16 Del. Admin. Code § 3355-7.0

Current through Register Vol. 28, No. 3, September 1, 2024

Section 3355-7.0 - General Patient Care Management

7.1 The admission policies shall be discussed with each patient entering the FSSC or their representative, if applicable.

7.2 The FSSC must develop and maintain a policy that identifies those patients who require a medical history and physical examination prior to surgery. The policy must:

7.2.1 Include the timeframe for medical history and physical examination to be completed prior to surgery.

7.2.2 At a minimum, address the following factors:

7.2.2.1 Patient age;

7.2.2.2 Diagnosis;

7.2.2.3 The type and number of procedures scheduled to be performed on the same surgery date;

7.2.2.4 Known comorbidities;

7.2.2.5 Planned anesthesia level; and

7.2.2.6 Be based on nationally recognized standards of practice and guidelines.

7.3 Upon admission to the FSSC, each patient must have a pre-surgical assessment completed by the physician or licensed independent practitioner. The patient's medical record must include documentation that the patient was examined prior to the commencement of surgery for changes since the comprehensive medical history and physical assessment.

7.4 Surgical procedures must be performed in a safe manner and in accordance with acceptable standards of practice.

7.5 Before discharge from the FSSC, each patient must be evaluated by a physician or certified registered nurse anesthetist for proper anesthesia recovery. It is expected that a patient will actually leave the FSSC within 15 - 30 minutes of the time when the physician signs the discharge order.

7.6 The FSSC must provide each patient with written discharge instructions and overnight supplies. Patients shall be informed, prior to leaving the FSSC, of their prescriptions, post-operative instructions, and physician contact information for follow-up care. When appropriate, the FSSC shall make a follow-up appointment for the patient with their physician.

7.7 The FSSC shall provide nutritional services for patients as follows:

7.7.1 Assure the availability of meals, beverages and supplemental snacks in accordance with each patient's individual needs.

7.7.2 Provide or make arrangements for a minimum of one (1) meal which is of suitable quality and quantity for patients who are in the FSSC for six (6) or more hours. The meal shall meet at least 1/3 of an adult's current recommended dietary allowance (RDA) of the Food and Nutrition Board, National Academy of Sciences-National Research Council.

7.7.3 Provide or make arrangements for a minimum of two (2) meals which are of suitable quality and quantity for patients who are in the FSSC for 12 or more hours. The meals shall meet at least 2/3 of an adult's current recommended dietary allowance (RDA) of the Food and Nutrition Board, National Academy of Sciences-National Research Council.

7.7.4 Provide therapeutic diets as necessary in accordance with each patient's individual needs.

7.7.5 Meals prepared on-site must be approved by a dietitian.

7.7.6 All employees/contractors involved in direct patient care shall be trained on basic and special nutritional needs and proper food handling techniques. Training shall be part of the initial orientation and shall be conducted annually thereafter.

7.7.7 Appropriate food containers and utensils shall be available as needed for use by disabled patients.

7.7.8 The provision and consumption of meals and snacks shall be documented in the patient's medical record.

7.8 There must be healthcare professionals with specialized training or experience in emergency care including current Advance Cardiac Life Support certification, available in the FSSC to provide emergency treatment at all times when patients are present.

16 Del. Admin. Code § 3355-7.0

25 DE Reg. 627( 12/1/2021) (final)