Rules and Regulations 2013 - North Florida Regional Medical Center

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North Florida Regional Medical Center Rules And Regulations (4) Physicians are not responsible for any podiatric care of treatment of feet or consequences thereof. E.7. Dispositions of Specimens/Tissues - Unless otherwise specified by hospital policy, all tissues removed at the operation shall ordinarily be sent to the hospital pathologist who shall make such examination as he may consider necessary to arrive at a tissue diagnosis. His/her authenticated report shall be made a part of the patient's medical record. Exceptions to sending specimens removed during a surgical procedure to the laboratory should be made only when the quality of care has not been compromised by the exception, when another suitable means of verification of the removal has been routinely employed, and where there is an authenticated operative or other official report that documents the removal. The limited categories of specimens documented in the Surgical Specimens/Tissue Exemption List may be exempted from the requirement to be examined by a pathologist. E.8. E.9. Patients With History of Pulmonary or Cardiac Disease - Any patient of any age who gives a history suggestive of pulmonary or cardiac disease shall have appropriate studies just prior to surgery. Physical Examination Prior to Surgery - Patients who are admitted to the Hospital more than thirty (30) days prior to major surgery shall have a new physical examination to include at least the heart, lungs and other vital signs by the attending practitioner, the operating surgeon or the anesthesiologist. Proper notes shall be made in the progress notes as to the findings. It shall be the responsibility of the Operating Surgeon to see that such physical examinations have been completed prior to surgery. (11/22/10) E.10. Surgical Procedures Performed by Dentists and Podiatrists - Surgical procedures performed by dentists and podiatrists shall be under the overall supervision of the Chief of Surgery. F. OBSTETRICAL CARE F.1. Prenatal Records - The current obstetrical records shall include a complete prenatal record. The prenatal record may be a legible copy of the attending physician's office record transferred to the Hospital at thirty-six weeks gestation and shall be updated with any pertinent findings. F.2. Sterilization - Sterilization for the sole purpose of sterilization for female patients may be done at the discretion of the attending physician and the fully 33
North Florida Regional Medical Center Rules And Regulations informed consent of the patient being sterilized if over the age of majority in accordance with State and Federal laws. F.3. F.4. Interruption of Normal Pregnancy - All curettage or other procedures by which a known or suspected normal pregnancy may be interrupted shall be performed and reported in accordance with Florida Statute. Induction of Labor - Induction of labor shall be used in the following manner: a. Elective inductions will be scheduled by LDRP staff. The LDRP charge nurse will prioritize the schedule according to documented indication for induction. If inductions need to be postponed due to labor bed availability, the Obstetrics representation on the MEC will prioritize inductions according to the medical need of patients; and b. The reason for induction labor shall be stated in the history or progress notes. c. Intravenous oxytocin protocol and intravaginal misoprostil will be administered according to protocol. F.5. Cesarean Sections or Postpartum Tubal Ligations - Every Cesarean section will be defined as elective, non-elective, or emergency. An emergency Cesarean should be initiated within thirty (30) minutes of the decision. Patients having cesarean sections or postpartum tubal ligations shall have an updated history and physical examination. A progress note on important or new physical findings since her last physical examination on the pregnancy record shall suffice. F.6. Confirmation of Informed Consent for Delivery - Informed consent for the delivery shall be confirmed on the patient's arrival to labor area. F.7. F.8. F.9. Cancellation of Previous Orders - All previous orders are canceled after Cesarean section or postpartum tubal ligation. Terminations of Pregnancies - The reasons for the terminations must be clearly documented in the medical record. Anesthesia for Obstetrical Patients - All patients who are going to undergo caudal, spinal, saddle block or epidural anesthesia should have an IV started prior to the administration of the anesthesia. F.10. Obstetrical Consultation for Hospitalized Pregnant Patients - Any patient admitted to the hospital for medical reasons that has a viable pregnancy should be seen in 34
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Rules and Regulations 2013 - North Florida Regional Medical Center

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