical nursing personnel.
(b) The policies and procedures of the
					 surgical services shall establish:
(1)
					 Appointment procedures which will fairly evaluate the quality and competence of
					 each surgeon seeking appointment to the surgical staff.
(2) Reappointment procedures which provide
					 for the periodic reappraisal of the qualifications and competence of each
					 surgeon.
(3) Criteria to determine
					 what circumstances require an assistant present at surgery and to determine
					 whether the assistant should be a physician, a professional, or nonprofessional
					 personnel.
(4) Surgical specimens
					 that are exempt from pathological review in §
												135.15 (relating to surgical
					 specimens).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › POLICIES › Section 135.12 - Preoperative and postoperative records

Current through Register Vol. 54, No. 28, July 13, 2024
The medical staff shall establish procedures to ensure
						that preoperative and postoperative medical records are completed in a timely
						and accurate manner.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › POLICIES › Section 135.13 - Patient's medical record; preoperative procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The record of surgery shall be maintained
					 in accordance with §§
											115.31-115.33 (relating to patient
					 medical records; contents; and entries).
(b) After the patient has been placed on the
					 operating table, it is the responsibility of the primary operating surgeon and
					 the person administering anesthesia to properly identify the patient and to
					 document this identification in the patient's medical record. This procedure
					 shall be set forth in written policies designating the mechanism to be used to
					 identify each surgical patient.
(c)
					 Procedures shall be established to ensure that, except in emergencies, at least
					 the following data are recorded in the medical record of the patient prior to
					 surgery:
(1) Verification of identity of
					 patient.
(2) Medical history and
					 supplemental information regarding drug sensitivities and other pertinent
					 facts.
(3) General physical
					 examination, details of significant abnormalities, and evaluation of the
					 capacity of the patient to withstand anesthesia and surgery.
(4) Provisional diagnosis.
(5) Laboratory test results.
(6) Consultation reports.
(7) Signed informed consent obtained by the
					 surgeon.
(8) X-ray
					 reports.
(9) Dental X-ray reports
					 if applicable.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › POLICIES › Section 135.15 - Surgical specimens

Current through Register Vol. 54, No. 28, July 13, 2024
Tissues or exudates removed during a surgical procedure
						shall be properly labeled and sent to the laboratory for examination by the
						pathologist, who shall determine the extent of examination necessary for
						diagnosis except as provided in this section. The specimen shall be accompanied
						by pertinent clinical information, including its source and the preoperative
						and postoperative surgical diagnosis. A hospital may elect not to send the
						following categories of specimens to the laboratory for pathologic examination,
						as set forth in its written policies and procedures:
(1) Specimens that by nature or condition do
					 not permit fruitful examination, such as a cataract, orthopedic appliance,
					 calculi, foreign body or a portion of rib removed only to enhance operative
					 exposure.
(2) Therapeutic
					 radioactive sources, the removal of which shall be guided by radiation safety
					 requirements.
(3) Traumatically
					 injured members that have been amputated and for which examination for either
					 medical or legal reasons is not deemed necessary.
(4) Specimens known to rarely, if ever, show
					 pathological change, and removal of which is highly visible postoperatively,
					 such as the foreskin from the circumcision of a newborn infant.
(5) Placentas that are grossly normal and
					 have been removed in the course of operative and nonoperative
					 obstetrics.
(6) Teeth, if the
					 number, including fragments, is recorded in the medical record.
The provisions of this §
													135.15 amended under sections
						  801.1 and 803 of the Health Care
						  Facilities Act (35 P. S. §§
														448.801a and
						  448.803).
This section cited in 28 Pa. Code §
													135.11 (relating to policies and
						  procedures).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › POLICIES › Section 135.16 - Surgical procedures and consent

Current through Register Vol. 54, No. 28, July 13, 2024
A competent adult may authorize any surgical procedure to
						be performed upon his body, and the consent of no other person is
						required.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › SURGICAL NURSING SERVICES › Section 135.21 - Surgical suite nursing administration

