44:69:05:01.  Practitioner services. Each birth center shall have an organized practitioner service. At least one physician, certified nurse midwife, or registered nurse shall be on duty in the birth center at all times if a client is in active labor. Each licensed practical nurse and other nursing personnel involved in client care shall be under the direct supervision of a physician, certified nurse midwife, or registered nurse.

 

          Source: 38 SDR 115, effective January 9, 2012.

          General Authority: SDCL 34-12-62(2).

          Law Implemented: SDCL 34-12-62(2).

 

          44:69:05:02.  Emergency care. Each birth center shall establish and implement policies and procedures for emergency care and arrange for transport to a licensed hospital sufficiently close to provide prompt care to the birth center's clients if needed.

 

          Source: 38 SDR 115, effective January 9, 2012.

          General Authority: SDCL 34-12-62(3) and (12).

          Law Implemented: SDCL 34-12-62(3) and (12).

 

          44:69:05:03.  Emergency equipment and procedures to provide emergency care. Each birth center shall have in effect a transfer protocol with one or more hospitals sufficiently close to provide prompt inpatient hospital care to the center's clients if needed. The protocol shall provide for an interchange of medical and other information necessary or useful in the care and treatment of individuals transferred between the facilities.

 

          Each birth center shall have:

 

          (1)  Readily accessible emergency carts or trays for the mother and newborn equipped to carry out the written emergency procedure of the center and securely placed with a written log of routine maintenance for readiness;

 

          (2)  Properly maintained equipment and supplies for routine and emergency care of women and newborn including:

 

               (a)  Oxygen with flow meters and masks or equivalent;

               (b)  Mechanical suction and bulb suction;

               (c)  Cardiopulmonary resuscitation cart, including:

 

                      (i)      Resuscitation bags for mother and newborn;

                      (ii)     Endotrachael tubes for mother and newborn;

                      (iii)    Oral airways;

                      (iv)    Needles;

                      (v)     Syringes;

                      (vi)    Emergency drugs;

                      (vii)   Laryngoscope;

                      (viii)  Equipment for delivering positive pressure oxygen; and

                      (ix)    Cardiac monitor/defibrillator unit or automated external defibrillator;

 

               (d)  Emergency medications, intravenous fluids, and related supplies and equipment for both mother and newborn;

               (e)  Electronic fetal monitoring equipment;

               (f)  Infant scale;

               (g)  Sterile suturing equipment and supplies;

               (h)  Log book for registration of birth that contains the following information:

 

                      (i)      Mother's name;

                      (ii)     Client medical record number;

                      (iii)    Date of delivery;

                      (iv)    Time of delivery;

                      (v)     Mother's age;

                      (vi)    Gravida, Para;

                      (vii)    Newborn weight;

                      (viii)   Newborn sex;

                      (ix)    Gestational age;

                      (x)     Transport information:

 

                                  1)  Mother;

                                  2)  Baby;

                                  3)  Where;

                                  4)  When; and

                                  5)  By whom;

 

                      (xi)    Death information:

 

                                  1)  Neonatal;

                                  2)  Maternal; or

                                  3)  Stillbirth;

 

                      (xii)  Type of delivery;

                      (xiii)  Condition of newborn at delivery/congenital anomalies;

                      (xiv)  Delivering person; and

                      (xv)   APGAR score;

 

               (i)  Sphygmomanometer, stethoscope, and fetoscope; and

               (j)  Any other equipment necessary to provide full scope of service and to ensure safety of mother and newborn.

 

          Source: 38 SDR 115, effective January 9, 2012.

          General Authority: SDCL 34-12-62(3), (4), and (12).

          Law Implemented: SDCL 34-12-62(3), (4), and (12).

