N.J. Admin. Code § 8:43G-19.1

Current through Register Vol. 56, No. 21, November 4, 2024
Section 8:43G-19.1 - Scope of obstetrical standards-definitions; structural organization
(a) The standards in this subchapter shall apply only to hospitals that have a separate, designated unit or service for obstetrics.
(b) The following terms, when used in this subchapter, shall have the following meanings:

"Advanced practice nurse" means a licensed registered professional nurse with certification in a specialty requiring expertise in maternal and child health who has been certified by the New Jersey Board of Nursing as specified in N.J.A.C. 13:37-7.

"American Nurses Credentialing Center" means an organization that is a subsidiary of the American Nurses Association, which certifies nurses in specialty practice areas, and for which the contact information is American Nurses Credentialing Center, 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492. Phone: (800) 284-2378. Website: http://www.nursecredentialing.org.

"Birth center" means an ambulatory care facility or a distinct part of a facility which is separately licensed as an ambulatory care facility and provides routine prenatal and intrapartal care. These facilities provide care to low-risk maternity patients who are expected to deliver neonates of a weight greater than 2,499 grams and at least 37 weeks gestational age and who require a stay of less than 24 hours after birth.

"Boarder baby" means an infant abandoned in a hospital, or an infant still in the nursery after the mother's discharge for any reason, even if only temporarily.

"Clinical Practice Guidelines for Management of Hyperbilirubinemia" means the clinical practice guidelines established by the American Academy of Pediatrics Subcommittee on Hyperbilirubinemia, as set forth in "Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation." Pediatrics. 2004; 114(1); 297-316, incorporated herein by reference, as amended and supplemented, and available at http://pediatrics.aappublications.org/content/114/1/297.

"Community Perinatal Center" (CPC) means a licensed hospital designated within a Maternal and Child Health Service Region as one of the following:

1. "Basic" provides care to uncomplicated maternity patients and neonates in accordance with the scope of functions delineated in its formal letter of agreement with the Regional Perinatal Center. Such a facility shall provide care to patients expected to deliver neonates greater than 2,499 grams and at least 36 weeks gestation.
2. "Intermediate" provides care to complicated maternity patients and neonates in accordance with the scope of functions delineated in its letter of agreement with the Regional Perinatal Center. Such a facility shall provide care to patients expected to deliver neonates greater than 1,499 grams and at least 32 weeks gestation.
3. "Intensive" provides care to complicated maternity patients and neonates in accordance with the scope of functions delineated in its letter of agreement with the Regional Perinatal Center. Such a facility shall provide care to patients expected to deliver neonates greater than 999 grams and at least 28 weeks gestation.

"Construction Guidelines means the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities, 2014 edition. Facility Guidelines Institute; American Society for Healthcare Engineering, which is incorporated herein by reference, as amended and supplemented, and is available from the Facility Guidelines Institute, Inc., 350 N. Saint Paul St., Suite 100, Dallas, TX 75201. Website: www.fgiguidelines.org. E-mail: info@fgiguidelines.org.

"Contact hour" means a unit of measurement that describes 50 minutes of an approved, organized learning experience, either didactic or clinical practice.

"Core competencies" means the knowledge, skills, and judgment that a hospital determines to be essential to ensure the proficiency of staff in the independent performance of a particular patient care service.

"Expression" means a manual technique accomplished with the aid of an external device (that is a breast pump) to extract milk from a lactating woman.

"Formula" means infant formula as that term is defined at 21 U.S.C. § 321(z), which is incorporated herein by reference.

"Formula supplementation" means the practice of feeding breastfed infants prior to six months of age commercially prepared infant formula in addition to, or as a substitute for, breast milk.

"Gifts and promotional materials" means products and information provided free by commercial vendors or by hospitals for distribution to new mothers. These items may include infant formula, diaper bags, nursing pads, cooler packs for expressed breast milk or formula, and printed materials regarding infant feeding.

"Hand expression" means a manual technique to extract breast milk from a lactating woman that is accomplished without the aid of an external device.

"Implementing the Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding" means the publication developed by the United States Breastfeeding Committee to facilitate exclusive breastfeeding in hospitals, for which citation to the current edition is, Implementing the Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding, Rev. ed., Washington, D.C.: United States Breastfeeding Committee; 2010, which is incorporated herein by reference, as amended and supplemented and which can be accessed at: http://www.usbreastfeeding.org/Portals/0/Publications/Implementing-TJC-Measure-EBMF-2010-USBC.pdf;

"International Board of Lactation Consultant Examiners" means the independent international certification body that confers the International Board Certified Lactation Consultant (IBCLC) credential, and for which the contact information in the United States is International Board of Lactation Consultant Examiners in the Americas, 10301 Democracy Lane, Suite 400, Fairfax, VA 22030. Phone: (703) 560-7330. Fax: (703) 560-7332. Website: http://iblce.org/. E-mail: iblce@iblce.org.

