Code of Maryland Regulations
Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)
Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS
Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards
Section 30.08.12.15 - Policies and Protocols

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IV

A hospital shall have:

A. Written policies and protocols for the initial stabilization and continuing care of all obstetrical and neonatal patients appropriate to the designated level of care;

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E

B. Maternal and neonatal resuscitation protocols;

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E

C. A medical staff credentialing process that shall include documentation of competency to perform obstetrical and neonatal invasive procedures appropriate to its designated level of care;

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E

D. A written protocol for the initiating maternal and neonatal transports to an appropriate level of care;

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NA

E. A written protocol for the acceptance of maternal and neonatal transports;

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E

F. Written protocols for accepting or transferring obstetrical patients or neonates as "back transports";

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E

G. A licensed neonatal transport service or written agreement with a licensed neonatal transport service;

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E

H. Policies that allow families (including siblings) to be together in the hospital following the birth of an infant and that promote parental involvement in the care of the neonate including those in the NICU;

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E

I. A policy to eliminate deliveries by induction of labor or by cesarean section prior to 39 weeks gestation without a medical indication with a systematic internal review process to evaluate any occurrences and a plan for corrective action;

J. Written protocols and capabilities in place for the following:

(1) Assessment of risk for obstetrical hemorrhage;

(2) Maximizing accuracy in determining obstetrical blood loss;

(3) Massive transfusion;

(4) Emergency release of blood products before full compatibility testing is complete; and

(5) Management of multiple component therapy;

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E

K. Written protocol to evaluate all infants born at or transferred to the institution for birth defects and to report findings to the Birth Defects Reporting and Information System as required by Health-General Article, § 18-206, Annotated Code of Maryland;

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E

L. Written policy for the management of obstetrical patients with opioid use and opioid use disorder that addresses the following and other relevant issues:

(1) Universal screening of obstetrical patients for opioid use;

(2) Pharmacotherapy of the pregnant, laboring, and postpartum patient;

(3) Breastfeeding;

(4) Linkages to appropriate postpartum psychosocial support services including substance use treatment and relapse prevention program; and

(5) Reproductive health planning;

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E

M. Written policy for the identification and management of neonatal abstinence syndromes;

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E

N. Written policy for optimizing post-delivery care of obstetrical patients that addresses the following and other relevant issues:

(1) Identification of postpartum patients at risk for poor health outcomes

(2) Breastfeeding support

(3) Linkages to appropriate medical and psychosocial services, and

(4) Reproductive health planning; and

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E

O. Written policy to address infant safety issues including safe sleep, abusive head trauma (shaken baby) and car seat safety.

E

E