59A-13.010. Nursing Services

(1) A registered nurse (RN) will serve full-time as the Director of Nursing. The Director of Nursing must have at least the following qualifications:

(a) Hold a current Florida registered nurse license.

(b) Hold a current certification in Cardiopulmonary Resuscitation (CPR).

(c) Have a minimum of two (2) years general pediatric nursing experience of which at least six (6) months must have been spent caring for medically fragile infants or children in a pediatric intensive care, neonatal intensive care, PPEC or similar care setting during the previous five (5) years.

(2) The Director of Nursing is responsible for the daily operation of the PPEC center.

(3) Registered nurse staffing standards:

(a) The registered nurse must have at least the following qualifications and experience:

1. Licensed as a registered nurse in Florida, pursuant to Chapter 464, F.S.

2. Current certification in CPR.

(b) The registered nurse staff must provide:

1. Nursing interventions; educational services to increase the parent’s or guardian’s confidence and competence in caring for the child with special needs; assistance to facilitate coping with the effects of chronic illness on the child and family and support effective relationships among siblings and the ill child; interventions to foster normal development and psychosocial adaptation.

2. Information regarding availability and access to community resources.

3. A collaborative relationship with the interdisciplinary health team.

(4) Licensed practical nurse (LPN) staffing standards:

Licensed practical nurses working in a PPEC center must be supervised by a registered nurse and have the following qualifications and experience;

(a) Hold a current Florida licensed practical nurse license pursuant to Chapter 464, F.S.; and

(b) Hold a current certification in CPR.

(5) Direct care personnel staffing standards. For the purposes of this subsection, other direct care personnel include: nursing assistants, nursing assistants certified pursuant to Chapter 464, F.S., patient care technicians, medical assistants, Emergency Medical Technicians (EMT) or Paramedics licensed pursuant to Chapter 401, F.S., and individuals with training and experience in education, social services or child care related fields.

(a) Direct care personnel must meet the following requirements:

1. Have one (1) year experience in the care of infants and toddlers,

2. Employment references documenting skill in the care of infants or children, and,

3. Hold a current certification in CPR.

(b) Direct care personnel must work under the supervision of the registered nurse and be responsible for providing direct care to PPEC center children.

(6) Total staffing for nursing services and direct care must, at a minimum, meet the following ratios:

Children	Total Staff	RN	RN or LPN	Direct Care, or Licensed Nurse (RN or LPN)
1	1	1
2-6	2	1		1
7-9	3	1	1	1
10-12	4	1	1	2
13-15	5	2	1	2
16-18	6	2	1	3
19-21	7	2	2	3
22-24	8	2	2	4
25-27	9	3	2	4
28-30	10	3	2	5
31-33	11	3	3	5
34-36	12	3	3	6
37-39	13	4	3	6
40-42	14	4	3	7
43-45	15	4	4	7

If the PPEC center has a census of more than 45 children, the staffing must increase by one staff for every three (3) children alternating between a direct care staff and licensed nurse.

Rulemaking Authority 400.914(1) FS. Law Implemented 400.914(1)(d) FS. History–New 3-8-89, Formerly 10D-102.010, Amended 6-22-06, 1-7-20.