"Lactation consultant" means an individual who is qualified to use the credential, "IBCLC," denoting certification as a lactation consultant conferred by the International Board of Lactation Consultant Examiners.

"Lactation support room" means a room designated for consultations, expression of breast milk, and/or breastfeeding, or a private space designated on a temporary basis for such purposes.

"Latch" means the attachment of a newborn to the breast for breastfeeding.

"LDR room" means a labor-delivery-recovery room designed to accommodate the birthing process from labor through delivery and recovery of a mother and her infant.

"Letter of agreement" means the document which defines the relationship between a Regional Perinatal Center and a Community Perinatal Center and specifies all tasks to be provided. This document must be developed in cooperation with the Maternal and Child Health Consortia in the region and signed by both facilities.

"Maternal postpartum room" means an obstetrics patient room where a mother stays after the birth of her newborn.

"Member in good standing" means that an acute care hospital has made timely payment of Maternal and Child Health Consortium (MCHC) financial assessments in accordance with the MCHC by-laws, which are based on a budget approved by the Department.

"Mother-infant room" means an obstetrics patient room where mother(s) and infant(s) stay after delivery and receive care in this continuously rooming-in space during the post-partum period. The room shall comply with the space requirement indicated in the Construction Guidelines.

"National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialties" means the not-for-profit organization that provides a national credentialing program for nurses in the obstetric, gynecologic, and neonatal nursing specialties, and for which the contact information is National Certification Corporation, 676 N. Michigan Ave, Suite 3600, Chicago, IL 60611. Phone: (312) 951-0207. Website: www.nccwebsite.org. E-mail: info@nccnet.org.

"Obstetric patient" means a female patient at any stage of pregnancy, including antepartum, and up to six weeks post partum, whose primary diagnosis is related to the management of labor, pregnancy complications or complications of the puperium.

"Perinatal" means occurring in, concerned with, or being in the period around the time of birth.

"Risk reduction specialist" means a registered professional nurse, a licensed or certified social worker or other professional in a maternal and child health addiction related field, who has specialized training and experience in perinatal addiction.

"Rooming-in" means the practice of placing the newborn(s) with the mother in the "maternal postpartum room" or "mother-infant room" 24 hours a day to facilitate maternal-infant bonding and breastfeeding on demand, as applicable, and to allow patient care to be given to mother and infant in the same room.

"United States Breastfeeding Committee" means the independent nonprofit organization whose mission is to improve the nation's health by working collaboratively to protect, promote, and support breastfeeding, and for which the contact information is United States Breastfeeding Committee, 4044 N Lincoln Ave, # 288, Chicago, IL 60618. Phone: (773) 359-1549. Fax: (773) 313-3498. Website: http://www.usbreastfeeding.org. E-mail: office@usbreastfeeding.org.

(c) All hospitals with obstetric services shall satisfy the following conditions:
1. The hospital shall be designated as a Community Perinatal Center or a Regional Perinatal Center; and
2. The hospital shall be a member in good standing of a Maternal and Child Health Consortium.
(d) All hospitals shall provide services in accordance with a letter of agreement facilitated by the Maternal Child Health Consortium for its region. Such services shall include:
1. Prenatal and pediatric services in accordance with the HealthStart Standards, N.J.A.C. 10:49-3; and
2. Routine prenatal care which incorporates use of a comprehensive standardized perinatal record.
(e) All Community Perinatal Centers shall have a written protocol which addresses the management of patients assessed to be at risk during the prenatal period. This protocol shall assure referral of the patient to a provider with advanced capabilities in maternal-fetal medicine for initial consultation and, if appropriate, treatment.
(f) All Regional Perinatal Centers shall have a distinct prenatal clinic service devoted to women identified as high risk. This clinic shall be staffed by an advanced practice nurse on-site and a risk reduction specialist available during hours of operation. One individual may fill both positions.
(g) All Regional Perinatal Centers shall provide high risk infant follow-up service accordance with N.J.A.C. 8:33C.

N.J. Admin. Code § 8:43G-19.1

Amended by 50 N.J.R. 552(b), effective 1/16/2018