16 Del. Admin. Code § 3375-9.0

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

Section 3375-9.0 - Quality Assurance

9.1 A Quality Assurance Committee shall be established and shall include a Board-certified pediatrician familiar with PPECC services, a registered nurse with special expertise in the care of medically/technologically dependent children, and one of the following: a developmentalist, child life specialist, or a social worker with expertise in the care of medically/technologically dependent children and their families.

9.2 All PPECCs shall have a quality assurance program and its QA Committee shall conduct quarterly reviews of the complete records for at least half of the children served by the PPECC at the time of the quality assurance review.

9.3 Each quarterly review shall include:

9.3.1 A review of the goals in each child's protocol;

9.3.2 A review of the steps, process, and success in achieving the goals;

9.3.3 Identification of goals not being achieved as expected, reasons for lack of achievement and plans to promote goal achievement;

9.3.4 Documentation of the results of the quality assurance review and records review.

9.3.5 Within fifteen (15) working days of its review, the Quality Assurance Committee shall furnish copies of its report to the PPECC medical and nursing directors.

9.3.6 Evidence that revisions have been made as recommended by the quality assurance report shall be forwarded to the Quality Assurance Committee within one week.

9.3.7 Implementation of the revisions to the protocol shall be documented on the child's record.

9.3.8 Maintenance of a high standard of patient care shall be evidenced by:

9.3.8.1 Case record for each child containing:

9.3.8.1.1 Comprehensive protocol for care specifying the goals for care and methods for goalachieving and time frame for reviewing and revising the plan;

9.3.8.1.2 A properly executed consent form;

9.3.8.1.3 A medical history for the child including notations from visits to health care providers and copy of a recent physical exam (updated annually);

9.3.8.1.4 Immunization record, documentation of allergies and special precautions;

9.3.8.1.5 Physician orders, properly signed;

9.3.8.1.6 Flow chart of treatment administered;

9.3.8.1.7 Concise, accurate information and initialed case.notes reflecting-progress toward protocol goal achievement or reasons for lack of progress;

9.3.8.1.8 Documentation of nutritional management and special diets, as appropriate;

9.3.8.1.9 Documentation of physical, occupational, speech and/or other special therapies.

9.3.8.2 Evidence of parent(s) or guardian(s) involvement including:

9.3.8.2.1 Pre-admission planning to develop a protocol for care to be rendered in the PPECC;

9.3.8.2.2 Interdisciplinary staffing conferences shall be scheduled on monthly or as necessary basis;

9.3.8.2.3 parent(s) or guardian(s) training and education, including:

9.3.8.2.3.1 Clearly written, practical and appropriately targeted training materials;

9.3.8.2.3.2 Scheduled individual and/or group education sessions for parent(s) or guardian (s) and other family members.

9.3.8.2.3.3 Evidence of formal discharge procedure, including:

9.3.8.2.3.3.1 Documentation that placement in the PPECC is no longer appropriate for the child;

9.3.8.2.3.3.2 Physician's discharge order;

9.3.8.2.3.3.3 Notification of anticipated discharge to the other agencies involved in the child's care;

9.3.8.2.3.3.4 Evidence of a pre-discharge conference involving the parent(s) or guardian(s), representatives of the PPECC professional staff and agencies involved in child care after discharge.

9.3.8.2.3.3.5 A written discharge summary signed by the primary physician and nursing director of the PPECC must be prepared within 1 week of the child's discharge.

9.3.8.2.4 Evidence of the disposition procedure to be followed in the event of an emergency medical situation.

16 Del. Admin. Code § 3375-9.0

25 DE Reg. 779( 2/1/2022) (final)