Section 11-94.2-39 - Nursing services(a) Each facility shall have nursing staff sufficient in number and qualifications to meet the nursing needs of the residents. There shall be at least one registered nurse at work full-time on the day shift, for eight consecutive hours, seven days a week, and at least one licensed nurse at work on the evening and night shifts, unless otherwise determined by the department.(b) Nursing services shall include but are not limited to the following:(1) A comprehensive nursing assessment of each resident and the development and implementation of a plan of care within five days of admission. The nursing plan of care shall be developed in conjunction with the physician's admission physical examination and initial orders. A nursing plan of care shall be integrated with an overall plan of care developed by an interdisciplinary team no later than the twenty-first day after, or simultaneously, with the initial interdisciplinary care plan conference;(2) Written nursing observations and summaries of the resident's status recorded, as appropriate, due to changes in the resident's condition, but no less than quarterly; and(3) Ongoing evaluation and monitoring of direct care staff to ensure quality resident care is provided.(c) There shall be a registered nurse designated as the nursing administrator or director of nursing who will be responsible for all nursing services.(d) Should drug or medication administration be delegated pursuant to chapter 16-89, subchapter 15, there shall be documented evidence of a training program, individuals receiving training, and ongoing monitoring and evaluation to assess compliance with requirements.(e) There shall be a policies and procedures manual that is kept current and consistent with current nursing and medical practices and approved by the medical advisor or director and the person responsible for nursing procedures. The policies and procedures shall include but not be limited to:(1) Written procedures for personnel to follow in an emergency including; (A) Care of the resident;(B) Notification of the attending physician and other persons responsible for the resident; and(C) Arrangements for transportation, hospitalization, or other appropriate services;(2) All treatment and care provided relative to the resident's needs and requirements for documentation; and(3) Medication or drug administration procedures that clearly define drug administration process, documentation. and authorized individuals able to administer medications or drugs.Haw. Code R. § 11-94.2-39
[Eff 9/16/2022] (Auth: HRS §§ 321-9, 321-11) (Imp: HRS §§ 321-9, 321-11)