Haw. Code R. § 11-94.2-39 - Nursing services
(a) Each facility
shall have nursing staff sufficient in number and qualifications to meet the
nursing needs of the residents. There shall be at least one registered nurse at
work full-time on the day shift, for eight consecutive hours, seven days a
week, and at least one licensed nurse at work on the evening and night shifts,
unless otherwise determined by the department.
(b) Nursing services shall include but are
not limited to the following:
(1) A
comprehensive nursing assessment of each resident and the development and
implementation of a plan of care within five days of admission. The nursing
plan of care shall be developed in conjunction with the physician's admission
physical examination and initial orders. A nursing plan of care shall be
integrated with an overall plan of care developed by an interdisciplinary team
no later than the twenty-first day after, or simultaneously, with the initial
interdisciplinary care plan conference;
(2) Written nursing observations and
summaries of the resident's status recorded, as appropriate, due to changes in
the resident's condition, but no less than quarterly; and
(3) Ongoing evaluation and monitoring of
direct care staff to ensure quality resident care is provided.
(c) There shall be a registered
nurse designated as the nursing administrator or director of nursing who will
be responsible for all nursing services.
(d) Should drug or medication administration
be delegated pursuant to chapter
16-89, subchapter
15, there shall be documented evidence
of a training program, individuals receiving training, and ongoing monitoring
and evaluation to assess compliance with requirements.
(e) There shall be a policies and procedures
manual that is kept current and consistent with current nursing and medical
practices and approved by the medical advisor or director and the person
responsible for nursing procedures. The policies and procedures shall include
but not be limited to:
(1) Written procedures
for personnel to follow in an emergency including;
(A) Care of the resident;
(B) Notification of the attending physician
and other persons responsible for the resident; and
(C) Arrangements for transportation,
hospitalization, or other appropriate services;
(2) All treatment and care provided relative
to the resident's needs and requirements for documentation; and
(3) Medication or drug administration
procedures that clearly define drug administration process, documentation. and
authorized individuals able to administer medications or drugs.
Notes
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