Nursing Services Requirements for the State of Hawaii
§11-94-23 Nursing services. (a) Each
facility shall have nursing staff sufficient in number and
qualifications to meet the nursing needs of the patients. In a
skilled nursing facility there must be at least one registered
nurse, full time, twenty-four hours per day, seven days a week.
In an intermediate care facility there must be at least one
registered nurse, full time on the day shift and at least one
licensed nurse whenever medications are administered.
(b) Nursing services shall include at least
the following:
(1) Assessment of each patient and
development and implementation of an appropriate plan of care.
(2) A nursing care plan incorporated in the
overall patient care plan and reviewed at least as often as the
patient is certified and recertified for a level of care.
(3) Nursing observations and summaries of
the patient's status recorded monthly or more frequently if
appropriate due to changes in patient's condition.
(4) Completion of all physicians’ orders
with appropriate documentation.
(5) Restorative and preventive nursing care
including patient education as appropriate for each patient.
(6) Supportive services to patients to
enable them to participate fully in appropriate daily
activities.
(7) Physical care to keep patients clean,
comfortable, well-groomed, and protected from accidents and
infections. As appropriate, patients shall be
dressed in their own clothes appropriate to the activity in
which they are engaged.
(8) Proper care to prevent or treat
decubitis ulcers and deformities.
(9) Weighing each patient at least monthly
and height taken upon admission.
(10) Coordination of an overall plan of
care for each patient, consonant with the attending physician's
medical care plan, and developed by the disciplines providing
services in the facility.
(11)
Physical restraint shall be used only under a physician's orders
for specified and limited period of time and shall be so
documented.
(A) If
they are used in an emergency situation, the attending physician
shall be contacted immediately for orders supporting the
temporary need
(B)
Regular observation and release of a patient shall be required
while restraints are in use.
(C) No
restraints with locking devices shall be used.
(D) There shall be written policies and procedures governing the
use of restraints.
(c)
There shall be an appropriately
equipped nurses' station in each unit. At a minimum it shall
include a telephone, writing space, storage cabinets, and
medical record space.
(d) There
shall be a nurses' call system which registers calls within
hearing range and directly visible by on-duty personnel.
(e) There
shall be appropriately equipped utility rooms within each
nursing unit or on each patient floor.
[Eff. May 3, 1985 ] (Auth: HRS §§321-9, 321-11) (Imp: HRS
§§321-9, 321-11) |
