63M-2.009. Episodic Care

(1) Medical issues that require immediate attention shall be defined by the DHA or physician designee.

(2) Any complaint of severe pain, including dental pain, shall be treated as an emergency with immediate referral to the on-site nursing staff, ARNP, PA or Physician.

(3) Non-licensed staff shall immediately report any youth who appears incapacitated to their supervisor and the onsite health care staff.

(4) If a program utilizes a Licensed Practical Nurse (LPN) without the presence of a Registered Nurse on-site, then the LPN shall review all episodic or emergency cases daily (either electronically, telephonically or in person) with either the Registered Nurse or a higher licensure level health care staff.

(5) When licensed health care professional staff is not on-site, a designated non-licensed staff person shall contact the on-call licensed health care professional and/or access off-site services promptly.

(6) All staff members shall have access to contact Emergency Medical Services (EMS) by calling “911” immediately under any circumstances that require immediate medical attention or evaluation.

(7) Episodic care provided by a non-licensed staff person must have a follow-up evaluation by a licensed health care professional the next time this person is on-site, or sooner, if warranted.

(8) The Designated Health Authority or physician designee shall be notified when a youth requires emergency transfer off-site for evaluation, treatment and/or hospitalization.

(9) Non-licensed staff members who provide first aid and/or emergency care are authorized to provide care only within their training and maintain required certifications as per Chapter 63H-2, F.A.C.

(10) First aid supplies shall be kept and maintained on-site as determined by the Designated Health Authority.

(11) All licensed health care professionals shall maintain, at a minimum, current certification in Basic Cardiopulmonary Resuscitation (with AED training, as applicable).

(12) Training records and proof of staff certifications shall be maintained per Division 63H, F.A.C.

(13) Emergency drills, both announced or unannounced, shall be conducted for each shift, on a quarterly basis at a minimum, and simulate an episodic care event that calls for immediate First Aid and/or administration of CPR techniques and the initiation of the emergency procedures to follow when a life-threatening emergency does occur. Documentation of these drills shall also be maintained per facility.

(14) A list of emergency telephone numbers and cell-phone numbers must be posted or located accessible to all staff, on all shifts and be inaccessible to youth.

(15) Episodic care subsequent to a Protective Action Response (PAR) shall be conducted pursuant to paragraph 63H-1.007(2)(d), F.A.C.

(16) All episodic care provided shall be documented in the chronological progress notes in the Individual Health Care Record. Episodic care provided by non-licensed staff may be recorded on the Report of On-Site Health Care by Non-Health Care Staff Form (HS 049, December 2006), which is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03815 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(17) All episodic care provided shall be documented on the Episodic Care (First Aid/Emergency) Care Log (HS 009, October 2006) The Episodic (First Aid/Emergency) Care Log is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03816 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399. The facility may utilize a form of their choice as long as the form includes all information required on the Episodic Care (First Aid/Emergency) Care Log that is incorporated by reference into Chapter 63M-2, F.A.C.

(18) The staff member who notifies the Designated Health Authority of the episodic event shall document the notification in the chronological progress notes.

(19) PAR Medical Review documentation is as follows:

(a) The Post-PAR interview and PAR Medical Review shall be documented on the progress note in the youth’s Individual Health Care Record. The individual performing the Post-PAR interview will also sign and date the PAR Report.

(b) If an off-site medical review is conducted, the relevant sections of the youth’s Individual Health Care Record and Medication Administration Record shall accompany the youth to the review.

(c) After an off-site medical review, the top of each page returned by the reviewer must be dated and labeled with “PAR Medical Review.” The documents will then be placed in reverse chronological order in the Progress Notes in the youth’s Individual Health Care Record.

(d) The facility Superintendent or Program Director shall review the PAR Incident report, Post-PAR interview and the PAR Medical Review.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.64(2), 985.145, 985.18 FS. History–New 3-16-14.