Current through Register Vol. XLI, No. 38, September 20, 2024
13.1.
The center shall provide patients a low stimulus environment to go through the
withdrawal process in a safe manner without additional discomfort.
13.2. The center shall use therapeutic
handling techniques, as tolerated, upon admission. Therapeutic handling
consists of the following techniques:
13.2.a.
Swaddling;
13.2.b.
C-Position;
13.2.c. Head-to-Toe
Movement;
13.2.d. Vertical
Rocking;
13.2.e.
Clapping;
13.2.f.
Feeding;
13.2.g. Controlling the
Environment; and
13.2.h.
Introducing Stimuli.
13.3. The center shall ensure all caregivers
will use soft voices and slow movements when handling patients.
13.4. The center shall provide an environment
with low lighting, as needed by the patient.
13.5. The center shall maintain a quiet
environment at all times.
13.6. The
center shall educate parents and/or legal representative on the first visit
about the low stimulus environment.
13.7. The center shall provide a consistent
routine for all patients.
13.8. The
center shall increase the amount of stimuli, including visual, auditory and
tactile, as tolerated by the patient and according to the plan of
care.
13.9. Feeding.
13.9.a. Prepared bottles shall be capped and
clearly labeled with the patient's name, contents and the date
prepared;
13.9.b. Prepared bottles
shall be refrigerated in a separate section of the refrigerator and accessible
only to employees;
13.9.c. Formula
shall be stored in containers specific to the purpose;
13.9.d. Formula that remains at a temperature
greater than 41 degrees Fahrenheit for more than one hour shall be
discarded;
13.9.e. Formula bottles
shall be used within timeframes established by the manufacturer and listed on
the package; and
13.9.f. A
microwave oven is not permitted for the heating of formula bottles under any
circumstances.
13.9.g. A center
shall have a planned three-day emergency food and water supply, and this may be
incorporated with the regular stock of supplies.
13.10. Bathing.
13.10.a. The facility shall have a policy
outlining the center's procedure for bathing patients in their care.
13.10.b. The center shall have a policy
outlining the center's procedure for cleaning and disinfecting patient
bathtubs.
13.11.
Transportation.
13.11.a. The center shall
have a policy to ensure the safety of the patient during transportation. 13.11
.b. Qualified employees shall ensure each patient is secured in an approved
rear-facing car seat.
13.12. Physician and Physician Services.
13.12.a. A physician shall approve in writing
a recommendation for a person to be admitted to a neonatal abstinence center.
Each patient shall remain under the care of an attending physician.
13.12.b. Physician supervision. A center
shall ensure the medical care of each patient is supervised by a
physician.
13.12.c. Physician
visits. The physician shall:
13.12.c.1.
Review the patient's plan of care, including medications and treatments, and
examine the patient personally at each visit required under the provision of
this rule;
13.12.c.2. Write, sign
and date progress notes at each visit; and
13.12.c.3. Sign and date all
orders.
13.12.d.
Frequency of physician visits. The patient shall be seen face-to-face by a
physician:
13.12.d.1. Within 24 hours of
admission; and
13.12.d.2. At least
twice per week, or more frequently as indicated by the needs of the
patient.
13.12.e. Except
as provided under the provisions of this rule, all required physician visits
shall be made by the physician personally.
13.12.f Availability of physician for
emergency care. A center shall provide or arrange for the provision of
physician services 24 hours a day, in case of an emergency.
13.12.g. Physician delegation of tasks.
Except as specified under the provisions of this rule, a physician may delegate
tasks to a physician assistant, nurse practitioner, or clinical nurse
specialist who:
13.12.g.1. Is licensed by the
State;
13.12.g.2. Is acting within
their scope of practice; and
13.12.g.3. Is under the supervision of the
physician.