 

          44:69:05:04.  Clinical policies and procedures. Each birth center shall establish and maintain policies and procedures, and practices to govern care, and related medical or other services necessary to meet the client's needs. The nursing service of the birth center shall provide safe and effective care through ongoing assessment and monitoring for each client and newborn, including medical, physical, mental, and emotional needs. The birth center shall establish and implement procedures for assessment and management of symptoms including pain. The policies shall include the following:

 

          (1)  Client eligibility criteria, including detailed definitions of screening criteria for, and procedures for identifying:

 

               (a)  Low-risk maternal clients who shall be eligible for birth services offered by the birth center;

               (b)  Persons who shall be ineligible for birth services at the birth center;

 

          (2)  Written plans and procedures for consultation, backup services, transfer and transport of a newborn or maternal client to a hospital where appropriate care is available;

 

          (3)  Policies and procedures developed for routine and for emergency care of both the maternal and the fetus or newborn client until completion of care by the birth center either through completion of the care program or through transfer to other levels of care;

 

          (4)  Written evidence of the availability of emergency transport services for clients;

 

          (5)  Staffing competency criteria;

 

          (6)  Provision for the education, orientation and training of clients, family and support persons in pregnancy, childbirth, and newborn care;

 

          (7)  Procedures for the registration of births and the examination for and the reporting of congenital physical and mental impairments in infants;

 

          (8)  Prophylactic treatment of the eyes of the newborn as required by SDCL chapter 34-24;

 

          (9)  Testing for metabolic diseases as required by SDCL chapter 34-24;

 

          (10)  Informed consent and disclosure requirements;

 

          (11)  Client care for the mother and newborn, including criteria for monitoring and assessment during all stages of labor and delivery;

 

          (12)  Transport protocols and physician referral protocols;

 

          (13)  Discharge criteria for mother and newborn, to include information on and access to client follow-up care;

 

          (14)  Assigning the nursing care of clients and newborns;

 

          (15)  Client rights policies;

 

          (16)  Administration and control of medications;

 

          (17)  Charting by nursing personnel;

 

          (18)  Quality assurance;

 

          (19)  Infection control, including cleaning, laundry, scrub area criteria, decontamination, disinfection, sterilization, storage of sterile supplies, storage of soiled products, and disposal of medical waste;

 

          (20)  Emergency and disaster plans;

 

          (21)  Birth center safety, including fire safety and construction;

 

          (22)  Emergency equipment and procedures to provide emergency care;

 

          (23)  Birth center operational functions;

 

          (24)  Medical record contents, noting of diagnostic and therapeutic orders; and

 

          (25)  Client and newborn safety, to include client and newborn identity and security measures.

 

          Source: 38 SDR 115, effective January 9, 2012.

          General Authority: SDCL 34-12-62(1), (2), (3), (4), (7), (8), (9), (10), (11), and (12).

          Law Implemented: SDCL 34-12-62(1), (2), (3), (4), (7), (8), (9), (10), (11), and (12).

 

          44:69:05:05.  Client plans and programs. The practitioner service of a birth center shall provide safe and effective care from the day of admission through the ongoing development and implementation of written plans for each client and newborn. The client plan shall address medical, physical, mental, and emotional needs of the client and infant.

 

          The client plan for birth center clients shall be based on the nursing admission assessment and approved by the client's attending physician or certified nurse midwife. The client plan shall describe the services necessary to meet the client's medical, physical, mental or cognitive, nursing, and psychosocial needs and shall contain objectives and timetables to attain and maintain the highest level of functioning of the client. The client plan shall be completed upon admission and the birth of the infant.

 

          Source: 38 SDR 115, effective January 9, 2011.

          General Authority: SDCL 34-12-62(12).

          Law Implemented: SDCL 34-12-62(12).

 

          44:69:05:06.  Medical records. The birth center shall maintain a separate medical record for each client and newborn in accordance with acceptable professional standards for the purpose of continuity and evaluation of care, and preservation as a legal document.

 

          Source: 38 SDR 115, effective January 9, 2011.

          General Authority: SDCL 34-12-62(4).

          Law Implemented: SDCL 34-12-62(4).