On November 10 the Neonatal Designation Rule Stakeholder Group held a meeting. This is the second stakeholder group meeting for these draft rules. Changes have been made from the first version, but the Perinatal Advisory Committee (PAC) will meet on December 2, 2014 to make further changes and try to tweak some of the language.
General Public Comments/Suggestions:
- No compounding at a level 1 or level 2
- Risking critical access in San Angelo – want a level 2 to be able to care for a 28 week and 1000 gram baby
- Larger facilities wouldn’t be able to handle the large influx if level 2’s cannot care for these babies
- Why is there no hour requirement for CME for the medical directors?
- Dr. Toy didn’t think that it necessarily correlated with quality of care
- The medical director should not dictate the competency of the nursing staff
- Requiring a level 2 to staff a pharmacist 24/7 is prohibitive
- Many use after hour remote pharmacies, want to change onsite to “on call”
- Are their drugs being compounded in level 2’s?
- TPN and antibiotics
- In each level “social services” needs to be more clearly defined
- The PAC will give a more specific definition for “social worker”
- The PAC will be reworking language about the level 3 NICU
- Level 3 requires a pediatric anesthesiologist to be onsite – want to change language to “be available”
- Level 3 requires radiologists to be onsite – want to change language to “on call”
- Dr. Toy wants to ensure neonatologist oversight on transportation of the babies in a level 4
- The PAC will define the range of subspecialties that must be on site in a level 4 NICU
- The Survey Team language is a first draft by the department – the PAC will make further recommendations on this section
Please see attached for the second draft of the neonatal designation rule.