| (a) A facility shall have personnel qualified to operate
emergency equipment and to provide emergency care to patients on site
and available at all treatment times.
(b) Nursing services.
(1) There shall be an organized nursing service under
the direction of a qualified registered nurse (RN). The facility shall
be staffed to ensure that the nursing needs of all patients are met.
(2) There shall be a written plan of administrative
authority for all nursing services with responsibilities and duties
of each category of nursing personnel delineated and a written job
description for each category. The scope of nursing services shall
be limited to nursing care rendered to patients as authorized by the
Nursing Practice Act, Occupations Code Chapter 301.
(A) The responsible individual for nursing services
shall be a qualified RN whose responsibility and authority shall be
clearly defined and shall include supervision of both personnel performance
and patient care.
(B) There shall be a written delineation of functions,
qualifications, and patient care responsibilities for all categories
of nursing personnel.
(C) Nursing services shall be provided in accordance
with current recognized standards or recommended practices.
(3) There shall be an adequate number of RNs on duty
to meet minimum staff requirements to include supervisory and staff
RNs to ensure the immediate availability of an RN for emergency care
or for any patient when needed.
(4) There shall be other nursing personnel in sufficient
numbers to provide nursing care not requiring the service of an RN.
An RN shall assign the nursing care of each patient to other nursing
personnel in accordance with the patient's needs and the preparation
and qualifications of the nursing staff available.
(5) An RN qualified, at a minimum, with current certification
in advanced cardiac life support and Pediatric Advanced Life Support
shall be on duty and on the premises at all times whenever patients
are present in the facility.
(6) All direct care staff members shall maintain current
certification and competency in Basic Cardiac Life Support.
(c) In addition to meeting the requirements for nursing
staff under subsection (b) of this section, facilities shall comply
with the following minimum staffing requirements.
(1) Facilities that provide only topical anesthesia,
local anesthesia, or minimal sedation are required to have a second
individual on duty on the premises who is trained and currently certified
in basic cardiac life support until all patients have been discharged
from the facility.
(2) Facilities that provide moderate sedation/analgesia
are required to have the following additional staff:
(A) a second individual on duty on the premises who
is trained and currently certified in basic cardiac life support until
all patients have been discharged from the facility; and
(B) an individual trained and currently certified in
advanced cardiac life support and pediatric advanced life support
shall be available until all patients have been discharged.
(3) Facilities that provide deep sedation/analgesia
and/or regional anesthesia shall have the following additional staff:
(A) a second individual on duty on the premises who
is trained and currently certified in basic cardiac life support until
all patients have been discharged from the facility; and
(B) an individual who is trained and currently certified
in advanced cardiac life support and pediatric advanced life support
shall be on duty on the premises and sufficiently free of other duties
to enable the individual to respond rapidly to emergency situations
until all patients have been discharged.
(d) Nursing peer review committees. The facility shall
establish a nursing peer review committee to conduct nursing peer
review, as required by Texas Occupations Code, Chapter 303.
|
