Title 7 . Health and Social Services

Chapter 12 . Assistance for Community Health Facilities

Section 150. Perinatal service

7 AAC 12.150. Perinatal service

(a) A general acute care hospital must offer perinatal services that include either

(1) an intensive care newborn nursery and other hospital facilities capable of treating the mother if problems arise that are beyond the normal capability of the perinatal service unit; or

(2) arrangements for consultation with a perinatal service unit at another hospital that has the capabilities described in (a)(1) of this section and the transfer of an infant or mother to that unit when necessary; the arrangements must include, at a minimum, the ability to immediately contact the other hospital by telephone or radio, and the ability to immediately obtain transportation for the mother or infant by the fastest method available.

(b) A hospital must provide individualized care for each infant patient.

(c) Every infant, whether a new patient or one transferred from another location, must be evaluated for evidence of infection before admission to a hospital.

(d) An infant who develops symptoms of an infection must be isolated from other infants immediately.

(e) Newborn infants must be marked for identification in the delivery room. The method of identification must positively identify an infant with the name of its mother, except when the infant is being placed for adoption.

(f) A hospital must have the capability for operative delivery at all times.

(g) Smoking must be prohibited in delivery rooms and nurseries.

(h) A general acute care hospital may obtain a waiver under 7 AAC 12.900(h) for its perinatal service only if

(1) the hospital has 25 or fewer acute care beds and 200 or fewer obstetrical deliveries per year;

(2) the hospital establishes a policy governing the use of a combined obstetrical delivery and surgical suite which ensures that a patient who presents an obstetrical emergency which requires immediate medical intervention to preserve the health and life of a mother or her infant is given first priority, and an obstetrical patient for whom delivery is imminent is given second priority, over other obstetrical and nonemergency surgical patients;

(3) the hospital's infection control committee established under 7 AAC 12.760 defines policies and procedures designed to prevent the transmission of infection through the use of combined surgical and obstetrical delivery suite facilities, and maintains a system for discovery, reporting, and investigation of all infections occurring in surgical patients, postpartum patients and neonates;

(4) a record of reports and investigations of all infections described in (3) of this subsection is kept on file for two years;

(5) the hospital excludes from the combined obstetrical delivery surgical room

(i) surgery on persons who have a known or suspected acute or chronic infection;

(ii) surgery on persons who are known carriers of a communicable disease before the maximum incubation period of the disease has expired;

(iii) change or removal of a cast;

(iv) mouth, nose, or throat surgery; and

(v) intestinal, rectal, anal, or perianal surgery other than an incidental or emergency appendectomy; and

(6) the hospital establishes policies and procedures and maintains appropriate equipment and supplies for rapid conversion of a labor room to an emergency delivery room if an obstetrical delivery becomes imminent at a time when all obstetrical delivery rooms or operating rooms are in use.

(i) A rural primary care hospital or a critical access hospital must meet the standards in this section if the governing body elects to offer perinatal service.

History: Eff. 11/19/83, Register 88; am 5/4/97, Register 142; am 9/1/2000, Register 155

Authority: AS 18.20.010

AS 18.20.060