N.J. Admin. Code § 8:43A-24.17

Current through Register Vol. 56, No. 24, December 18, 2024

Section 8:43A-24.17 - Requirements for pediatric dialysis services

(a) The physical plant requirements for pediatric dialysis services shall be established as follows:

1. If pediatric dialysis services are provided, they shall be located in a treatment area separate from the services provided to adults except if peritoneal dialysis is the service in which case, training and back-up care may be integrated into an adult unit. Pediatric patients are defined as patients who are less than 14 years of age.

2. The area housing the pediatric dialysis unit shall be enclosed with fixed partitions that extend from finished floor to ceiling. Vision panels in partitions are required.

3. The pediatric dialysis unit shall have handwashing facilities that are separate from the adult unit.

4. If pediatric patients are treated, the facility shall use equipment, supplies, and emergency devices to include blood pressure cuffs, dialyzers, and bloodlines approved for use on pediatric patients.

(b) All patients admitted to the facility under the age of 18 for renal dialysis services shall be evaluated by a pediatric nephrologist. Any patient 13 years old or under shall be under the care of a pediatric nephrologist at all times. After the initial evaluation and at the discretion of the pediatric nephrologist, the treatment of patients 14 to 18 years old may be referred to nephrologists who specialize in the care of adult dialysis patients.

(c) The requirements for nursing care shall be established as follows:

1. The facility shall maintain documentation of competencies in general pediatrics and/or pediatric nephrology for all licensed professional nurses responsible for providing care to a pediatric renal patient. Such individuals shall demonstrate current competencies in pediatric care.

2. Patients age 13 and under must be dialyzed by a registered nurse.

3. Patients over the age of 13 and whose weight is greater than 30 kilograms may be dialyzed by a licensed practical nurse or patient care technician only after a registered nurse has assessed this patient and only under the supervision of a registered nurse.

4. All patient assessments are the responsibility of the registered nurse.

5. Nurse-patient ratios shall be established as follows:

i. For patients whose weight is less than 20 kilograms, the nurse-patient ratio shall be one to one;

ii. For patients whose weight is 20 to 40 kilograms, the nurse-patient ratio shall be one to two; and

iii. For patients whose weight is greater than 40 kilograms, the nurse-patient ratio shall be one to three.

(d) The pediatric care plan shall be established, as follows;

1. The pediatric care plan shall be developed by a multidisciplinary team as set forth at N.J.A.C. 8:43G- 30.7.

i. The pediatric patient care plan shall address those issues specific to but not limited to growth and development, nutrition, and patient and family education.

ii. All pediatric renal patients shall be seen and evaluated by a transplantation team within 90 days of admission.

(e) The requirements for infection control practices and procedures shall be established as follows:

1. Patients shall receive all age appropriate immunizations with documentation noted in the record. If immunizations are not administered, the reasons must be documented.

2. Varicella vaccine shall be administered to all patients over the age of 12 months who have not had documented varicella infection or documented varicella antibody titer.

N.J. Admin. Code § 8:43A-24.17

Amended by 54 N.J.R. 60(a), effective 1/3/2022