Recovery services

1. Postoperative recovery services must be provided by all general acute hospitals in which surgery is performed. a. Recovery services must be provided in a room where patients who have undergone surgical procedures can be immediately observed, receive specialized care by selected and trained personnel, and when necessary, prompt emergency care can be initiated. b. The services of the postoperative recovery room may be utilized for postpartum if the delivery room or place of delivery is in close proximity to the postoperative recovery room. Postpartum patients, after appropriate observation, must be returned to the obstetrical service area. c. A physician shall be responsible for the conduct of the recovery services and for the establishment of admission and discharge policies and procedures. d. A registered nurse who has education and experience in postoperative recovery services shall supervise all personnel performing nursing service functions. (1) A licensed nurse shall be in attendance at all times when patients are in the recovery room. (2) There must be sufficient nursing personnel to provide the specialized care required for the postsurgical patient. e. Known contaminated cases must be returned to the isolation room or a private room. f. A member of the medical staff shall provide initial orders for the care of each patient upon admission to the recovery services. (1) A member of the medical staff shall be responsible for the patient's discharge from the recovery services. (2) Patients under or recovering from anesthesia, and those who have received sedatives or analgesics, must remain under continuous, direct nursing supervision until vital signs have stabilized. Any nurse performing this duty must have been instructed in the management of postanesthetic patients, must have no other clinical duties while supervising such patients, and must have immediate recourse to the attending surgeon or anesthesiologist, or certified registered nurse anesthetist, present in the hospital. (3) Side rails must be attached to movable carts and beds and raised above mattress level when occupied by anesthetized patients. Cribs must be provided for the anesthetized or postsurgical child. g. Personnel with communicable diseases must be excluded from the recovery services. h. Drugs, supplies, and equipment must be immediately and continually accessible in the unit during postoperative care, including emergencies. These include cardiac-respiratory resuscitation materials. 2. If the primary care hospital provides recovery services, the hospital shall comply with recovery services requirements for general acute hospitals in this section. 3. If a specialized hospital provides surgical services, the hospital is required to provide recovery services consistent with the recovery services requirements for general acute hospitals in this section.