Section 325.1027. Patient care.

(1) All persons admitted to a hospital shall be under the continuing daily care of a physician licensed to practice in Michigan.

(a)   The hospital shall require that an admitting diagnosis be recorded promptly on each patient.

(b)   There shall be a written hospital policy denoting when consultation should be held. Consultation shall be recorded.

(c)   No medication or treatment shall be given to any patient except on the written order of a physician.

(d)   Verbal orders for medication, whether given over the telephone or otherwise, shall be written into the record as such.

(e)   Verbal orders, whether given over the telephone or otherwise, shall be received only by a person or persons approved and authorized by the administrator and by the medical staff, and shall be indicated as verbal orders, initialed by the physician's initials per the receiver's initials and countersigned by the physician at the time of the next visit.

(2)   The hospital shall provide personnel, space, equipment, and supplies for routine laboratory analyses. It shall utilize regularly the services of an experienced pathologist for the examination of tissue suspected of being diseased, except tonsils, removed at operations.

(3)     Equipment  shall   be  provided  for   diagnostic   radiographic examinations. The hospital shall require that the responsibility for film interpretation and the proper protection against radiation, electric shock, and combustion of stored film shall be assigned to the general supervision of a licensed physician with  training  or experience  in radiology.

(4)   The hospital shall employ professional and auxiliary personnel to give patients necessary services.

(a)   The nursing service shall be in the charge of a graduate nurse registered to practice in Michigan.

(b)    Each nursing shift shall be personally supervised by a graduate nurse registered to practice in Michigan.

(c)   Personnel assigned to the maternity service, including the formula room, and all food handlers shall have a written record of pre-employment and annual physical examination.

(i)    Persons found upon examination to have conditions dangerous to patients shall be removed from assignment until recovery.

(ii)    All persons with respiratory, skin, gastrointestinal, or other communicable infection shall be excluded from working on these services.

(d)   Duty in the nursery or in food handling areas shall not be resumed until the administrator or his agent has a medical statement based on appropriate physical examination and tests to the effect that return to duty is safe.

(5)   Meals provided for the various types of patients shall be planned in accordance with the recommended daily allowances of the national research council.

(a)    Only pasteurized milk and milk products or evaporated or dried milk shall be used.

(b)   Meals shall be prepared and served in a sanitary manner.

(c)   Food returned from patients' trays is considered contaminated and shall not be re-served.

(6)   Rooms for adult patients shall provide a minimum of 80   square  feet of floor space per bed. In multiple bedrooms, beds shall be at least 3 feet apart.

(7)   There shall be sufficient equipment for care according to  the  type of patients accepted by the hospital.

(a)   Individual linens shall be provided each patient.

(b)    A wash basin, emesis basin, bedpan, and when indicated, a urinal shall be immediately available for each patient. Bedside equipment shall be sterilized  or sanitized between patients in a manner  approved by the state health commissioner.

(c)   There shall be at least as many thermometers available as there are patients.

(d)  Autoclaves and other sterilizers shall be provided as needed.

(e)   Each hospital shall have facilities for blood transfusions.

(f)  Each   hospital  shall  have   facilities  for  immediate   intravenous therapy and for the administration of parenteral fluids, including blood substitutes.

(8)   Rules governing visitors shall be posted in a conspicuous place.

(9)       Hospitals   shall   isolate    patients  with   communicable   disease,   carriers   of communicable  diseases,  or  those  suspected of having communicable diseases.

(a)   A lavatory and a toilet shall be provided within the isolation area.

(b)    The  hospital  shall   make  written   policies  concerning  isolation techniques available to all personnel concerned.

History: 1954 AC; 1979 AC.