10.07.02.14-2

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=160 BGCOLOR="#006699" TEXT="#080000" background="16d00a03.jpg"> <div> <I><B>V</B></I><FONT SIZE="6" COLOR="#000080" FACE="Verdana" ><I><B>oices</B></I></FONT><FONT SIZE="6" COLOR="#000080" FACE="TimesRoman" ><I><B> </B></I></FONT><FONT SIZE="5" COLOR="#000080" FACE="Verdana" ><I><B>for Quality Care (LTC), Inc.</B></I></FONT></div> <bR> <div> <B>P.O. 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A respiratory care unit shall meet the:</B></div> <div> <B>(1) General requirements established for all special care units as outlined in Regulation .14-1 of this chapter; and</B></div> <div> <B>(2) Requirements of this regulation.</B></div> <div> <B>B. The facility shall submit to the Department and obtain approval of the following:</B></div> <div> <B>(1) All documents required in Regulation .14-1C of this chapter;</B></div> <div> <B>(2) Policies and procedures for all aspects of care as outlined in Regulation .14-1C(6) of this chapter, and the following:</B></div> <div> <B>(a) Qualifications, duties, and responsibilities of staff, including the staff who are permitted to perform the following procedures:</B></div> <div> <B>(i) Cardiopulmonary resuscitation,</B></div> <div> <B>(ii) Obtaining arterial blood gas samples and their analyses,</B></div> <div> <B>(iii) Pulmonary function testing,</B></div> <div> <B>(iv) Therapeutic percussion and vibration,</B></div> <div> <B>(v) Bronchopulmonary drainage,</B></div> <div> <B>(vi) Coughing and breathing exercises,</B></div> <div> <B>(vii) Mechanical ventilatory and oxygenation support for residents, and</B></div> <div> <B>(viii) Aerosol, humidification, and medical gas administration;</B></div> <div> <B>(b) Weaning from mechanical ventilatory support and discharge planning for residents of the respiratory care unit; and</B></div> <div> <B>(c) The procurement, handling, storage, and dispensing of medical gases.</B></div> <div> <B>C. Physician Coordinator. If the facility's medical director does not have special training and experience in diagnosing, treating, and assessing respiratory problems, the facility shall hire a physician who has the special knowledge and experience to provide:</B></div> <div> <B>(1) Overall medical supervision of the respiratory care unit; and</B></div> <div> <B>(2) Coordination of all services for the respiratory care unit.</B></div> <div> <B>D. Staffing. The facility shall ensure that:</B></div> <div> <B>(1) Respiratory care services are provided by a sufficient number of qualified personnel;</B></div> <div> <B>(2) Respiratory care personnel provide respiratory care services commensurate with their documented training, experience, and competence; and</B></div> <div> <B>(3) As appropriate, respiratory care personnel are competent in the following:</B></div> <div> <B>(a) The fundamentals of cardiopulmonary physiology and of fluids and electrolytes,</B></div> <div> <B>(b) The recognition, interpretation, and recording of signs and symptoms of respiratory dysfunction and medication side effects, particularly those that require notification of a physician,</B></div> <div> <B>(c) The initiation and maintenance of cardiopulmonary resuscitation and other related life-support procedures,</B></div> <div> <B>(d) The mechanics of ventilation and ventilator function,</B></div> <div> <B>(e) The principles of airway maintenance, including endotracheal and tracheostomy care,</B></div> <div> <B>(f) The effective and safe use of equipment for administering oxygen and other therapeutic gases and for providing humidification, nebulization, and medication,</B></div> <div> <B>(g) Pulmonary function testing and blood gas analysis, when these procedures are performed within the respiratory care unit,</B></div> <div> <B>(h) Methods that assist in the removal of secretions from the bronchial tree, such as hydration, breathing and coughing exercises, postural drainage, therapeutic percussion and vibration, and mechanical clearing of the airway through proper suctioning technique,</B></div> <div> <B>(i) Procedures and observations to be followed during and after extubation, and</B></div> <div> <B>(j) Recognition of and attention to the psychosocial needs of residents and their families.</B></div> <div> <B>E. Design.</B></div> <div> <B>(1) Emergency Power. The facility unit shall meet all applicable requirements in Regulation .26F of this chapter for emergency electrical power, including the provision of:</B></div> <div> <B>(a) Emergency lighting in the respiratory care unit where life support equipment is used; and</B></div> <div> <B>(b) Duplex receptacles connected to the facility's emergency generator to provide emergency power to operate life support equipment and nonflammable medical gas systems in the respiratory care unit.</B></div> <div> <B>(2) Ventilator Alarms. The facility shall ensure that each ventilator is equipped with an alarm on both the pressure valve and the volume valve for safety.</B></div> <div> <B>F. The facility shall provide pulmonary function testing, and blood gas or pulse analysis capability onsite or through contractual arrangements with providers who meet applicable State and federal laws and regulations.</B></div> <div> <B>G. Contractual Services. When any respiratory care services are provided by an outside contractor, the facility shall:</B></div> <div> <B>(1) Approve the contractor based on the contractor's credentials, training, and experience;</B></div> <div> <B>(2) Ensure that all contractors:</B></div> <div> <B>(a) Provide services 24 hours a day,</B></div> <div> <B>(b) Meet all safety requirements,</B></div> <div> <B>(c) Abide by all pertinent policies and procedures of the facility,</B></div> <div> <B>(d) Provide services in accordance with all laws and regulations governing the facility, and</B></div> <div> <B>(e) Participate in the monitoring and evaluation of the appropriateness of services provided as required by the facility's quality assurance program; and</B></div> <div> <B>(3) Ensure that all contractual services receive overall medical supervision and coordination by the facility's physician coordinator of the respiratory care unit.</B></div> <bR> </td> </tr></table></body>