7 AAC 12.670 - Nursing service
(a) A licensed nurse shall write a patient
care plan for each patient in consultation with other patient care personnel
and the patient.
(b) The patient
care plan must reflect analysis of patient problems and needs, treatment goals,
medication prescribed and, upon discharge, instructions given to the patient
and the patient's family regarding medication management, including any risks,
side effects, and benefits expected, and including any recommended activities
and diet.
(c) Each facility must
have a registered nurse as the director for nursing services. The director
shall perform the following duties:
(1)
assure that all nurses comply with the requirements of (a) of this
section;
(2) provide a sufficient
number of registered nurses to meet patient needs;
(3) write an annual evaluation on the
performance of each nurse;
(4)
maintain records on the number of nurses employed and the hours and weeks of
employment;
(5) delegate to a
registered nurse the responsibility to plan, assign, supervise, and evaluate
the nursing care for each patient;
(6) select and promote nursing personnel
based on their qualifications and terminate employees when necessary;
and
(7) establish and implement a
standard procedure for the safe administration of medications.
(d) Only a registered nurse who
has been appropriately trained may perform a blood transfusion. All other
nursing services may be performed only under the direction of a registered
nurse. A licensed practical nurse may administer medications, or perform
limited infusion therapy functions, if
(1)
the licensed practical nurse is authorized under AS 08 to perform these
services;
(2) these services are
authorized in the facility program standards; and
(3) the program standards have been approved
by the hospital administrator and the pharmacist.
(e) Licensed nursing personnel who meet the
requirements under (d) of this section to administer medications, and who have
been authorized in writing by the hospital administrator and the pharmacist,
may perform the following services if a pharmacist is not available:
(1) inventory and restocking of emergency
drugs at least every 30 days; and
(2) removal of a single dose of a prescribed
drug for a patient or any drug packaged by a pharmacist from the licensed
pharmacy or drug room.
(f) If licensed nursing personnel perform a
service described in (e)(2) of this section, a pharmacy or drug room record
must be kept and signed by the licensed nurse showing the name, strength and
amount of the drug, the date and time taken, and the patient to whom the drug
is administered.
(g) Except as
provided in (i) of this section for a critical access hospital or
7 AAC 12.275 for a nursing facility, a facility that
provides a nursing service must have a registered nurse on duty at all
times.
(h) The nursing staff shall
hold regular meetings to review and evaluate ways of improving nursing care.
Minutes of the meetings must be made available to staff members.
(i) The department will waive the requirement
of (g) of this section for a critical access hospital if the hospital
establishes to the department's satisfaction that
(1) to have a registered nurse on duty at all
times is not financially feasible for the hospital;
(2) the community served by the hospital was
involved in the decision to discontinue having a registered nurse on duty at
all times and is aware that the hospital's emergency department may close on
occasion;
(3) the hospital's
emergency medical service plan submitted under
7 AAC 12.612(c) (6) assures that a
registered nurse will be available at the hospital's emergency room to receive
patients delivered by local emergency services personnel; and
(4) the hospital will have a registered nurse
on duty whenever an inpatient is present in the facility.
(j) A frontier extended stay clinic is exempt
from the requirements of this section.
Notes
Authority:AS 18.05.040
AS 47.32.010
AS 47.32.030
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