6 Colo. Code Regs. § 1011-1-22-15

Current through Register Vol. 47, No. 11, June 10, 2024

Section 6 CCR 1011-1-22-15 - CLIENT CARE

15.1 Client Rights. The facility shall be compliant with 6 CCR 1011.1, Chapter 2, Part 7.

15.2 Policies and Procedures. The facility shall develop and implement written policies and procedures to provide comprehensive perinatal care for low-risk pregnancy, newborn care and referral of high risk pregnancy consistent with current standards of practice. Policies and procedures shall include, but not be limited to:

(A) parent education, including orientation to the philosophy of care and the scope of services of the facility.

(B) continuous screening for high risk that addresses:

(1) a screening process that includes written criteria for admission of only low risk pregnancies.

(2) the routine evaluation of clients throughout pregnancy to assure that their pregnancy remains low risk.

(3) protocols for referral of high risk persons and newborns to appropriate providers of obstetrical and newborn care.

(C) breastfeeding supportive practices.

(D) availability or actual contact with clinical staff on a 24 hour per day, 7 days per week basis.

15.3 Provision of Care

(A) All persons admitted to the facility shall be under the direct care of a member of the clinical staff and agree to remain at the facility not less than four hours postpartum.

(B) Antenatal Care

(1) There shall be a program of education including provision of information to include, but not be limited to:

(a) anticipated changes during pregnancy.

(b) the signs of preterm labor.

(c) preparation for labor and delivery, including pain management and obstetrical complications and procedures.

(d) feeding options and care of the newborn, including infant safe sleep practices.

(e) signs of depression during pregnancy and after childbirth.

(f) preparation needed for discharge of the client and the newborn following delivery, including referrals associated with ensuring the continuity of care.

(2) Each client shall have a plan of care developed by clinical staff. The plan shall identify the care to be provided and the need for postpartum services. The client shall be involved in reassessments and revisions of the plan that may be required.

(3) Each client shall be assessed for immunity to rubella and counselled on associated risks.

(4) Each client shall undergo prenatal testing in accordance with professional standards of care.

(C) Care During Labor and Delivery

(1) The facility shall provide regular and appropriate assessment of the client and fetus throughout labor.

(2) Anesthesia

(a) Only local anesthesia for episiotomies and repair of lacerations may be provided.

(D) Postpartum Care. Care during the postpartum period shall include, but not be limited to:

(1) Client

(a) maternal assessments and follow up care.

(b) screening and referral for postpartum depression. (2) Newborn

(a) newborn assessments and follow up care.

(b) eye prophylaxis in accordance with Section 25-4-301, C.R.S.

(c) newborn screenings based on current standards of practice as well as in accordance with Section 25-4-1001, et seq., C.R.S. If the facility does not provide newborn hearing screening, it shall provide information regarding where parents may have their infants' hearing screened and the importance of such screening.

(d) a newborn identified with abnormalities shall be referred for appropriate follow up, in accordance with facility policy. The facility shall communicate with the pediatric care provider and transfer birth and newborn records to the pediatric care provider.

15.4 Staffing

(A) There shall be sufficient staff to meet the demands for services routinely provided and coverage during periods of high demand or emergency.

(B) Clinical staff shall be present at each birth and until the client and newborn are stable postpartum. At a minimum, there shall be a second person in addition to the clinical staff, who is a registered nurse with adult and infant resuscitation skills, present during the delivery.

(C) Clinical staff or a registered nurse with adult and infant resuscitation skills shall be present at the facility at all times when a client or newborn is present postpartum through discharge. Additional and sufficient personnel shall be provided when more than one client is in active labor.

6 CCR 1011-1-22-15