Utah Admin. Code R432-100-18 - Emergency Care Service
(1)
(a) Each licensee shall evaluate and classify
itself to show its capability in providing emergency care. Type I, II, or III
represents acute care hospitals and critical access hospitals and Type IV
category represents specialty hospitals.
(b) A Type I Acute or Critical Access
Hospital licensee shall provide in-hospital support by members of the medical
staff for:
(i) medical;
(ii) surgical;
(iii) orthopedic;
(iv) obstetric;
(v) pediatric; and
(vi) anesthesia services.
(c) The licensee shall ensure
specialty consultation is available within 30 minutes, or two-way voice
communication is available for the initial consultation.
(d) A Type III licensee shall ensure that
specialty consultation is available by request of the attending medical staff
member by transfer to a type I or type II hospital where care can be
provided.
(2)
(a) The licensee shall organize and staff the
emergency service with qualified individuals based on the defined capability of
the hospital.
(b) An individual
appointed and authorized by the hospital administrator shall direct the
emergency services.
(c) One or more
members of the medical staff shall define in writing and provide medical
direction of emergency services. The medical staff shall provide back-up and
on-call coverage for emergency services and as needed for emergency specialty
services.
(d) A licensed
practitioner is responsible for the evaluation and treatment of a patient who
presents them self or is brought to the emergency care area including:
(i) an appropriate medical screening
examination;
(ii) stabilizing
treatment; and
(iii) if necessary
for definitive treatment, an appropriate transfer to another medical facility
that has agreed to accept the patient for care.
(e) Trained personnel using guidelines by the
emergency room director and approved by the medical staff may determine the
priority that a physician sees a person seeking emergency care.
(f) The licensee shall post rosters
designating medical staff members on duty or on-call for primary coverage and
specialty consultation in the emergency care area.
(g) A designated registered nurse who is
qualified by relevant training, experience, and current competence in emergency
care shall supervise the care provided by nursing service personnel in the
department, including:
(i) the emergency nurse
supervisor shall ensure that there is enough nursing service personnel for the
types and volume of patients served;
(ii) type I and II emergency department
licensees shall have at least one registered nurse with advanced cardiac life
support certification, and enough other nursing staff assigned and on duty
within the emergency care area; and
(iii) the emergency nurse supervisor shall
participate in internal committee activities concerned with the emergency
service.
(h) The
licensee shall ensure that the emergency service is integrated with other
departments in the hospital.
(i)
The licensee shall provide clinical laboratory services with the capability of
performing any routine studies and standard analyses of blood, urine, and other
body fluids.
(j) The licensee shall
ensure that a supply of blood is available 24 hours a day.
(k) The licensee shall ensure that diagnostic
radiology services are is available 24 hours a day.
(l) The licensee shall define, in writing,
the duties and responsibilities of personnel, including physicians and nurses,
providing care within the emergency service area.
(3)
(a)
Each licensee shall define its scope of emergency services in writing and
implement a plan for emergency care, based on community needs and on the
capabilities of the hospital.
(b)
Each licensee shall comply with federal anti-dumping regulations as defined in
the 19 CFR
351.101 (1998).
(c) The licensee shall define the role of the
emergency service in the hospital's disaster plans.
(d) Each licensee shall have a communication
system that permits instant contact with law enforcement agencies, rescue
squads, ambulance services, and other emergency services within the
community.
(e) The licensee's
emergency department policies and protocols shall address:
(i) the care, security, and control of
prisoners or people to be detained for police or protective custody;
(ii) providing care to an unemancipated minor
not accompanied by parent or guardian, or to an unaccompanied unconscious
patient;
(iii) handling of
hazardous materials and contaminated patients;
(iv) reporting of persons dead-on-arrival to
the proper authorities including the legal requirements for the collection and
preservation of evidence; and
(v)
the evaluation and handling of alleged or suspected child or adult abuse
cases.
(f) The licensee
shall develop criteria to alert emergency department and service personnel to
possible child or adult abuse. The criteria shall address:
(i) suspected physical assault;
(ii) suspected rape or sexual
molestation;
(iii) suspected
domestic abuse of elders, spouses, partners, and children;
(iv) the collection, retention, and
safeguarding of specimens, photographs, and other evidentiary materials;
and
(v) visual and auditory privacy
during examination and consultation of patients.
(g) The licensee shall make a list available
in the emergency department that outlines private and public community agencies
and resources that provide, arrange, evaluate, and care for the victims of
abuse.
(4) The licensee
shall make reasonable and timely efforts to contact the guardian, parents, or
next of kin of any unaccompanied minor, or any unaccompanied unconscious
patient admitted to the emergency department.
Notes
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No prior version found.