§ 2803-V*2 — Standing orders for newborn care in a hospital

* § 2803-v. Standing orders for newborn care in a hospital. 1. A\nhospital may establish standing orders for the care of newborns in the\nhospital until the discharge of the newborn from the hospital following\nthe birth, which may authorize an attending nurse to provide services\nand care to healthy newborns.\n 2. As used in this section, unless the context clearly requires\notherwise:\n (a) "Hospital" means a hospital that routinely provides perinatal care\nto newborns.\n (b) "Attending practitioner" means the physician, nurse practitioner,\nphysician assistant or midwife, acting within his or her lawful scope\nand terms of practice, attending the birth or postnatal care of a\nnewborn in a hospital.\n (c) "Attending nurse" means a registered nurse attending the postnatal\ncare of a newborn, acting within his or her lawful scope of practice.\n (d) "Standing order" means a non-patient specific order for the care\nof healthy newborns in the hospital, established under this section.\n 3. A standing order may be implemented in the case of any newborn when\n(a) directed by the attending practitioner, or (b) in the absence of a\nspecific direction by the attending practitioner, the attending nurse\ndetermines, in his or her professional judgment, that implementing the\nstanding order for the newborn is clinically appropriate and consistent\nwith the standing order, the hospital's policies and applicable\nregulations. The standing order shall not be implemented in a specific\nsituation where the hospital's policies, the standing order, or\napplicable regulations provide otherwise.\n 4. (a) A standing order shall provide for the circumstances in which\nthe condition or change in condition of the newborn or the newborn's\nmother, or other circumstances relating to providing services and care\nto the newborn, require departure from the terms of the standing order.\n (b) Where an attending nurse implementing a standing order becomes\naware of circumstances that, in his or her professional judgment,\nreasonably indicate a need to depart from the terms of the standing\norder, he or she shall so advise the attending practitioner. In such\ncircumstances, if the attending nurse determines, in his or her\nprofessional judgment, that the health of the newborn requires departing\nfrom the standing order prior to receiving direction from the attending\npractitioner, the attending nurse may do so, consistent with his or her\nlawful scope of practice, the hospital's policies and applicable\nregulations.\n (c) The standing order shall provide, including the times and manner,\nthat an attending practitioner shall review and acknowledge in writing\nthe services and care provided to the newborn under the standing order\nand the condition of the newborn.\n 5. (a) A standing order may provide for circumstances in which it\nshall not be implemented, or implemented only at the order of an\nattending practitioner, which may include but not be limited to:\n (i) lack of or inadequate prenatal care;\n (ii) a birth not attended by an attending practitioner;\n (iii) a birth not occurring in a hospital; or\n (iv) a premature or low birth weight birth.\n (b) A standing order shall be dated, timed, and authenticated promptly\nin the patient's medical record by the attending practitioner acting in\naccordance with law, including scope-of-practice laws, hospital\npolicies, and medical staff bylaws, rules and regulations.\n 6. A standing order may be implemented only if the implementing\nhospital:\n (a) establishes that the order has been reviewed and approved by the\nhospital's medical staff and nursing and pharmacy leadership, and signed\nby a physician affiliated with the hospital or, in the case of a\nmidwifery birth center, by a midwife affiliated with the hospital;\n (b) demonstrates that the order is consistent with nationally\nrecognized evidence-based guidelines; and\n (c) ensures that the periodic and regular review of the order is\nconducted by the hospital's medical staff and nursing and pharmacy\nleadership to determine the continuing usefulness and safety of the\norder.\n 7. A standing order is a medical regimen; it shall be consistent with\nthe lawful scope of practice of a registered nurse.\n 8. The commissioner may make regulations governing the terms,\nprocedures and implementation of standing orders.\n * NB There are 2 § 2803-v's\n