Bill Text: NY S08774 | 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: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2018-06-18 - SUBSTITUTED BY A9950B [S08774 Detail]

Download: New_York-2017-S08774-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                         8774--B
            Cal. No. 1508
                    IN SENATE
                                      May 15, 2018
                                       ___________
        Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health -- reported favora-
          bly from said committee, ordered to first  report,  amended  on  first
          report,  ordered  to  a second report and ordered reprinted, retaining
          its place in the order of second report -- ordered to a third reading,
          amended and ordered reprinted, retaining its place  in  the  order  of
          third reading
        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.
    20    3. A standing order may be implemented in the case of any newborn when
    21  (a)  directed  by the attending practitioner, or (b) in the absence of a
    22  specific direction by the attending practitioner,  the  attending  nurse
    23  determines,  in  his or her professional judgment, that implementing the
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14792-05-8
        S. 8774--B                          2
     1  standing order for the newborn is clinically appropriate and  consistent
     2  with  the  standing  order, the hospital's policies and applicable regu-
     3  lations. The standing order shall not be implemented in a specific situ-
     4  ation  where  the hospital's policies, the standing order, or applicable
     5  regulations provide otherwise.
     6    4. (a) A standing order shall provide for the circumstances  in  which
     7  the  condition  or  change  in condition of the newborn or the newborn's
     8  mother, or other circumstances relating to providing services  and  care
     9  to the newborn, require departure from the terms of the standing order.
    10    (b)  Where  an  attending  nurse implementing a standing order becomes
    11  aware of circumstances  that,  in  his  or  her  professional  judgment,
    12  reasonably  indicate  a  need  to  depart from the terms of the standing
    13  order, he or she shall so advise the  attending  practitioner.  In  such
    14  circumstances,  if the attending nurse determines, in his or her profes-
    15  sional judgment, that the health of the newborn requires departing  from
    16  the standing order prior to receiving direction from the attending prac-
    17  titioner,  the  attending  nurse  may  do so, consistent with his or her
    18  lawful scope of practice, the hospital's policies and  applicable  regu-
    19  lations.
    20    (c)  The standing order shall provide, including the times and manner,
    21  that an attending practitioner shall review and acknowledge  in  writing
    22  the  services  and care provided to the newborn under the standing order
    23  and the condition of the newborn.
    24    5. (a) A standing order may provide  for  circumstances  in  which  it
    25  shall not be implemented, or implemented only at the order of an attend-
    26  ing practitioner, which may include but not be limited to:
    27    (i) lack of or inadequate prenatal care;
    28    (ii) a birth not attended by an attending practitioner;
    29    (iii) a birth not occurring in a hospital; or
    30    (iv) a premature or low birth weight birth.
    31    (b) A standing order shall be dated, timed, and authenticated promptly
    32  in  the patient's medical record by the attending practitioner acting in
    33  accordance with law, including scope-of-practice  laws,  hospital  poli-
    34  cies, and medical staff bylaws, rules and regulations.
    35    6. A standing order may be implemented only if the implementing hospi-
    36  tal:
    37    (a)  establishes  that the order has been reviewed and approved by the
    38  hospital's medical staff and nursing and pharmacy leadership, and signed
    39  by a physician affiliated with the hospital or, in the case of a midwif-
    40  ery birth center, by a midwife affiliated with the hospital;
    41    (b) demonstrates that the order is consistent with  nationally  recog-
    42  nized evidence-based guidelines; and
    43    (c)  ensures  that  the  periodic  and  regular review of the order is
    44  conducted by the hospital's medical staff and nursing and pharmacy lead-
    45  ership to determine the continuing usefulness and safety of the order.
    46    7. A standing order is a medical regimen; it shall be consistent  with
    47  the lawful scope of practice of a registered nurse.
    48    8.  The  commissioner may make regulations governing the terms, proce-
    49  dures and implementation of standing orders.
    50    § 2. Section 6909 of the education law is  amended  by  adding  a  new
    51  subdivision 9 to read as follows:
    52    9.  A  registered  professional nurse may execute a standing order for
    53  newborn care  in  a  hospital  established  under  section  twenty-eight
    54  hundred  three-v  of the public health law, as provided in that section.
    55  The commissioner may make regulations relating to implementation of this
    56  subdivision.
        S. 8774--B                          3
     1    § 3. This act shall take effect on the one hundred twentieth day after
     2  it shall have become a law.  Effective immediately, the commissioner  of
     3  health  and  the commissioner of education may make regulations and take
     4  other actions reasonably necessary to implement this act on that date.