Current through Register Vol. 54, No. 28, July 13, 2024
Surgical suite nursing service shall be under the
						direction and supervision of a professional registered nurse who is qualified
						by training and experience in operating room management and
						techniques.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › SURGICAL NURSING SERVICES › Section 135.22 - Professional and nonprofessional surgical suite nursing personnel

Current through Register Vol. 54, No. 28, July 13, 2024
When surgical services are provided, professional or
						nonprofessional personnel, or both, who are trained and experienced in
						postoperative care shall be provided on a 24-hour basis.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › SURGICAL NURSING SERVICES › Section 135.23 - Surgical recovery room nursing personnel

Current through Register Vol. 54, No. 28, July 13, 2024
At least one professional registered nurse shall be on
						duty in the recovery room whenever the room is occupied. Additional personnel
						shall be provided to meet the needs of each patient.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 135 - SURGICAL SERVICES › SURGICAL NURSING SERVICES › Section 135.24 - Surgical nursing service

Current through Register Vol. 54, No. 28, July 13, 2024
If surgical nursing is a distinct and separate service,
						the following conditions shall be met, in addition to those governing nursing
						services generally:
(1) The surgical
					 nursing service shall be under the direction and supervision of a professional
					 registered nurse who is qualified by training and experience in the field of
					 surgical nursing.
(2) A patient
					 care unit with patients requiring skilled nursing care shall have professional
					 registered nurse supervision on each tour of duty, and the skilled care shall
					 be administered by professional registered nurses.
(3) A patient care unit with patients
					 requiring moderate or minimal nursing care, or both, shall have supervision by
					 either a professional registered nurse or a licensed practical nurse on each
					 tour of duty. If the person so assigned is a licensed practical nurse, he shall
					 work under the direction and supervision of a professional registered
					 nurse.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 136 - OPEN HEART SURGICAL SERVICES › GENERAL PROVISIONS › Section 136.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
Adult open heart surgical services and pediatric open and
						closed heart surgical services 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 136 - OPEN HEART SURGICAL SERVICES › PROGRAM, SERVICE AND PERSONNEL REQUIREMENTS › Section 136.11 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Director of
					 the open heart surgery program shall be a Board certified thoracic surgeon. The
					 director of a pediatric heart surgery program shall be a Board certified
					 pediatric and thoracic surgeon.
(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. 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 136 - OPEN HEART SURGICAL SERVICES › PROGRAM, SERVICE AND PERSONNEL REQUIREMENTS › Section 136.12 - Medical staff

Current through Register Vol. 54, No. 28, July 13, 2024
Supporting medical staff of the service shall
						include:
(1) Thoracic surgeons who are
					 either Board certified or who have attained preboard certification status.
					 There shall be a sufficient number of surgeons within the service to allow for
					 24-hour-per-day continuous coverage. In a pediatric service, the medical staff
					 shall include pediatric and thoracic surgeons who are either Board certified or
					 who have attained preboard certification status.
(2) A Board certified medical cardiologist
					 with subspecialty certification in cardiovascular disease or who has
					 demonstrated competence as determined by peer review. A pediatric open heart
					 surgery program shall include a board certified pediatric
					 cardiologist.
(3) A cardiac
					 catheterization team with interventional ability on call 24 hours per
					 day.
(4) A Board certified
					 anesthesiologist experienced in open heart anesthesia. There shall be a
					 sufficient number of anesthesiologists within the service for 24 hour per day
					 continuous coverage. The anesthesiologists in a service performing pediatric
					 surgery shall have experience in pediatric anesthesia.
(5) A physician who is Board certified in
					 anatomic and clinical pathology.
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 136.13 - Nursing staff; other health care personnel

