Ala. Admin. Code r. 420-5-7-.11

Current through Register Vol. 43, No. 1, October 31, 2024

Section 420-5-7-.11 - Nursing Services

(1) The hospital shall have an organized nursing service that provides 24-hour nursing services. The nursing services shall be furnished or supervised by a registered nurse.

(2) Organization. The hospital shall have a well-organized service with a plan of administrative authority and delineation of responsibilities for patient care. The director of the nursing service shall be a licensed registered nurse with an active, unencumbered registered nurse license issued by the Alabama Board of Nursing. He or she is responsible for the operation of the service, including determining the types and numbers of nursing personnel and staff necessary to provide nursing care for all areas of the hospital.

(3) Staffing and delivery of care. The nursing service shall have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. There shall be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient. Where there is a question about a physician's order the physician may be contacted by nursing staff.

(a) The hospital shall provide 24-hour nursing services furnished or supervised by a registered nurse, and have a licensed practical nurse or registered nurse on duty at all times.

(b) The nursing service shall have a procedure to ensure that hospital nursing personnel for whom licensure is required have valid and current licensure.

(c) A registered nurse shall supervise and evaluate the nursing care for each patient.

(d) The hospital shall ensure that the nursing staff develops, and keeps current, a nursing care plan for each patient.

(e) A registered nurse shall assign the nursing care of each patient to other nursing personnel in accordance with the patient's needs and the specialized qualifications and competence of the nursing staff available.

(f) Non-employee licensed nurses who are working in the hospital shall adhere to the policies and procedures of the hospital. The director of nursing service shall provide for the adequate supervision, licensure verification, and evaluation of the clinical activities of non-employee nursing personnel which occur within the responsibility of the nursing service.

(4) Preparation and administration of drugs. Drugs and biologicals shall be prepared and administered in accordance with federal and state laws, the orders of the practitioner or practitioners responsible for the patient's care, and accepted standards of practice.

(a) All drugs and biologicals shall be administered by, or under supervision of, nursing or other personnel in accordance with federal and state laws and regulations, including applicable licensing requirements, and in accordance with the approved medical staff policies and procedures.

(b) With the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per physician-approved hospital policy after an assessment of contraindications, orders for drugs and biologicals shall be documented and signed by a practitioner who is authorized to write orders by hospital policy, and who is responsible for the care of the patient.

1. If verbal orders are used, they are to be used infrequently.

2. When verbal orders are used, they shall only be accepted by persons who are authorized to do so by hospital policy and procedures consistent with federal and state law.

(c) Blood transfusions and intravenous medications shall be administered in accordance with state law and approved medical staff policies and procedures.

(d) There shall be a hospital procedure for reporting transfusion reactions, adverse drug reactions, and errors in administration of drugs.

Ala. Admin. Code r. 420-5-7-.11

Filed September 1, 1982. Amended: Filed May 23, 1986. Repealed and New Rule: Filed November 18, 1994; effective December 23, 1994. Repealed and New Rule: Filed August 24, 2012; effective September 28, 2012. Amended: Filed July 22, 2013; effective August 26, 2013.

Rule .09 was renumbered to .11 as per certification filed August 24, 2012; effective September 28, 2012.

Author: W.T. Geary, Jr., M.D., Carter Sims

Statutory Authority:Code of Ala. 1975, §§ 22-21-20, et seq.