N.J. Admin. Code § 8:43A-28.8

Current through Register Vol. 56, No. 23, December 2, 2024

Section 8:43A-28.8 - Additional patient care services

(a) A certified nurse-midwife and/or physician shall perform an initial physical assessment of the patient and an evaluation of the patient's medical and emotional needs.

(b) A certified nurse-midwife and/or physician shall develop and implement a plan of care, if needed, for each patient with the patient's participation. The plan shall include at least care and treatment to be provided for the duration of the pregnancy, including laboratory studies and provision for the patient's health, psychosocial and nutritional needs.

(c) Each patient shall have at least the following prenatal laboratory tests and diagnostic procedures performed:

1. Urinalysis for glucose and protein;

2. Hemoglobin and hematocrit repeated at 28 weeks;

3. Sickle cells preparation (when appropriate);

4. Rh factor and blood typing;

5. Serological test for syphilis at the first prenatal visit, and in the last trimester of pregnancy or at delivery. If the patient is exposed to an infected partner, a serological test for syphilis shall be performed no sooner than three weeks after exposure;

6. Papanicolaou smear at the first prenatal visit if not documented within the previous six months;

7. Tuberculin test with indicated follow-up if in close contact with a diagnosed case of tuberculosis or from a high-incidence area so designated by the Department;

8. Rubella titer. If this is negative, rubella vaccine with appropriate counseling regarding timing of future pregnancies shall be offered to the patient after delivery and prior to discharge from the birth center;

9. One hour glucose tolerance test at 28 weeks gestation, if indicated by risk factors;

10. Maternal serum alpha-fetoprotein testing offered at 15 to 20 weeks; and

11. Hepatitis B virus screen with appropriate follow-up.

(d) Each patient shall be individually counseled about her progress in pregnancy by a certified nurse-midwife, physician, or a registered professional nurse at every visit, and a progress note shall be recorded in the patient's medical record.

(e) Each patient shall be examined at least once a month during the first seven months of gestation. Thereafter, the patient shall be seen every two weeks until 36 weeks and once a week thereafter. The examination shall be performed by either a certified nurse midwife or a physician.

(f) The results of all tests performed during patient examinations shall be documented in the patient's medical record including at a minimum: blood pressure, weight, dipstick urine analysis for glucose and protein, uterine growth, fetal heart rate, abdominal inspection and palpation, any unusual symptoms reported by the patient, and any physical evidence of abnormality. Evaluation of nutritional status and breast and pelvic examinations shall be documented on a regular basis. The medical record shall be in conformance with 8:33C-4.3.

N.J. Admin. Code § 8:43A-28.8