Section 79731 - Outpatient Surgical Care-General Requirements(a) If outpatient surgery is performed, the written policies and procedures, approved by the governing body of the correctional treatment center, shall make provision for at least the following: (1) The types of operative procedures that may be performed shall be specified.(2) The types of anesthesia that may be used shall be specified.(3) Preoperative evaluation of the patient, meeting the same standards as apply to inpatient surgery.(5) The delivery of all anatomical parts, tissues and foreign objects removed to a pathologist designated by the hospital with a report of findings to be filed in the patient's medical record.(6) Written preoperative instructions to patients covering: (A) Applicable restrictions upon food and drugs before surgery.(B) Any special preparations to be made by the patient.(C) Any postoperative requirements.(D) An understanding that admission to a hospital may be required in the event of an unforeseen circumstance.(7) Examination of each patient by a physician prior to discharge.(b) Where general anesthesia is to be administered, written policies and procedures shall be developed and maintained by the physician responsible for the service in consultation with other appropriate health professionals and administration. Policies and procedures shall be approved by the administration and medical director. The policies and procedures shall include provision for at least: (1) Preanesthesia evaluation of the patient by a physician or a certified registered nurse anesthetist with appropriate documentation of pertinent information relative to the choice of anesthesia and the surgical or obstetrical procedure anticipated.(2) Review of the patient's condition immediately prior to induction of anesthesia.(3) Safety of the patient during the anesthetic period.(4) Recording of all events taking place during the induction of, maintenance of and emergence from anesthesia, including the amount and duration of all anesthetic agents, other drugs, intravenous fluids and blood or blood fractions.(c) Prior to commencing surgery, the person responsible for administering anesthesia, or the surgeon if a general anesthetic is not be administered, shall verify the patient's identity, the site and side of the body to be operated on, and ascertain that a record of the following appears in the patient's medical record: (1) An interval medical history and physical examination performed and recorded within the previous 24 hours.(2) Appropriate screening tests, based on the needs of the patient, accomplished and recorded within 72 hours prior to surgery.(3) An informed consent, in writing, for the contemplated surgical procedure.(d) The requirements of subsection (c), above, do not preclude rendering emergency medical or surgical care to a patient.(e) A register of operations shall be maintained including the following information for each surgical procedure performed. (1) Name, age, sex and identity number of the patient.(2) Date and time of the operation and the operating room number.(3) Preoperative and postoperative diagnosis.(4) Name of surgeon, assistants, anesthetists and scrub and circulating assistants.(5) Surgical procedure performed and anesthetic agent used.(6) Complications, if any, during the operation.(f) An affiliation agreement or contract for the referral and transfer of patients with emergency medical problems shall be established and available for inspection by the Department.(g) Periodically, the patient care policy committee shall evaluate the services provided and make appropriate recommendations to the medical director and administration.Cal. Code Regs. Tit. 22, § 79731
1. New section filed 6-10-94; operative 1-1-96 pursuant to Health and Safety Code section 1250 (Register 94, No. 23). Note: Authority cited: Sections 208(a), 1205.1(k) and 1267.10(a), Health and Safety Code. Reference: Sections 1250(j) and 1254, Health and Safety Code.
1. New section filed 6-10-94; operative 1-1-96 pursuant to Health and Safety Code section 1250 (Register 94, No. 23).