R432-100-18. Perinatal Services

  (1) Each hospital shall comply with the requirements of this section and shall designate its capability to provide perinatal (antepartum, labor, delivery, postpartum and nursery) care in accordance with Level I basic, Level II specialty, or Level III sub-specialty or tertiary care as described in the Guidelines for Perinatal Care, Sixth Edition and the Guidelines for Design and Construction of Heath Care Facilities, 2010 Edition, which are incorporated by reference.

  (a) A qualified member of the hospital staff shall provide administrative, medical and nursing direction and oversight for perinatal services according to each hospital's designated level of care, Level I, IIA, IIB, IIIA, IIIB or IIIC.

  (b) A qualified registered nurse shall be immediately available at all hours of the day and as well as sufficient numbers of trained competent staff to meet the designated level.

  (c) Support personnel shall be available to the perinatal care service according to each hospital's designated level of care.

  (2) Each hospital shall establish and implement security protocols for perinatal patients.

  (3) The perinatal department shall include facilities and equipment for antepartum, labor and delivery, nursery, postpartum, and optional birthing rooms.

  (a) Perinatal areas shall be located and arranged to avoid non-related traffic to and from other areas.

  (b) The hospital shall isolate patients with infections or other communicable conditions. The use of maternity rooms for patients other than maternity patients shall be restricted according to hospital policy.

  (c) Each hospital shall have at least one surgical suite for operative delivery.

  (d) Equipment and supplies shall be immediately available and maintained for the mother and newborn, including:

  (i) furnishings suitable for labor, birth, and recovery;

  (ii) oxygen with flow meters and masks or equivalent;

  (iii) mechanical suction and bulb suction;

  (iv) resuscitation equipment;

  (v) emergency medications, intravenous fluids, and related supplies and equipment;

  (vi) a device to assess fetal heart rate;

  (vii) equipment to monitor and maintain the optimum body temperature of the newborn;

  (viii) a clock capable of showing seconds;

  (ix) an adjustable examination light; and

  (x) a newborn warming unit with temperature controls that comply with Underwriters' Laboratories requirements. The unit must be capable of administering oxygen and suctioning.

  (e) The hospital shall maintain a delivery room record keeping system for cross referencing information with other departments.

  (4) If birthing rooms are provided, they shall be equipped in accordance with 100-18(3(d)).

  (5) The nursery shall include facilities and equipment according to its designated level of care: Level I - Basic Newborn Care; Level II - Specialty Continuing Care; and Level III - Sub-specialty or Tertiary Newborn Intensive Care including an individual bassinet for each infant; with space between bassinets as follows:

  (a) Level I Basic: Full Term or Well Baby Nursery 24 inches between bassinets;

  (b) Level II Specialty: Continuous Care Nursery four feet between bassinets for Continuing Care nurseries;

  (c) Level III Sub-specialty: Newborn Intensive Care Nursery four feet between bassinets.

  (d) accurate scales; and

  (e) a wall thermometer;

  (6) The following equipment and supplies shall be available:

  (a) an individual thermometer, or one with disposable tips, for each infant;

  (b) a supply of medication shall be immediately available for emergencies;

  (c) a covered soiled-diaper container with removable lining;

  (d) a linen hamper with removable bag for soiled linen other than diapers;

  (e) a newborn warming unit with temperature controls that comply with Underwriters' Laboratories requirements;

  (f) oxygen, oxygen equipment, and suction equipment; and

  (g) an oxygen concentration monitoring device.

  (7) Temperature shall be maintained between 70-80 degrees Fahrenheit in the nursery area.

  (8) Infant formula storage space shall be available that conforms to the manufacturer's recommendations. Only single-use bottles shall be used for newborn feeding.

  (9) A suspect nursery or isolation area shall be available. Equipment and supplies shall be provided for the isolation area.

  (a) Isolation facilities shall be used for any infant who:

  (i) has a communicable disease;

  (ii) is delivered of an ill mother infected with a communicable disease;

  (iii) is readmitted after discharge from a hospital; or

  (iv) is delivered outside the hospital.

  (b) There shall be separate hand washing facilities for the isolation area.

  (10) Each hospital shall comply with the following provisions:

  (a) No attempt shall be made to delay the imminent, normal birth of a child;

  (b) A prophylactic solution in accordance with R386-702-14 shall be instilled in the eyes of the infant within three hours of birth;

  (c) Disease screening including phenylketonuria (PKU) shall be performed in accordance with Section 26-10-6 and R398-1; and

  (d) A newborn hearing screening shall be performed in accordance with R398-2.