| (a) Purpose. This rule establishes conditions and procedures
for youth to be admitted to and discharged from infirmaries in Texas
Juvenile Justice Department (TJJD) facilities.
(b) General Provisions.
(1) Nursing care will be provided in the infirmary
at each institution through contract health care staff for youth who
do not need hospitalization but who need increased observation or
medical care. Infirmary admissions are utilized for youth who are
acutely ill, injured, medically compromised due to mental health decompensation,
or recovering from surgery or illness.
(2) Juvenile correctional officers shall supervise
youth admitted to the infirmary at all times.
(3) Only nursing staff may receive medical orders from
the medical provider.
(c) Infirmary Admission for Medical Diagnosis.
(1) The medical provider or health services administrator
or designee determines if a youth requires observation or treatment
for a medical diagnosis or condition.
(2) The health services administrator or registered
nurse designee may admit a youth to the infirmary for a medical diagnosis
or condition for up to 24 hours. Only a medical provider may authorize
admission to the infirmary for 24 hours or longer.
(3) Only a medical provider may discharge the youth
if the youth:
(A) was admitted to the infirmary for 24 hours or longer;
or
(B) was admitted by a medical provider for any length
of time.
(4) A nurse or medical provider may discharge the youth
if he/she was admitted to the infirmary by a nurse.
(d) Infirmary Admission for Psychiatric Monitoring.
(1) A psychiatrist or physician, if readily available,
may admit a youth to the infirmary for close observation and/or monitoring
after a psychiatric-related incident. The designated mental health
professional may authorize the admission when a psychiatrist or medical
provider is not readily available. The nurse will immediately notify
the psychiatrist, or a physician if a psychiatrist is not available,
and document the notification and any order/instructions in the electronic
medical record. Psychiatrist or physician orders shall be obtained
for youth admitted to the infirmary within two hours of admission.
(2) In obtaining psychiatrist or physician orders for
youth experiencing a psychiatric crisis, nursing staff provides the
psychiatrist relevant medical information such as current medications,
vital signs, subjective or objective data (e.g., laboratory values),observations,
and assessment. The psychiatrist or physician order includes instructions
regarding any observations that nursing staff must make about the
youth's mental status, as well as instructions for any other type
of monitoring or medications that are to be administered.
(3) A Ph.D. level psychologist or psychologist associate
(if a Ph.D. level is not available) evaluates the youth at least once
a day.
(4) Disposition (discharge or referral) is made by
the psychiatrist or physician.
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| Source Note: The provisions of this §380.9186 adopted to be effective December 16, 1999, 24 TexReg 10372; amended to be effective August 1, 2009, 34 TexReg 4916; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended to be effective April 15, 2015, 40 TexReg 1976 |
