File No. 35471

This rule was published in the December 15, 2011, issue (Vol. 2011, No. 24) of the Utah State Bulletin.


Health, Family Health and Preparedness, Licensing

Rule R432-100

General Hospital Standards

Notice of Proposed Rule

(Amendment)

DAR File No.: 35471
Filed: 11/18/2011 04:19:52 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The referenced standards are out of date and out of print. These changes have been vetted in two meetings with providers and interested parties and have been approved by the Health Facilities Committee.

Summary of the rule or change:

Updates the adopted references from the fifth edition of the Guidelines for Perinatal Care to the sixth edition and updates from the 2001 Guidelines for Design and Construction of Hospital and HealthCare Facilities to the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities.

State statutory or constitutional authorization for this rule:

  • Title 26, Chapter 21

This rule or change incorporates by reference the following material:

  • Updates Guidelines for Design and Construction of Health Care Facilities, published by ASHE (American Society of Healthcare Engineering), 2010 edition

Anticipated cost or savings to:

the state budget:

The cost of purchasing a copy of the Guidelines for Perinatal Care for the DAR library is $80. The cost of purchasing copies of the Guidelines for Design and Construction of Health Care Facilities is $168 and is covered in Rule R432-4, General Construction, which is being amended concurrent with this rule. State expenses are expected to be completed within the usual course of business and existing budgets. (DAR NOTE: The proposed amendment to Rule R432-4 is under DAR No. 35459 in this issue, December 15, 2011, of the Bulletin.)

local governments:

The rule change has no impact on local government because these standards are enforced at the state level.

small businesses:

Architects and engineers that design hospitals will have the cost of purchasing the new standards. The cost of the new Guidelines for Perinatal Care is $80. Assuming 5 small businesses purchase copies of the new Guidelines for Perinatal Care the aggregate cost to small business is $400. The cost of purchasing the 2010 Guidelines for Design and Construction of Health Care Facilities is covered in Rule R432-4 which is being amended concurrent with this rule.

persons other than small businesses, businesses, or local governmental entities:

Hospitals will have the cost of purchasing the new referenced standard at $80. Assuming all 33 General Hospitals purchase the new Guidelines for Perinatal Care the aggregate cost to business is $2,640. The cost of constructing larger newborn intensive care nurseries is addressed in Rule R432-4 which is being amended concurrent with this rule.

Compliance costs for affected persons:

The cost for each hospital to purchase the new Guidelines for Perinatal Care is $80. The rule changes will not increase any compliance costs.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule has been extensively discussed with the regulated businesses and they appear to concur that updating the rule to adopt updated federal accessibility standards and the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities is appropriate. Public comment received will be carefully evaluated for any unforeseen fiscal impact.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

  • Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at jhoffman@utah.gov
  • Andrew Baxter at the above address, by phone at 801-538-6140, by FAX at 801-538-6325, or by Internet E-mail at andrewbaxter@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

01/17/2012

This rule may become effective on:

01/24/2012

Authorized by:

David Patton, Executive Director

RULE TEXT

R432. Health, Family Health and Preparedness, Licensing.

R432-100. General Hospital Standards.

R432-100-1. Legal Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

 

R432-100-17. 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, [Fifth]Sixth Edition and the Guidelines for Design and Construction of [Hospital and] Heath Care Facilities, [2001]2010 Edition, which [is]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, II A, IIB, IIIA, IIIB or III C.

(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 100-17(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 [50 square feet per bassinet and] four feet between bassinets for Continuing Care nurseries;

(c) Level III Sub-specialty: Newborn Intensive Care Nursery [100 square feet per bassinet and] 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 Farenheit 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 R386-702-9 shall be instilled in the eyes of the infant within three hours of birth;

(c) Metabolic screening 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.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [October 1, 2011]2012

Notice of Continuation: December 13, 2010

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-2.1; 26-21-20

 


Additional Information

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For questions regarding the content or application of this rule, please contact Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at jhoffman@utah.gov; Andrew Baxter at the above address, by phone at 801-538-6140, by FAX at 801-538-6325, or by Internet E-mail at andrewbaxter@utah.gov.