Assembly Bill A8876

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8876
 
                           I N  A S S E M B L Y
 
                             January 19, 2022
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law and the education law, in relation
   to standing orders in hospitals
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 2803-v-1 to read as follows:
   § 2803-V-1. STANDING ORDERS IN A HOSPITAL. 1. A HOSPITAL MAY ESTABLISH
 STANDING ORDERS FOR THE CARE OF PATIENTS  IN  THE  HOSPITAL,  WHICH  MAY
 AUTHORIZE  AN ATTENDING NURSE TO PROVIDE SERVICES AND CARE TO A PATIENT.
 NOTWITHSTANDING THIS SECTION, SECTION TWENTY-EIGHT  HUNDRED  THREE-V  OF
 THIS  ARTICLE SHALL APPLY IN THE CASE OF STANDING ORDERS FOR THE CARE OF
 NEWBORNS IN THE HOSPITAL.
   2. AS USED IN THIS SECTION, UNLESS THE CONTEXT CLEARLY REQUIRES OTHER-
 WISE:
   (A) "HOSPITAL" MEANS  A  HOSPITAL  THAT  ROUTINELY  PROVIDES  CARE  TO
 PATIENTS THAT IS THE SUBJECT OF THE STANDING ORDER.
   (B)  "ATTENDING PRACTITIONER" MEANS THE PHYSICIAN, NURSE PRACTITIONER,
 PHYSICIAN  ASSISTANT  OR  MIDWIFE  OR  OTHER  HEALTH  CARE  PROFESSIONAL
 LICENSED,  CERTIFIED  OR  OTHERWISE  AUTHORIZED  TO PRACTICE UNDER TITLE
 EIGHT OF THE EDUCATION LAW, ACTING WITHIN HIS OR HER  LAWFUL  SCOPE  AND
 TERMS OF PRACTICE, ATTENDING A PATIENT IN A HOSPITAL.
   (C) "ATTENDING NURSE" MEANS A REGISTERED NURSE ATTENDING TO A PATIENT,
 ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE.
   (D)  "STANDING  ORDER" MEANS A NON-PATIENT SPECIFIC ORDER FOR THE CARE
 OF A PATIENT IN THE HOSPITAL, ESTABLISHED UNDER THIS SECTION.
   3. A STANDING ORDER MAY BE IMPLEMENTED IN THE CASE OF ANY PATIENT WHEN
 (A) DIRECTED BY THE ATTENDING PRACTITIONER, OR (B) IN THE ABSENCE  OF  A
 SPECIFIC  DIRECTION  BY  THE ATTENDING PRACTITIONER, THE ATTENDING NURSE
 DETERMINES, IN HIS OR HER PROFESSIONAL JUDGMENT, THAT  IMPLEMENTING  THE
 STANDING  ORDER FOR THE PATIENT IS CLINICALLY APPROPRIATE AND CONSISTENT
 WITH THE STANDING ORDER, THE HOSPITAL'S POLICIES  AND  APPLICABLE  REGU-
 LATIONS. THE STANDING ORDER SHALL NOT BE IMPLEMENTED IN A SPECIFIC SITU-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD14115-02-2
 A. 8876                             2
 
