Bill Text: NY A09950 | 2017-2018 | General Assembly | Amended

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Bill Title: Authorizes hospitals to establish standing orders for the care of newborns in the hospital until the discharge of the newborn from the hospital following the birth, which may authorize an attending nurse to provide services and care to healthy newborns.

Spectrum: Moderate Partisan Bill (Democrat 33-7)

Status: (Passed) 2018-12-07 - signed chap.366 [A09950 Detail]

Download: New_York-2017-A09950-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                         9950--B
                   IN ASSEMBLY
                                    February 27, 2018
                                       ___________
        Introduced by M. of A. GOTTFRIED, BRAUNSTEIN, ENGLEBRIGHT, CAHILL, McDO-
          NALD,  D'URSO,  CROUCH,  THIELE, SEAWRIGHT, BUCHWALD, LIFTON, DICKENS,
          TAYLOR, JAFFEE, NIOU, LUPARDO, BARRON,  ZEBROWSKI,  NORRIS,  LAWRENCE,
          ERRIGO,  MONTESANO, BLAKE, ORTIZ, COOK, MOSLEY, LAVINE, GLICK, CRESPO,
          BICHOTTE, DE LA ROSA, GOODELL, RIVERA, FAHY -- Multi-Sponsored  by  --
          M.  of  A.  DAVILA,  GIGLIO,  HYNDMAN -- read once and referred to the
          Committee on Health -- reported and referred to the Committee on Codes
          -- committee discharged, bill amended, ordered  reprinted  as  amended
          and  recommitted  to  said  committee  -- reported and referred to the
          Committee on  Rules  --  Rules  Committee  discharged,  bill  amended,
          ordered reprinted as amended and recommitted to the Committee on Rules
        AN ACT to amend the public health law and the education law, in relation
          to hospital standing orders for the care of newborns
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The public health law is amended by adding  a  new  section
     2  2803-v to read as follows:
     3    § 2803-v. Standing orders for newborn care in a hospital.  1. A hospi-
     4  tal may establish standing orders for the care of newborns in the hospi-
     5  tal  until  the discharge of the newborn from the hospital following the
     6  birth, which may authorize an attending nurse to  provide  services  and
     7  care to healthy newborns.
     8    2. As used in this section, unless the context clearly requires other-
     9  wise:
    10    (a) "Hospital" means a hospital that routinely provides perinatal care
    11  to newborns.
    12    (b)  "Attending practitioner" means the physician, nurse practitioner,
    13  physician assistant or midwife, acting within his or  her  lawful  scope
    14  and  terms  of  practice,  attending  the  birth  or postnatal care of a
    15  newborn in a hospital.
    16    (c) "Attending nurse" means a registered nurse attending the postnatal
    17  care of a newborn, acting within his or her lawful scope of practice.
    18    (d) "Standing order" means a non-patient specific order for  the  care
    19  of healthy newborns in the hospital, established under this section.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14792-04-8
        A. 9950--B                          2
     1    3. A standing order may be implemented in the case of any newborn when
     2  (a)  directed  by the attending practitioner, or (b) in the absence of a
     3  specific direction by the attending practitioner,  the  attending  nurse
     4  determines,  in  his or her professional judgment, that implementing the
     5  standing  order for the newborn is clinically appropriate and consistent
     6  with the standing order, the hospital's policies  and  applicable  regu-
     7  lations. The standing order shall not be implemented in a specific situ-
     8  ation  where  the hospital's policies, the standing order, or applicable
     9  regulations provide otherwise.
    10    4. (a) A standing order shall provide for the circumstances  in  which
    11  the  condition  or  change  in condition of the newborn or the newborn's
    12  mother, or other circumstances relating to providing services  and  care
    13  to the newborn, require departure from the terms of the standing order.
    14    (b)  Where  an  attending  nurse implementing a standing order becomes
    15  aware of circumstances  that,  in  his  or  her  professional  judgment,
    16  reasonably  indicate  a  need  to  depart from the terms of the standing
    17  order, he or she shall so advise the  attending  practitioner.  In  such
    18  circumstances,  if the attending nurse determines, in his or her profes-
    19  sional judgment, that the health of the newborn requires departing  from
    20  the standing order prior to receiving direction from the attending prac-
    21  titioner,  the  attending  nurse  may  do so, consistent with his or her
    22  lawful scope of practice, the hospital's policies and  applicable  regu-
    23  lations.
    24    (c)  The standing order shall provide, including the times and manner,
    25  that an attending practitioner shall review and acknowledge  in  writing
    26  the  services  and care provided to the newborn under the standing order
    27  and the condition of the newborn.
    28    5. (a) A standing order may provide  for  circumstances  in  which  it
    29  shall not be implemented, or implemented only at the order of an attend-
    30  ing practitioner, which may include but not be limited to:
    31    (i) lack of or inadequate prenatal care;
    32    (ii) a birth not attended by an attending practitioner;
    33    (iii) a birth not occurring in a hospital; or
    34    (iv) a premature or low birth weight birth.
    35    (b) A standing order shall be dated, timed, and authenticated promptly
    36  in  the patient's medical record by the attending practitioner acting in
    37  accordance with law, including scope-of-practice  laws,  hospital  poli-
    38  cies, and medical staff bylaws, rules and regulations.
    39    6. A standing order may be implemented only if the implementing hospi-
    40  tal:
    41    (a)  establishes  that the order has been reviewed and approved by the
    42  hospital's medical staff and nursing and pharmacy leadership, and signed
    43  by a physician affiliated with the hospital or, in the case of a midwif-
    44  ery birth center, by a midwife affiliated with the hospital;
    45    (b) demonstrates that the order is consistent with  nationally  recog-
    46  nized evidence-based guidelines; and
    47    (c)  ensures  that  the  periodic  and  regular review of the order is
    48  conducted by the hospital's medical staff and nursing and pharmacy lead-
    49  ership to determine the continuing usefulness and safety of the order.
    50    7. A standing order is a medical regimen; it shall be consistent  with
    51  the lawful scope of practice of a registered nurse.
    52    8.  The  commissioner may make regulations governing the terms, proce-
    53  dures and implementation of standing orders.
    54    § 2. Section 6909 of the education law is  amended  by  adding  a  new
    55  subdivision 9 to read as follows:
        A. 9950--B                          3
     1    9.  A  registered  professional nurse may execute a standing order for
     2  newborn care  in  a  hospital  established  under  section  twenty-eight
     3  hundred  three-v  of the public health law, as provided in that section.
     4  The commissioner may make regulations relating to implementation of this
     5  subdivision.
     6    § 3. This act shall take effect on the one hundred twentieth day after
     7  it  shall have become a law.  Effective immediately, the commissioner of
     8  health and the commissioner of education may make regulations  and  take
     9  other actions reasonably necessary to implement this act on that date.