Section 68.3 - Standards for operation of a regional poison control center

68.3 Standards for operation of a regional poison control center.

(a) Services provided. A regional poison control center shall receive or have a reasonable expectation of receiving not less than 4,000 poison control calls per year and shall perform the following functions:

(1) serve the population of the designated service area;

(2) provide expert information and consultation services to professional personnel in the region on the diagnosis, treatment and management of any suspected or actual poisoning(s);

(3) provide information, emergency care, and referral services to the general public;

(4) assure that tertiary referral treatment centers willing to accept poison patients are identified for the region;

(5) coordinate, develop and monitor poison prevention and medical management programs for medical professionals and the general public in the region;

(6) periodically report and/or conduct investigations of new toxic risks and injuries, as indicated; and

(7) collect uniform data and engage in research activity to enhance poison prevention and control management.

(b) Staffing. Regional poison control centers shall be staffed by a physician medical director, qualified poison information specialists, an administrator or administrative director, a health educator, and other personnel deemed necessary to operate the poison control center within the requirements of this Part. The following personnel standards and qualifications shall be met:

(1) The medical director shall have completed sufficient training to qualify for certification in a medical primary care specialty, have certification or appropriate experience in medical toxicology and have a medical staff appointment at the hospital designated as the poison control center.

(i) The medical director shall provide training to and supervision of poison information specialists; be responsible for medical decisions and treatment protocols; and provide direct patient care, telephone supervision, or case consultation to the hospitalized poison patient, either as the attending physician or as a consultant.

(ii) The medical director shall spend not less than 20 hours per work week in poison control center activities.

(2) Poison information specialists shall be qualified to read, understand and interpret standard poison information resources and transmit that information in a logical, concise and understandable way to both health care professionals and consumers and to communicate information from standardized poison center treatment protocols approved by the medical director.

(3) An administrator or administrative director shall be employed who is qualified by training and experience to supervise operations, finance, personnel, data collection and analysis and other administrative functions of the poison control center.

(4) A health educator shall be employed who is qualified by training and/or experience to conduct outreach and to develop and provide training for both professional and public groups and organizations in basic elements of poison prevention and treatment, especially to underserved populations of the region.

(c) Operations. (1) Poison control center services shall be available to both the general public and health professionals 24 hours per day, 365 days per year.

(2) The center shall be easily accessible by telephone at no charge to the public from all areas within the designated region. The availability of poison control information by telephone shall be widely publicized throughout the region to both the public and health care providers.

(4) The following services shall be available at the telephone answering site: (i) current toxicology information;

(ii) a comprehensive set of current texts covering both general and specific aspects of acute poisoning management;

(iii) primary information resources and access to a major medical library or information system;

(iv) poison control center specialty consultants available on an on-call basis; and

(v) a list of general hospitals in the region capable of delivering comprehensive care for poison victims and willing to accept such patients for care.

(5) The center shall develop and maintain written policies and protocols for responding to calls from the public and health professionals that provide consistent prehospital evaluation and treatment of toxic exposures. The center shall also develop operational guidelines prepared in conjunction with the medical director of the regional emergency medical system. These policies, protocols and guidelines shall be approved in writing by the medical director of the center and shall be available at the central telephone answering site.

(6) The center shall function as a source of comprehensive toxicology information and consultation to health professionals in the region, and shall report and/or conduct investigations of new toxic risks and injuries, as indicated. (d) Regional coordination of poison control activities. The designated regional poison control center shall function as the focal point for the coordination of all poison control activities in a region.

(1) All medical care treatment facilities in the region shall be evaluated by the center for participation in and contribution to the regional poison control treatment program. This information shall be available for the regional poison control center staff as a guide to the facilities' capabilities in managing the poison patient.

(2) One or more tertiary treatment centers for the management of pediatric, adolescent and adult poisoning victims shall be identified for the region. A formal relationship shall be established between such treatment centers and the regional poison control center for the treatment of poison victims and to improve management of the poisoned patient.

(3) Comprehensive analytical toxicology services from laboratories approved as required by law shall be identified and available within the region 24 hours a day, 365 days a year so that required emergency analysis can be performed within a time frame appropriate to the needs of patients. There shall be a written poison control center protocol describing the available tests and the process for submission of specimens and interpretation of results.

(4) The regional poison control center shall have a protocol for interacting with the transport service(s) and communication capability with the prehospital transport service(s) where this is available and needed for acute management of patients. Such services shall be available to all emergency patients.

(e) Health professional education, public education and public outreach programs. The regional poison control center shall provide the following educational services:

(1) instruction and programs in the prevention, care and management of poisonings for health care professionals involved directly in the regional treatment system, and to other professionals with an interest or involvement in care of poison patients; and

(2) public and professional outreach programs to promote or provide education on concepts related to poison prevention or control.

(f) Regional data collection system. Each regional program shall utilize a data collection system that includes recording of all inquiries and cases handled or admitted by the center. The center shall complete a record containing data elements prescribed by the commissioner for all poison-related calls or admissions. Such data elements shall include origin of call, type of call, substance involved, description of the victim, designation as an accidental or intentional incident, management and final disposition, and medical outcome, if any. The center shall assure the confidentiality of such data as required by section 405.25(a)(9) of this Title.

(g) Reporting and evaluation. (1) Regional poison control centers shall submit semiannually to the department a report which shall include, but not be limited to, a statement or regional program goals and specific objectives for each year and progress toward meeting the stated goals and objectives, and statistical data regarding the effectiveness of the regional poison prevention and control activities.

(2) Regional poison control centers shall submit to the department an annual report which shall include, but not be limited to the number and percentage of total calls received from each county, narrative information on program operations, the extent and type of targeted outreach and education to professional and public groups in the region, the relationship of center expenditures to program accomplishments, estimated cost savings, if any, evaluation of poison patient outcomes, and other overall findings and recommendations related to the program.

(3) The department shall conduct periodic onsite program reviews to determine whether each regional poison control center is in compliance with the standards set forth in this Part. A report summarizing the findings of each review shall be made available in writing to the center within 30 days of such review.

(i) If the review report identifies areas in which the center is out of compliance with the standards of this Part, the center shall submit to the commissioner, within 30 days of issuance of the report, a plan detailing steps to be taken for corrective action and a timetable for bringing the center into compliance with the applicable standards.

(ii) After receiving and accepting such a plan for corrective action, the department may conduct a follow-up onsite review to determine whether the plan has been implemented and whether the center has come into compliance with applicable standards.

(iii) Failure to submit an acceptable plan for corrective action shall constitute grounds for revocation of poison control center designation.

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