New Pediatric Regulations

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Britton Haynes
6 years ago
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1 New Pediatric Regulations New York State Department of Health The "Hospital Pediatric Care" regulations encompass an array of updates to the state hospital code, including changes in surgical, anesthesia, and radiologic/nuclear medicine services. The Department of Health (DOH) advanced these regulations to ensure that hospitals are admitting only those patients for whom they have appropriate staff, resources, and equipment; and transferring others, except in extraordinary circumstances, such as during a disaster or emergency surge. DOH has committed to working with HANYS and our members on education to assist with implementing these new regulations.

2 Policy Revision : Admissions, Transfers And Care Of Pediatric Or Adolescent Patient What s new? NYS DOH has developed the PARENT S BILL OF RIGHTS. Every pediatric patient s parent or other medical decision maker will be given a copy of a Parent s Bill of Rights at the time of admission, procedure or emergency department visit. Every patient or patient s representative must be asked if they have a primary provider. If the patient has a primary provider, documentation of the provider information will be documented in the chart. All information will be presented to the patient or if the patient is not legally capable of making decisions, the patient s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations, in a manner that reasonably assures that the patient, their parents or other medical decision makers understand the health information provided in order to make appropriate health decisions.

3 Parent Presence To the extent possible given the patient s health and safety, the hospital shall allow at least one parent to remain with the patient at all times. A parent may spend the night in a private room if an adolescent is admitted. If no private rooms are available, the placement will be directed by the Administrative Coordinator.

4 Admissions In accordance with the physician admitting privileges listed in the following grid in the policy (Admissions, Transfers and Care of Pediatric or Adolescent Patient) adolescents may be admitted to a private inpatient room on 1-4, 2-8, 4-1, 5-2, 5-1, L&D, or to an observation bed for medical/surgical treatment. Privileges for any Physician who admits or cares for adolescents and is not listed in the policy, (Admissions, Transfers and Care of Pediatric or Adolescent Patient) can be accessed in the echo portal on the privileges site.

5 Discharge From Hospital Or Emergency Department: All diagnostic test results must be reviewed by a MD, NP, PA who is familiar with the patient s presenting condition. No discharge will occur while the results of a test that is expected to yield a critical value is pending, to assure appropriate care is provided to the patient. At the time of discharge, A patient, his or her parent or other medical decision maker will receive a written discharge plan, which will be reviewed with them. Critical lab values and other diagnostic tests will be identified during the patient stay and any other test which have not been concluded results will be identified in the discharge plan. Communication with the patient, his or her parent or other medical decision maker must be accomplished in a manner that reasonably assures that the patient, their parents or other medical decision makers understand the health information provided in order to make appropriate health decisions. Hospitals shall provide all lab results to the patient s primary care provider, if known, after review by a physician, physician assistant or nurse practitioner. On discharge, the hospital must provide a patient, his or her parent or other medical decision maker a phone number that the patient, his or her parent or other medical decision maker could call for advice in the event that complications or questions arise.

6 New Policy: Emergency Equipment: Pediatric Patients Pediatric Resuscitation/Emergent Event: Call a pediatric cart for pediatric patients less than 14 years old regardless of weight or less than or equal to 17 years old and less than 50 kilograms. To call a pediatric cart call 5555 and state your location and that it is a pediatric cart. The emergency color coded Broselow carts have resuscitation equipment and medications for emergent situations. A rapid response may be called for admissions who are ages 14 years to less than or equal to 17 years. (Refer to Rapid Response Policy for criteria)

7 Pediatric Cart Calls When a pediatric cart is called in the main hospital, the 3-1 staff will bring the pediatric cart to the area where the patient is located. The OR/PACU and the ED handle cart calls internally. An emergency department nurse will arrive with the life pack defibrillator. All pediatric resuscitation carts have hands off pads for defibrillation on top of the cart. The pediatric Broselow Carts have pediatric emergency reference books on the top of the cart that have emergency medications and dosages calculated by weight. Appropriate equipment is listed for the weight of the child for up to 46 kilograms, however, the green drawer has adult size equipment The pediatric emergency reference book can also be found electronically in Work tools in SJen and in Work tools in the ED manual.

8 Bag -mask Ventilation All areas caring for children have pediatric self -inflating resuscitation bags and the appropriate size masks available. The pediatric size bag can be used for children up to age 8 years old. The adult bag may be used for children over 8 years old. Individual areas have different size masks and the emergency cart has masks per the weight of the child. The specific size mask will be listed in the pediatric emergency reference book. The correct size mask should extend from the bridge of the nose to the to the cleft of the chin, covering the nose and mouth but not compressing the eyes.

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North York General Hospital Policy Manual

North York General Hospital Policy Manual ORIGINATOR: Code Blue/Pink Committee APPROVED By: Operations Committee Medical Advisory Committee ORIGINAL DATE APPROVED: September, 1999 DATE REVIEWED: April, 2012 DATE OF IMPLEMENTATION: June 29, 2012