 ATION  WHERE  THE HOSPITAL'S POLICIES, THE STANDING ORDER, OR APPLICABLE
 REGULATIONS PROVIDE OTHERWISE.
   4.  (A)  A STANDING ORDER SHALL PROVIDE FOR THE CIRCUMSTANCES IN WHICH
 THE CONDITION OR CHANGE IN CONDITION OF THE PATIENT,  OR  OTHER  CIRCUM-
 STANCES  RELATING TO PROVIDING SERVICES AND CARE TO THE PATIENT, REQUIRE
 DEPARTURE FROM THE TERMS OF THE STANDING ORDER.
   (B) WHERE AN ATTENDING NURSE IMPLEMENTING  A  STANDING  ORDER  BECOMES
 AWARE  OF  CIRCUMSTANCES  THAT,  IN  HIS  OR  HER PROFESSIONAL JUDGMENT,
 REASONABLY INDICATE A NEED TO DEPART FROM  THE  TERMS  OF  THE  STANDING
 ORDER,  HE  OR  SHE  SHALL SO ADVISE THE ATTENDING PRACTITIONER. IN SUCH
 CIRCUMSTANCES, IF THE ATTENDING NURSE DETERMINES, IN HIS OR HER  PROFES-
 SIONAL  JUDGMENT, THAT THE HEALTH OF THE PATIENT REQUIRES DEPARTING FROM
 THE STANDING ORDER PRIOR TO RECEIVING DIRECTION FROM THE ATTENDING PRAC-
 TITIONER, THE ATTENDING NURSE MAY DO SO,  CONSISTENT  WITH  HIS  OR  HER
 LAWFUL  SCOPE  OF PRACTICE, THE HOSPITAL'S POLICIES AND APPLICABLE REGU-
 LATIONS.
   (C) THE STANDING ORDER SHALL PROVIDE, INCLUDING THE TIMES AND  MANNER,
 THAT  AN  ATTENDING PRACTITIONER SHALL REVIEW AND ACKNOWLEDGE IN WRITING
 THE SERVICES AND CARE PROVIDED TO THE PATIENT UNDER THE  STANDING  ORDER
 AND THE CONDITION OF THE PATIENT.
   5.  (A)  A  STANDING  ORDER  MAY PROVIDE FOR CIRCUMSTANCES IN WHICH IT
 SHALL NOT BE IMPLEMENTED, OR IMPLEMENTED ONLY AT THE ORDER OF AN ATTEND-
 ING PRACTITIONER.
   (B) A STANDING ORDER SHALL BE DATED, TIMED, AND AUTHENTICATED PROMPTLY
 IN THE PATIENT'S MEDICAL RECORD BY THE ATTENDING PRACTITIONER ACTING  IN
 ACCORDANCE  WITH  LAW,  INCLUDING SCOPE-OF-PRACTICE LAWS, HOSPITAL POLI-
 CIES, AND MEDICAL STAFF BYLAWS, RULES AND REGULATIONS.
   6. A STANDING ORDER MAY BE IMPLEMENTED ONLY IF THE IMPLEMENTING HOSPI-
 TAL:
   (A) ESTABLISHES THAT THE ORDER HAS BEEN REVIEWED AND APPROVED  BY  THE
 HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEADERSHIP, AND SIGNED
 BY A PHYSICIAN AFFILIATED WITH THE HOSPITAL;
   (B)  DEMONSTRATES  THAT THE ORDER IS CONSISTENT WITH NATIONALLY RECOG-
 NIZED EVIDENCE-BASED GUIDELINES; AND
   (C) ENSURES THAT THE PERIODIC AND  REGULAR  REVIEW  OF  THE  ORDER  IS
 CONDUCTED BY THE HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEAD-
 ERSHIP TO DETERMINE THE CONTINUING USEFULNESS AND SAFETY OF THE ORDER.
   7.  A STANDING ORDER IS A MEDICAL REGIMEN; IT SHALL BE CONSISTENT WITH
 THE LAWFUL SCOPE OF PRACTICE OF A REGISTERED NURSE.
   8. THE COMMISSIONER MAY MAKE REGULATIONS GOVERNING THE  TERMS,  PROCE-
 DURES AND IMPLEMENTATION OF STANDING ORDERS.
   §  2.  Subdivision 9 of section 6909 of the education law, as added by
 chapter 366 of the laws of 2018, is  amended to read as follows:
   9. A registered professional nurse may execute (A)  a  standing  order
 for  newborn  care  in a hospital established under section twenty-eight
 hundred three-v of the public health law, as provided in  that  section,
 AND  (B) A STANDING ORDER ESTABLISHED UNDER SECTION TWENTY-EIGHT HUNDRED
 THREE-V-1 OF THE PUBLIC HEALTH LAW, AS PROVIDED IN THAT  SECTION.    The
 commissioner  may  make  regulations  relating to implementation of this
 subdivision.
   § 3. This act shall take effect immediately.