N.Y. Public Health Law 2803-V*2 – Standing orders for newborn care in a hospital
* § 2803-v. Standing orders for newborn care in a hospital. 1. A hospital may establish standing orders for the care of newborns in the hospital until the discharge of the newborn from the hospital following the birth, which may authorize an attending nurse to provide services and care to healthy newborns.
Terms Used In N.Y. Public Health Law 2803-V*2
- Hospital: means a facility or institution engaged principally in providing services by or under the supervision of a physician or, in the case of a dental clinic or dental dispensary, of a dentist, or, in the case of a midwifery birth center, of a midwife, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, a rural emergency hospital under 42 USC 1395x(kkk), or successor provisions, dental clinic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home, tuberculosis hospital, chronic disease hospital, maternity hospital, midwifery birth center, lying-in-asylum, out-patient department, out-patient lodge, dispensary and a laboratory or central service facility serving one or more such institutions, but the term hospital shall not include an institution, sanitarium or other facility engaged principally in providing services for the prevention, diagnosis or treatment of mental disability and which is subject to the powers of visitation, examination, inspection and investigation of the department of mental hygiene except for those distinct parts of such a facility which provide hospital service. See N.Y. Public Health Law 2801
- Midwifery birth center: means a hospital engaged principally in providing prenatal and obstetric care, where such services are provided principally by midwives. See N.Y. Public Health Law 2801
2. As used in this section, unless the context clearly requires otherwise:
(a) "Hospital" means a hospital that routinely provides perinatal care to newborns.
(b) "Attending practitioner" means the physician, nurse practitioner, physician assistant or midwife, acting within his or her lawful scope and terms of practice, attending the birth or postnatal care of a newborn in a hospital.
(c) "Attending nurse" means a registered nurse attending the postnatal care of a newborn, acting within his or her lawful scope of practice.
(d) "Standing order" means a non-patient specific order for the care of healthy newborns in the hospital, established under this section.
3. A standing order may be implemented in the case of any newborn when (a) directed by the attending practitioner, or (b) in the absence of a specific direction by the attending practitioner, the attending nurse determines, in his or her professional judgment, that implementing the standing order for the newborn is clinically appropriate and consistent with the standing order, the hospital's policies and applicable regulations. The standing order shall not be implemented in a specific situation where the hospital's policies, the standing order, or applicable regulations provide otherwise.
4. (a) A standing order shall provide for the circumstances in which the condition or change in condition of the newborn or the newborn's mother, or other circumstances relating to providing services and care to the newborn, require departure from the terms of the standing order.
(b) Where an attending nurse implementing a standing order becomes aware of circumstances that, in his or her professional judgment, reasonably indicate a need to depart from the terms of the standing order, he or she shall so advise the attending practitioner. In such circumstances, if the attending nurse determines, in his or her professional judgment, that the health of the newborn requires departing from the standing order prior to receiving direction from the attending practitioner, the attending nurse may do so, consistent with his or her lawful scope of practice, the hospital's policies and applicable regulations.
(c) The standing order shall provide, including the times and manner, that an attending practitioner shall review and acknowledge in writing the services and care provided to the newborn under the standing order and the condition of the newborn.
5. (a) A standing order may provide for circumstances in which it shall not be implemented, or implemented only at the order of an attending practitioner, which may include but not be limited to:
(i) lack of or inadequate prenatal care;
(ii) a birth not attended by an attending practitioner;
(iii) a birth not occurring in a hospital; or
(iv) a premature or low birth weight birth.
(b) A standing order shall be dated, timed, and authenticated promptly in the patient's medical record by the attending practitioner acting in accordance with law, including scope-of-practice laws, hospital policies, and medical staff bylaws, rules and regulations.
6. A standing order may be implemented only if the implementing hospital:
(a) establishes that the order has been reviewed and approved by the hospital's medical staff and nursing and pharmacy leadership, and signed by a physician affiliated with the hospital or, in the case of a midwifery birth center, by a midwife affiliated with the hospital;
(b) demonstrates that the order is consistent with nationally recognized evidence-based guidelines; and
(c) ensures that the periodic and regular review of the order is conducted by the hospital's medical staff and nursing and pharmacy leadership to determine the continuing usefulness and safety of the order.
7. A standing order is a medical regimen; it shall be consistent with the lawful scope of practice of a registered nurse.
8. The commissioner may make regulations governing the terms, procedures and implementation of standing orders.
* NB There are 2 § 2803-v's