When it comes to medical emergencies during surgery, it is essential that all patients are under the care of a qualified medical staff. Each hospital should have a plan in place that includes effective mechanisms for the periodic review of patient care policies and procedures. No medication or treatment will be administered without a signed order from a person legally authorized by state laws. Furthermore, each hospital must have a reliable method for identifying each patient, including newborns.
In addition, each hospital must include in its visiting policy a provision that allows each adult patient to receive visits from anyone they wish to receive visits from, subject to other restrictions contained in the visiting policy, including the patient's medical condition and the number of visits allowed in the patient's room simultaneously. If the governor has declared a public health emergency related to the novel coronavirus (COVID-19), each hospital must allow a person with a disability who requires assistance as a result of that disability to be accompanied by a designated support person at any time during which health care services are provided. The hospital must make such policies available to the public on a website maintained by the hospital and provide such policies, in writing, to the patient at the time health care services are provided. Each hospital must also operate a sterile supply service or handle the processing, sterilization, storage and dispensing of clean, sterile supplies and equipment. Facilities must be provided for the cleaning, preparation, sterilization, aeration, storage and dispensing of supplies and equipment for patient care. Each hospital must have at least one dietitian who meets the criteria of § 54.1 - 2731 of the Virginia Code, employed on a full-time, part-time, or consultative basis, to direct the nutritional aspects of patient care and advise on food preparation and service.
Space, equipment and supplies must be provided for receiving, storing, refrigerating, preparing and serving food in an efficient, safe and sanitary manner. The dietary service must maintain a dietary manual approved by the medical staff. Diets served to patients must comply with the principles set out in the diet manual. All patient diets, including therapeutic diets, must be ordered in writing by a physician or dietitian as authorized by the medical staff responsible for the patient's care. Relevant observations and information related to special diets and dietary treatment must be recorded in the patient's medical record. A hospital that contracts for food service must require as part of the contract that the contractor comply with the provisions of this section.
The plan must provide for widespread disasters as well as disasters that occur in the local community and in hospital facilities. A copy of the plan and any revision of the plan must be made available to the OLC upon request. The hospital must provide equipment, medicines, supplies and ancillary services commensurate with the scope of expected needs including radiology and laboratory services and facilities for handling and administration of blood and blood products. Medications and emergency equipment must remain accessible in the emergency department at all times. The current list of medical staff members on emergency calls including alternates and medical specialists or consultants must be published in the emergency department. Hospitals should provide special training as needed to emergency department staff.
Toxicological reference material and information on toxicological antidotes should be available together with telephone numbers of nearest poison control centers. Each emergency department must publish a notice of existence of an anti-trafficking hotline to alert potential witnesses or victims of trafficking in persons to availability of means to obtain assistance or report crimes. This notice must be in place that is easily visible and accessible to public such as patient intake area or public or patient restrooms. The notice must meet requirements of § 40.1-11.3 C of Code of Virginia. All hospitals with an emergency department must establish protocols to ensure that emergency service security personnel receive adequate training for populations served by emergency department. This training may include training based on trauma-based approach to safely identify and address situations involving patients or others who pose risk of harm to themselves or others due to mental illness or substance abuse or who are experiencing mental health crisis. The director of laboratory service will be physician member of medical staff.
If managing physician of laboratory service is not pathologist, pathologist will be hired as consultant. Measures will be taken to ensure continued availability of emergency laboratory services. Examinations in fields of hematology, chemistry, microbiology, seroimmunology, clinical microscopy and other services necessary to meet patient care needs will be provided directly or through contractual agreement with reference laboratory. In accordance with statutes of medical staff surgically removed tissues will be examined by pathologist and findings will be included in patient's medical history. Each hospital must provide adequate facilities and equipment for storage and administration of whole blood and blood products. The medical records department must have staff and equipment to facilitate accurate processing, verification, indexing, archiving and retrieval of all medical records. A medical record will be established and maintained for each person treated inpatient outpatient (outpatient) or emergency in any unit of hospital.
Registration will be available for all other units. A separate medical record will be kept for each newborn. The newborn's medical history including any pathology and information about complications of delivery and mother's medication during delivery and delivery will be noted in newborn's medical history. Entries in medical record will be made by responsible person in accordance with hospital policies and procedures. All medical records whether original or exact reproductions will be kept for minimum of five years after patient's discharge. Nursing staff will be assigned to patient care units in manner that minimizes risk of cross-infection and accidental contamination.
Each hospital must provide pharmaceutical services under direction of pharmacist.
- Medical Emergencies: It is essential that all patients are under qualified medical staff during surgery.
- Visiting Policy: Each hospital should include provisions that allow adult patients to receive visits from anyone they wish.
- Sterile Supply Service: Hospitals should handle processing, sterilization, storage & dispensing clean & sterile supplies & equipment.
- Dietary Service: Each hospital should maintain dietary manual approved by medical staff & serve diets ordered by physician/dietitian.
- Emergency Department: Hospitals should provide special training & toxicological reference material & anti-trafficking hotline.