R426-10-2500. Medical Staff and Patient Safety Welfare

  (1) Medical personnel scheduling and individual work schedules shall demonstrate strategies to minimize duty-time fatigue, length of shift, number of shifts per week, and day-to-night rotation.

  (2) On-site scheduled shifts for a period to exceed twenty-four (24) hours are not acceptable under most circumstances.

  (3) The following criteria shall be met for shifts scheduled more than twelve (12) hours:

  (a) medical personnel are not required to routinely perform any duties beyond those associated with the transport services;

  (b) medical personnel are provided with access to and permission for uninterrupted rest after daily medical personnel duties are met;

  (c) the physical base of operations includes an appropriate place for uninterrupted rest;

  (d) medical personnel shall have the right to call "time out" and be granted a reasonable rest period if the team member (or fellow team member) determines that he or she is unfit or unsafe to continue duty, no matter the shift length;

  (e) there shall be no adverse personnel action or undue pressure to continue in a "time-out" circumstance;

  (f)licensed air ambulance management shall monitor transport volumes and personnel's use of a "time out" policy;

  (g) licensed air ambulance providers shall utilize a fatigue risk management tool that is widely recognized in the industry; and

  (h) shifts extended over several days may be scheduled to address long commutes at programs with low volumes.

  (4) The licensed air ambulance provider shall clearly demonstrate and document it meets this above criteria for shifts over twelve (12) hours.

  (5) Provide at least (10) hours of rest in each twenty-four (24) hour period.

  (6) If the location of the base is remote and one-way commutes are more than two (2) hours, transportation time shall be considered.

  (7) Licensed air ambulance providers shall utilize a fatigue risk management tool that is widely recognized in the industry.

  (8) Scheduling of on-call shifts shall be evaluated to address fatigue in a written policy based on monitoring of duty times by managers, quality management tracking, and fatigue risk management.

  (9) The license air ambulance provider shall establish safety and infection control protocol that comply with the Occupational Safety and Health Administration (OSHA) Standards.

  (10) The licensed air ambulance provider shall have an appropriate dress code that addresses mission specific hazards as well as jewelry, hair, and other personal items that may possibly be used by medical personnel that may interfere with patient care.