Exhibit | Description |
---|---|
Exhibit I | Drugs for Newborn Resuscitation |
Exhibit II | Recommendations for Preventive Health Care |
Exhibit III | Office of Indian Education Program (OIEP)
Indian Health Service (IHS) procedures for preparation and transmittal of
Health Records of American Indian and Alaska Native Students in OIEP
Boarding Schools (Signed March 7, 1983) |
Appendix 3-13-A | Obstetrical Services |
3-13.1 |
INTRODUCTION
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3-13.2 |
MATERNAL AND NEONATAL HEALTH SERVICES
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Objectives: |
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To provide national and IHS guidelines and standards for use by Area/Program and service unit staff that will enable them to develop plan6 for the provision of comprehensive maternal and neonatal health services. |
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Each service unit will be designated a6 to the technical level of maternity and newborn service6 that it will deliver. All IHS maternity services will meet at least Level I standard6 except for the cesarean section and anesthesia standards which could not be met by units unable to support an operative Obstetric/surgical unit. These unit6 are designated as low-risk maternity units in contrast to the full-service obstetric departments of the larger IHS hospitals. However, even the low risk maternity unit6 will meet all other requirements of Level I program6 in order to assure the highest possible level of care. |
4. |
Each service unit will have on file verified documentation of the obstetrical and pediatric credentials and privileges for each primary care provider delivering services to maternal and newborn patients, in accordance with specifications outlined in the Service Unit Medical Staff Bylaws and Rules and Regulations. |
5. |
Tribal, referral and contract care providers and facilities shall meet at least Level I standards and provide at least the same quality of care as outlined for the IHS. |
6. |
A free-standing low risk maternity unit (Birthing Center) may be an acceptable site for labor and delivery depending on the Wishes of the patient and the availability of a unit which (1) meets the obstetric and newborn care standards of this manual and (2) meets the Guidelines for Licensing and Regulating Birth Centers as adopted by the American Public Health Association 17 November 1982. The Area/Program MCH Chief, with consultation from the OB/GYN and pediatric senior clinicians, is responsible for assuring that any unit utilized meets these standards. |
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Responsibilities: |
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General: |
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3-13.3 |
OBSTETRIC ANESTHESIA CARE |
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Objectives: |
(1) |
To define IHS staff responsibilities for implementation of this policy. |
(2) |
To assure that all obstetric anesthesia care meets these quality standards. |
D. |
Procedures |
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3-13.4 |
NURSE-MIDWIFERY |
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Nurse-midwifery services may be provided as part of the comprehensive MCH services offered by the IHS. |
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Certified nurse-midwives (CNM) will adhere to IHS policies and standards which relate to their area of practice. |
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Headquarters - Chief, Nurse-Midwifery Branch. |
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3-13.5 |
PERINATAL AND INFANT MORTALITY REVIEWS
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Responsibility: |
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3-13.6 |
CARE OF THE INFANT AND CHILD |
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3-13.7 |
CHILD ABUSE AND NEGLECT
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3-13.8 |
SEXUAL ABUSE |
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To assure that service units understand their responsibility in providing care to victims of sexual abuse and their family members. |
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To assure that services are delivered in a sensitive manner. |
3. |
To define the legal requirements involving sexual abuse cases. |
4. |
To assure that such service meet all clinical, legal and reporting standards. |
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Pre-Examination - Culturally sensitive counseling of the victim and/or the family prior to medical care is of utmost importance and can aid in the ultimately satisfactory emotional resolution of the problem. |
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Post-Examination - Supportive contact may need to be provided to the victim for months after the event. Appropriate referral to trained counselors may be indicated. |
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3-13.9 |
SCHOOL HEALTH |
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To make available to each American Indian and Alaska Native student a school health program that is integrated with his/her entire educational experience. |
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Educational services are now provided to American Indian and Alaskan Native children through a variety of community, county and State systems as well as the traditional BIA program. |
2. |
Each service unit will have written school health plans and supporting protocols, based on standards found in this manual and "School Health: A Guide for Health Professionals" American Academy of Pediatrics, (1981) and appropriate to the role of direct provider (BIA) see Exhibit III, OIEP-IHS) or consultant (State and local). |
3. |
Serious outbreaks of disease or a death should be immediately reported to the Area Communicable Disease Officer. MCH Consultant and CMO. |
4. |
Each school health program should address the following areas School Health Services, School Health Education, Healthful School Environment. |
5. |
All forms used and statistical data maintained must conform to IHS standards and policies, (See IHS Manual, Part 3, Chapter 3, Medical Records; Part 3, Chapter 4, Nursing; Part 4, Chapter 3, Program Analysis Reports and Statistics.) |
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3-13.10 |
CARE OF THE ADOLESCENT |
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Objectives: |
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Definition - The term adolescent refers to those individuals between puberty and legal age of maturity. They are usually capable of actively participating in their own health care but, solely because of age, are not competent under State law to give signed consent for treatment. |
2. |
Consent Regulations - In accordance with applicable State laws, counseling and service6 regarding pregnancy, sexually transmitted diseases and family planning may be provided without the parents knowledge and consent. In general the IHS policy is to encourage adolescent6 to involve their parent6 in their health care. It is the adolescent's responsibility to inform his/her parents. The health care provider should encourage, counsel and support adolescents in the process of involving their parents. |
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3-13.11 |
PREVENTIVE HEALTH SERVICES FOR WOMEN |
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3-13.12 |
FAMILY PLANNING SERVICES
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3-13.13 |
HYSTERECTOMIES RESULTING IN STERILIZATION
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Reference - |
Federal Register 42 CFR, Parts 50 and
441, Sterilization and Abortions, November 8, 1978, Requirements Applicable
to Sterilizations (Hysterectomies) August 4, 1982 (47-FR-33695). |
3-13.14 |
ABORTION SERVICES |
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Reference - | Federal Register, 42 CFR, Part 36. |