R432-700-21. Nursing Services

  (1) Nursing services provided through a home health agency shall be under the supervision of a director of nursing services.

  (2) Nursing services shall be provided by or under the supervision of a registered nurse and according to the plan of care.

  (3) When an agency provides or contracts for services, the service shall be provided according to the plan of care and supervised by designated, qualified personnel.

  (4) Nursing staff shall observe, report, and record written clinical notes.

  (5) Nursing services should recognize and use opportunities to teach health concepts to the patient and family.

  (6) All registered nurses or licensed practical nurses employed by, or on contract with, the agency shall have a valid license from the Utah Department of Commerce, Title 58, Chapter 31b.

  (7) Licensed nurses shall have the following responsibilities:

  (a) Administer prescribed medications and treatments according to law and as permitted within the scope of the individual's license;

  (b) Perform nursing care according to the needs of the patient and as indicated in the written plan of care;

  (c) Inform the physician and other personnel of changes in the patient's condition and needs;

  (d) Write clinical notes in the individual patient record for each visit or contact;

  (e) Teach self-care techniques to the patient or family, or both;

  (f) Develop plans of care;

  (g) Participate in in-service programs.

  (8) The director of nursing services shall be responsible for and shall be accountable for the following functions:

  (a) Designate a registered nurse to act as director of nursing services during his absence;

  (b) Assume responsibility for the quality of nursing services provided by the agency;

  (c) Develop nursing service policies and procedures that must be reviewed annually and revised as necessary;

  (d) Establish work schedules for nursing personnel according to patient needs;

  (e) Assist in development of job descriptions for nursing personnel;

  (f) Complete performance evaluations for nursing personnel according to agency policy;

  (g) Direct in-service programs for all nursing personnel.

  (9) In addition to the general responsibilities, a registered nurse shall have the following responsibilities:

  (a) Make the initial nursing evaluation visit;

  (b) Re-evaluate nursing needs based on the patient's status and condition;

  (c) Initiate the plan of care and make necessary revisions;

  (d) Provide services which require specialized nursing skill;

  (e) Initiate appropriate preventive and rehabilitative nursing procedures;

  (f) Supervise staff assignments based on specific patient needs, family capabilities, staff training and experience, and degree of supervision needed;

  (g) Assist in coordinating all services provided;

  (h) Prepare termination of services statements;

  (i) Supervise and consult with licensed practical nurses as necessary;

  (j) Provide written instructions for certified nursing aide to ensure provision of required services written in the plan of care;

  (k) Supervise certified nursing aide in the patient's home as necessary, and be readily available for consultation by telephone;

  (l) Make supervisory visits with or without the certified nursing aide's presence as follows:

  (i) Initial assessment;

  (ii) Every two weeks to patients who receive skilled services;

  (iii) Every three months to patients who require long-term maintenance services;

  (iv) Any time there is a question of change in the patient's condition.

  (10) The licensed practical nurse shall have the following responsibilities:

  (a) Work under the supervision of a registered nurse;

  (b) Observe, record, and report to the immediate supervisor the general physical or mental condition of the patient;

  (c) Assist the registered nurse in performing specialized procedures;

  (d) Assist in development of the plan of care.