Section 250.1320   Postoperative Recovery Facilities

a)         Provision and use of postoperative recovery facilities

1)         Postoperative recovery facilities shall be provided by all hospitals in which surgery is performed.  They shall be in a separate room where patients who have undergone surgical procedures can be immediately observed and receive specialized care by selected and trained personnel, and where, when necessary, prompt emergency care can be initiated.

2)         The services of the postoperative recovery room may be utilized for postpartum if the delivery room or place of delivery is in proximity to the postoperative recovery room.  Only clean (non-infected or non-infectious) postpartum patients may be admitted to the postoperative recovery room and may after appropriate observation be returned to the maternity department.

b)         Personnel

1)         Physician

            A physician shall be responsible for the conduct of the recovery room, for the training of recovery room personnel, and for the establishment of admission and discharge policies and procedures.

2)         Nurse

A)        A registered nurse who has education and experience in postoperative recovery room care shall supervise all personnel performing nursing service functions.

B)        A registered nurse shall be in attendance at all times when patients are in the recovery room.

C)        There shall be sufficient nursing personnel to provide the specialized care required for the post surgical patient.  It is recommended that a ratio of one nursing personnel to three patients be maintained at all times.

D)        Nursing personnel shall be assigned permanently to the postoperative recovery room when patients are present.

c)         Practices for operation of postoperative recovery rooms

1)         Only clean surgical cases shall be admitted to the postoperative recovery room.

2)         Contaminated cases shall be returned to the isolation room or a private room. When a separate isolation facility is within or adjacent to the postoperative recovery room, contaminated cases may be admitted to it.

3)         A member of the medical staff shall provide initial orders for the care of each patient upon admission.

4)         A member of the medical staff shall be responsible for the patient's discharge from the recovery room.

5)         Anesthetized patients shall be constantly attended.  Side rails shall be attached to movable carts and beds and raised above mattress level when occupied by anesthetized patients. Cribs shall be provided for the anesthetized or post surgical child.

6)         Written policies and procedures, which are reviewed regularly and revised as necessary, shall be established.

7)         A complete orientation program and continuing in-service education program shall be provided for all personnel assigned to the recovery room.

8)         Personnel with communicable diseases shall be excluded from the recovery room.

9)         No visitors shall be permitted in the postoperative recovery room, except in the case where a hospital has adopted a policy, approved through the Governing Board, that allows a parent or guardian, or other individual selected by a child's parent or guardian, of a child 12 years of age or younger to be present with the child in recovering from a surgical procedure. Before allowing individuals to be present in the recovery area with their child, the hospital shall have a policy in place that includes at least the following:

A)        Written consent of both the parent, guardian or other individual and the physician performing the surgery;

B)        Notation in the patient's medical record of the presence of additional persons in the postoperative recovery room during recovery of the child from a surgical procedure;

C)        Application of safeguards against the introduction of infection or other hazards by the parent, guardian or other individual including orientation, education and training of the person prior to the performance of the procedure; this shall include, at minimum, specifics regarding the procedure and recovery, what can be expected, and basic infection control practices expected of the person;

D)        Provision of at least one additional staff person in the recovery room assigned to oversee, supervise and assist the parent, guardian or other designated individual for the period of time the parent, guardian or designated individual is present;

E)         Provision of safeguards to ensure the privacy of other patients who may be recovering from surgical procedures, which may include separate rooms or some other type of separation for recovery of children who would have a parent present.  Whatever method is chosen must allow for constant attention of anesthetized patients by recovery room staff; and

F)         If at any point during the recovery of the minor patient it is determined by the recovery room personnel that the parent, guardian or other individual poses a threat to the safe recovery of the patient, he or she may require the parent, guardian or other individual to leave the recovery room.

d)         Drugs, supplies and equipment

            Drugs, supplies and equipment shall be immediately and continually accessible in the unit for postoperative care including emergencies.  These shall include cardiac-respiratory resuscitation materials.

e)         The post-operative recovery facility shall contain and provide for a drug distribution station, including a secure area, adequate handwashing facilities, charting and dictating area, soiled utility area with bedpan flushing device, and adequate storage space for supplies and equipment.

(Source:  Amended at 23 Ill. Reg. 13913, effective November 15, 1999)