W. Va. Code R. § 69-9-13

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 69-9-13 - NON-PHARMACOLOGICAL INTERVENTIONS

13.1. The center shall provide patients a low stimulus environment to go through the withdrawal process in a safe manner without additional discomfort.

13.2. The center shall use therapeutic handling techniques, as tolerated, upon admission. Therapeutic handling consists of the following techniques:

13.2.a. Swaddling;

13.2.b. C-Position;

13.2.c. Head-to-Toe Movement;

13.2.d. Vertical Rocking;

13.2.e. Clapping;

13.2.f. Feeding;

13.2.g. Controlling the Environment; and

13.2.h. Introducing Stimuli.

13.3. The center shall ensure all caregivers will use soft voices and slow movements when handling patients.

13.4. The center shall provide an environment with low lighting, as needed by the patient.

13.5. The center shall maintain a quiet environment at all times.

13.6. The center shall educate parents and/or legal representative on the first visit about the low stimulus environment.

13.7. The center shall provide a consistent routine for all patients.

13.8. The center shall increase the amount of stimuli, including visual, auditory and tactile, as tolerated by the patient and according to the plan of care.

13.9. Feeding.

13.9.a. Prepared bottles shall be capped and clearly labeled with the patient's name, contents and the date prepared;

13.9.b. Prepared bottles shall be refrigerated in a separate section of the refrigerator and accessible only to employees;

13.9.c. Formula shall be stored in containers specific to the purpose;

13.9.d. Formula that remains at a temperature greater than 41 degrees Fahrenheit for more than one hour shall be discarded;

13.9.e. Formula bottles shall be used within timeframes established by the manufacturer and listed on the package; and

13.9.f. A microwave oven is not permitted for the heating of formula bottles under any circumstances.

13.9.g. A center shall have a planned three-day emergency food and water supply, and this may be incorporated with the regular stock of supplies.

13.10. Bathing.

13.10.a. The facility shall have a policy outlining the center's procedure for bathing patients in their care.

13.10.b. The center shall have a policy outlining the center's procedure for cleaning and disinfecting patient bathtubs.

13.11. Transportation.

13.11.a. The center shall have a policy to ensure the safety of the patient during transportation. 13.11 .b. Qualified employees shall ensure each patient is secured in an approved rear-facing car seat.

13.12. Physician and Physician Services.

13.12.a. A physician shall approve in writing a recommendation for a person to be admitted to a neonatal abstinence center. Each patient shall remain under the care of an attending physician.

13.12.b. Physician supervision. A center shall ensure the medical care of each patient is supervised by a physician.

13.12.c. Physician visits. The physician shall:

13.12.c.1. Review the patient's plan of care, including medications and treatments, and examine the patient personally at each visit required under the provision of this rule;

13.12.c.2. Write, sign and date progress notes at each visit; and

13.12.c.3. Sign and date all orders.

13.12.d. Frequency of physician visits. The patient shall be seen face-to-face by a physician:

13.12.d.1. Within 24 hours of admission; and

13.12.d.2. At least twice per week, or more frequently as indicated by the needs of the patient.

13.12.e. Except as provided under the provisions of this rule, all required physician visits shall be made by the physician personally.

13.12.f Availability of physician for emergency care. A center shall provide or arrange for the provision of physician services 24 hours a day, in case of an emergency.

13.12.g. Physician delegation of tasks. Except as specified under the provisions of this rule, a physician may delegate tasks to a physician assistant, nurse practitioner, or clinical nurse specialist who:

13.12.g.1. Is licensed by the State;

13.12.g.2. Is acting within their scope of practice; and

13.12.g.3. Is under the supervision of the physician.

W. Va. Code R. § 69-9-13