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Nursing personnel shall include nurses
					 with specialized education which includes theory, advanced technical skills,
					 and supervised experience in a surgical intensive care unit or in a
					 postoperative cardiovascular unit before assuming primary responsibility for
					 the nursing care of open heart patients.
(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, when
					 applicable.
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 136.14 - Support team in the operating room

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 The operating room support team shall include:
(1) A circulating registered professional
					 nurse and additional nursing personnel as required.
(2) A perfusionist. Each open heart procedure
					 shall have a designated perfusionist in attendance. This individual shall meet
					 the requirements for Board certification as established by the American Board
					 of Cardiovascular Perfusion. If the perfusionist is not Board certified, all
					 duties shall be performed under the supervision of a certified perfusionist,
					 cardiologist or cardiac surgeon, until the perfusionist obtains Board
					 certification. This certification shall be obtained within 2 years of the
					 commencement of the perfusionist's employment at the hospital. The
					 perfusionist's duties shall include the operation of the extracorporeal pump
					 oxygenator (heart-lung machine) in accordance with the requirements of the
					 hospital. The perfusionist shall have immediate access to hospital and surgeon
					 specific procedure manuals for the conduct of cardiopulmonary bypass during all
					 open heart procedures.
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 136.15 - Other support services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Supportive
					 services within the hospital shall include the following, which shall be
					 provided 24 hours per day and shall be either available or onsite, as noted:
(1) Medicine (cardiology onsite; availability
					 of nuclear cardiology; hematology; pulmonary; nephrology; neurology; and
					 infectious disease).
(2)
					 Anesthesiology-available.
(3)
					 Clinical laboratory services, onsite for blood banking, hematology, blood
					 chemistry and urinalysis. These services shall be under the same direct
					 management and quality assurance programs as the main hospital
					 laboratories.
(4) Diagnostic
					 radiology, including bedside X-rays-onsite.
(5) Cardiac catheterization and
					 interventional angiography laboratory-onsite.
(6) Respiratory care
					 services-available.
(7) Cardiac
					 intensive care service-onsite.
(8)
					 Inpatient service for continuing care after transfer from the intensive care
					 unit.
(9) An advanced cardiac life
					 support certified physician-onsite.
(10) Cardiographic laboratory, including
					 continuous electrocardiogram monitoring-available.
(11) Echocardiography service (this may or
					 may not be a part of the cardiographic laboratory)-available.
(12) Installation of
					 pacemakers-available.
(13)
					 Organized and designated cardiopulmonary resuscitation team-onsite.
(14) Bioengineering
					 service-available.
(15) Peripheral
					 vascular surgery and a noninvasive vascular laboratory-available.
(16) Acute inpatient
					 dialysis-available.
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 136.16 - Rapid mobilization

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
					 open heart surgery program shall have the capability for rapid mobilization of
					 the cardiac surgical service and support team members for emergency procedures,
					 24 hours per day.
(b) There shall
					 be an on-call schedule of physicians established and posted at each patient
					 unit and other areas where cardiac surgical patients are admitted and at the
					 communications center of the hospital to ensure that there is 24-hour-per-day
					 emergency care and peri-operative care available.
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 136.17 - Observation of patients

Current through Register Vol. 54, No. 28, July 13, 2024
A cardiac surgical care service shall include the
						capability of visual observation of all patients.
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 136.18 - Postoperative care

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An intensive
					 surgical care service shall be available immediately after surgery to provide
					 invasive monitoring, including Swan-Ganz catheter, arterial pressure and
					 intra-aortic balloon pumps.
(b) The
					 cardiac surgical service shall be responsible for postoperative care and
					 involved in discharge planning of patients.
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 136.19 - Education and training

Current through Register Vol. 54, No. 28, July 13, 2024
The staff of the open heart surgical program shall engage
						in the following activities:
(1)
					 Ongoing programs of continuing education in cardiovascular care.
(2) Provision of training and consultation
					 services with other providers of cardiovascular care and others.
(3) Patient and family education.