Rule 111-8-40-.21 - Nursing ServicesThe hospital shall have an organized nursing service that provides twenty-four (24) hour nursing care to meet the needs of patients. Critical access hospitals are exempted from providing on-site twenty-four (24) hour nursing care when there are no hospitalized patients.
(a)Organization of Nursing Services. The hospital's nursing services shall be directed by a licensed registered nurse who shall be responsible for implementing a system for supervision and evaluation of nursing clinical activities. 1. The chief nurse executive shall establish and implement policies and procedures for nursing services based on generally accepted standards of practice including the evaluation of the effectiveness of the services in coordination with the hospital's quality management program.2. The chief nurse executive shall be responsible for ensuring that nursing personnel are oriented to nursing policies and procedures.3. Nursing services shall have and follow a written plan for organization, administrative authority, delineation of responsibilities for patient care, and staff qualifications and competencies. (i) The nursing service plan shall include the types and numbers of nursing personnel necessary to provide appropriate nursing care for each patient in the hospital.(ii) Specialty areas shall specify nursing requirements for their areas that also define any special nursing competency requirements, staffing patterns based on patient acuity, and the required ratio of nurses to technical staff.(iii) A system of patient assignment shall be defined which reflects a consideration of patient needs and nursing staff qualifications and competencies.(b)Delivery of Nursing Services. Nursing services must be delivered in accordance with patients' needs and generally accepted standards of practice. 1. A license registered nurse must be on duty at all times to provide or supervise the provision of care. Critical access hospitals are permitted some flexibility in meeting this requirement as set forth in Rule 111-8-40-.38.2. Within the first twelve (12) hours after admission, a basic nursing assessment shall be completed for each patient and a plan of care initiated.3. The patient's condition shall be monitored by nursing staff on a schedule appropriate to the patient's needs.4. Nursing staff shall be responsible for updating the patient's plan of care based on any changes in the patient's condition.5. Nursing staff administering drugs and biologicals shall act in accordance with the orders from the medical staff responsible for the patient's care, generally accepted standards of practice, and any federal and state laws pertaining to medication administration.6. Nursing staff shall report medication administration errors and adverse drug reactions in accordance with established hospital policies.7. Blood transfusions and other blood products shall be administered by licensed nursing staff or other qualified practitioners as authorized by law in accordance with established hospital policies, which shall include, at a minimum, the following: (i) Obtaining and documenting appropriate patient consent to treatment and procedures, as required;(ii) Responding to and reporting of transfusion reactions;(iii) Monitoring patients appropriately; and(iv) Designating personnel qualified to perform these procedures.Ga. Comp. R. & Regs. R. 111-8-40-.21
O.C.G.A. § 31-7-2.1.
Original Rule entitled "Nursing Services" adopted. F. Feb. 20, 2013; eff. Mar. 12, 2013.