Kan. Admin. Regs. § 109-2-5 - Ambulance service operational standards
(a) Each ground ambulance shall have a
two-way, interoperable communications system to allow contact with the
ambulance service's primary communication center and with the medical facility,
as defined by
K.S.A.
65-411 and amendments thereto, to which the
ambulance service most commonly transports patients.
(b) Smoking shall be prohibited in the
patient and driver compartments of each ambulance at all times.
(c) Each operator shall ensure that the
interior and exterior of the ambulance are maintained in a clean manner and
that all medications, medical supplies, and equipment within the ambulance are
maintained in good working order and according to applicable expiration
dates.
(d) Each operator shall
ensure that freshly laundered linen or disposable linen is on cots and pillows
and ensure that the linen is changed after each patient is
transported.
(e) When an ambulance
has been utilized to transport a patient known or suspected to have an
infectious disease, the operator shall ensure that the interior of the
ambulance, any equipment used, and all contact surfaces are disinfected
according to the ambulance service's infectious disease control policies and
procedures. The operator shall place the ambulance out of service until a
thorough disinfection according to the ambulance service's infection control
policies and procedures has been completed.
(f) Each operator shall ensure that all items
and equipment in the patient compartment are placed in cabinets or properly
secured.
(g) Each operator shall
park all ground ambulances in a completely enclosed building with a solid
concrete floor. Each operator shall maintain the interior heat of the enclosed
building at no less than 50 degrees Fahrenheit. Each operator shall ensure that
the interior of the building is kept clean and has adequate lighting. Each
operator shall store all supplies and equipment in a clean and safe
manner.
(h) Each licensed ambulance
shall meet all regulatory requirements for the ambulance license type, except
when the ambulance is out of service.
(i) If an operator is unable to provide
service for more than 24 hours, the operator or agent shall notify the
executive director and submit an alternative plan, in writing and within 72
hours, for providing ambulance service for the operator's primary territory of
coverage. The alternative plan shall be subject to approval by the executive
director and shall remain in effect no more than 30 days from the date of
approval. Approval by the executive director shall be based on whether the
alternate plan will provide sufficient coverage to transport and provide
emergency care for persons within the operator's primary territory. A written
request for one or more extensions of the alternative plan for no more than 30
days each may be approved by the executive director if the operator has made a
good faith effort but, due to circumstances beyond the operator's control, has
been unable to completely remedy the problem.
(j) Each operator subject to public call
shall have a telephone with an advertised emergency number that is answered by
an attendant or other person designated by the operator 24 hours a day.
Answering machines shall not be permitted.
(k) Each operator shall produce the ambulance
service permit and service records upon request of the board.
(l) Each operator shall maintain service
records for three years.
(m) Each
operator shall ensure that documentation is completed for each request for
service and for each patient receiving patient assessment, care, or
transportation. Each operator shall furnish a completed copy or copies of each
patient care report form upon request of the board.
(n) Each operator shall maintain a daily
record of each request for ambulance response. This record shall include the
date, time of call, scene location, vehicle number, trip number, caller, nature
of call, and disposition of each patient.
(o) Each operator shall maintain a copy of
the patient care documentation for at least three years.
(p) Each operator shall ensure that a copy of
the patient care documentation for initial transport of emergency patients is
made available to the receiving medical facility, within 24 hours of the
patient's arrival.
(q) Each
operator shall maintain a current duty roster that demonstrates compliance with
K.S.A.
65-6135, and amendments thereto. The duty
roster shall reflect appropriate staffing for the service and ambulance type as
specified in K.A.R. 109-2-6 and 109-2-7 .
(r) Each operator shall provide a quality
improvement or assurance program that establishes medical review procedures for
monitoring patient care activities. This program shall include policies and
procedures for reviewing patient care documentation. Each operator shall review
patient care activities at least once each quarter of each calendar year to
determine whether the ambulance service's attendants are providing patient care
commensurate with the attendant's scope of practice and local protocols.
(1) Review of patient care activities shall
include quarterly participation by the ambulance service's medical director in
a manner that ensures that the medical director is meeting the requirements of
K.S.A.
65-6126, and amendments thereto.
(2) Each operator shall, upon request,
provide documentation to the executive director demonstrating that the operator
is performing patient care reviews and that the medical director is reviewing,
monitoring, and verifying the activities of the attendants pursuant to
K.S.A.
65-6126, and amendments thereto, as indicated
by the medical director's electronic or handwritten signature.
(3) Each operator shall ensure that
documentation of all medical reviews of patient care activities is maintained
for at least three years.
(4)
Within 60 days after completion of the internal review processes of an
incident, each operator shall report to the board on forms approved by the
board any incident indicating that an attendant or other health care provider
functioning for the operator met either of the following conditions:
(A) Acted below the applicable standard of
care and, because of this action, had a reasonable probability of causing
injury to a patient; or
(B) acted
in a manner that could be grounds for disciplinary action by the board or other
applicable licensing agency.
(s) Each ambulance service operator shall
develop and implement operational policies or guidelines, or both, that have a
table of contents and address policies and procedures for each of the following
topics:
(1) Radio and telephone
communications;
(2) interfacility
transfers;
(3) emergency driving
and vehicle operations;
(4) do not
resuscitate (DNR) orders, durable powers of attorney for health care decisions,
and living wills;
(5)
multiple-victim and mass-casualty incidents;
(6) hazardous material incidents;
(7) infectious disease control;
(8) crime scene management;
(9) documentation of patient
reports;
(10) consent and refusal
of treatment;
(11) management of
firearms and other weapons;
(12)
mutual aid, which means a plan for requesting assistance from another
resource;
(13) patient
confidentiality;
(14) extrication
of persons from entrapment; and
(15) any other procedures deemed necessary by
the operator for the efficient operation of the ambulance service.
(t) Each ambulance service
operator shall provide the operational policies to the executive director, upon
request.
(u) Each ambulance service
operator shall adopt and implement medical protocols developed and approved in
accordance with
K.S.A.
65-6112, and amendments thereto. The medical
protocols shall be approved annually.
(v) Each operator's medical protocols shall
include a table of contents and treatment procedures at a minimum for the
following medical and trauma-related conditions for pediatric and adult
patients:
(1) Diabetic emergencies;
(2) shock;
(3) environmental emergencies;
(4) chest pain;
(5) abdominal pain;
(6) respiratory distress;
(7) obstetrical emergencies and care of the
newborn;
(8) poisoning and
overdoses;
(9) seizures;
(10) cardiac arrest;
(11) burns;
(12) stroke or cerebral-vascular
accident;
(13) chest
injuries;
(14) abdominal
injuries;
(15) head
injuries;
(16) spinal
injuries;
(17) multiple-systems
trauma;
(18) orthopedic
injuries;
(19) drowning;
and
(20) anaphylaxis.
(w) Each operator shall make
available a current copy of the ambulance service's operational policies or
guidelines and medical protocols to any person listed as an attendant and any
other health care provider on the ambulance service's attendant
roster.
Notes
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