Acts and Regulations

92-84 - General

Full text
Current to 1 January 2024
NEW BRUNSWICK
REGULATION 92-84
under the
Hospital Act
(O.C. 92-508)
Filed June 23, 1992
Under section 35 of the Hospital Act, the Lieutenant-Governor in Council makes the following Regulation:
1This Regulation may be cited as the General Regulation - Hospital Act.
2In this Regulation
“Act” means the Hospital Act;(Loi)
“attending medical practitioner” means a member of the medical staff who has principal responsibility for the medical care of a patient;(médecin traitant)
“attending midwife” means a member of the medical staff who has principal responsibility for the health care of a patient;(sage-femme traitante)
“attending oral and maxillofacial surgeon” means a member of the medical staff who has principal responsibility for the medical care of a patient;(chirurgien buccal et maxillo-facial traitant)
“board of directors” means the board of directors of a regional health authority;(conseil d’administration)
“chief executive officer” means the chief executive officer of a regional health authority;(directeur général)
“clinical record” means a written, printed or electronic record maintained by a regional health authority of the care of a patient in a hospital facility and includes a clinical record as set out in section 20;(dossier clinique)
“dental practitioner” means a person lawfully entitled to practise dentistry in the Province, and includes a dental officer of the Canadian Forces serving in the Province;(dentiste)
“fiscal year” means the fiscal year of a regional health authority;(année financière)
“foreign body” means any matter that is not human tissue;(corps étranger)
“health region” means a region of the Province designated as a health region under the Regional Health Authorities Act;(région de la santé)
“medical advisory committee” Repealed: 2002-28
“medical practitioner” means a person lawfully entitled to practise medicine in the Province, and includes a dental officer of the Canadian Forces serving in the Province;(médecin)
“medical staff” means medical practitioners, oral and maxillofacial surgeons, dental practitioners and midwives who are appointed by a board of directors to the medical staff of a regional health authority and given privileges;(personnel médical)
“midwife” means a midwife as defined in the Midwifery Act;(sage-femme)
“mission statement” Repealed: 2002-28
“nurse” means a nurse who is lawfully entitled to practise nursing in the Province but does not include a registered nursing assistant;(infirmière)
“nurse practitioner” means a registered nurse who is lawfully entitled to practise as a nurse practitioner in the Province;(infirmière praticienne)
“oral and maxillofacial surgeon” means a dental practitioner whose name is entered in the specialists register and who is the holder of a specialist’s licence in oral and maxillofacial surgery issued pursuant to the New Brunswick Dental Act, 1985, and includes a dental officer of the Canadian Forces serving in the Province, who specializes in oral and maxillofacial surgery;(chirurgien buccal et maxillo-facial)
“privileges” means permission granted by a board of directors to(privilèges)
(a) a medical practitioner to render medical care to a patient and to use the diagnostic services in a hospital facility,
(b) an oral and maxillofacial surgeon to render medical care to a patient and to use the diagnostic services in a hospital facility,
(c) a dental practitioner to render dental care to a patient and to use the diagnostic services in a hospital facility, or
(d) a midwife to render health care to a patient and to use the diagnostic services in a hospital facility.
“regional health authority” Repealed: 2016-28
93-6; 2002-28; 2002-55; 2003-49; 2008-97; 2016-28; 2019, c.12, s.14
DESIGNATION
Repealed: 96-64
96-64
3Repealed: 96-64
96-64
BOARD OF TRUSTEES
Repealed: 2002-28
2002-28
4Repealed: 2002-28
2002-28
5Repealed: 2002-28
94-10; 96-64; 2002-28
6Repealed: 2002-28
2000, c.26, s.158; 2002-28
7Repealed: 2002-28
2002-28
8Repealed: 2002-28
2002-28
9Repealed: 2002-28
2002-28
10Repealed: 2002-28
2002-28
11Repealed: 2002-28
96-64; 2002-28
12Repealed: 2002-28
2002-28
13Repealed: 2002-28
2002-28
14Repealed: 2002-28
2002-28
CHIEF EXECUTIVE OFFICER
Repealed: 2002-28
2002-28
15Repealed: 2002-28
2000, c.26, s.158; 2002-28
ADVISORY COMMITTEES
94-10
15.1(1)In this section
“advisory committee” means an advisory committee referred to in subsection 15.1(1) of the Act.
15.1(2)An advisory committee shall be made up of not more than eight members.
15.1(3)The religious order that owns in whole or in part a hospital facility for which there is an advisory committee shall designate one of the members of the advisory committee to be the chairperson of the committee.
15.1(4)The regional health authority responsible for the operation of a hospital facility for which there is an advisory committee shall, in accordance with guidelines established by the Minister,
(a) pay an honorarium to the chairperson of the advisory committee,
(b) reimburse the members of the advisory committee for expenses incurred by them as members of the advisory committee, and
(c) reimburse the advisory committee for expenses incurred by the advisory committee in exercising its powers and carrying out its duties under the Act and the regulations.
15.1(5)The Minister may establish guidelines for the payment of honorariums to the chairpersons of advisory committees, and for the reimbursement of advisory committees and members of advisory committees for the expenses referred to in subsection (4).
15.1(6)An advisory committee shall provide to the Minister and to the board of directors of the regional health authority a copy of the statement prescribed under subsection 15.1(4) of the Act and shall indicate to the Minister and the board of directors the mission programs and services determined by the advisory committee under subsection 15.1(4) of the Act to be essential to fulfil the mission set out in the statement prescribed under subsection 15.1(4) of the Act.
15.1(7)The board of directors of the regional health authority shall ensure that the advisory committee has reasonable access, for purposes directly related to the powers and duties of the advisory committee under the Act and the regulations,
(a) to the chief executive officer of the regional health authority,
(b) to the senior administrative officer and to medical and other staff at the hospital facility,
(c) to persons employed at the hospital facility, and
(d) to regional health authority and hospital facility records that directly relate to the preservation of the religious character of the hospital facility, excluding clinical and financial records of individuals.
94-10; 2002-28
PATIENT CARE
2008-97
16A regional health authority shall keep a master patient index of patients admitted to each hospital facility operated by the regional health authority.
2002-28; 2008-97
17(1)Where a person is admitted as an inpatient to a hospital facility operated by a regional health authority, the regional health authority shall ensure that the person is issued an admission number and that the name and address of a relative or person to be notified is obtained.
17(2)An admission number referred to in subsection (1) shall be issued to each inpatient by assigning the number “1” to the first inpatient admitted to each facility in each fiscal year and then by assigning numbers in the numerical order of admission of each inpatient.
17(3)An inpatient shall retain the same admission number until discharged from the hospital facility.
17(4)For the purposes of subsection (1), a baby born alive in a hospital facility shall be deemed to be admitted at the time of birth.
2002-28; 2008-97
18(1)An inpatient is discharged from a hospital facility when the attending medical practitioner, attending oral and maxillofacial surgeon or attending midwife writes an order that the inpatient is discharged from the hospital facility and advises the inpatient or a person responsible for the inpatient that the inpatient is discharged.
18(2)Where an inpatient is discharged from a hospital facility, the inpatient shall leave the hospital facility or a person responsible for the inpatient shall remove the inpatient from the hospital facility as soon as reasonably possible.
18(3)Where an inpatient is discharged from a hospital facility and refuses to leave or a person responsible for the inpatient refuses to remove the patient, a chief executive officer may make arrangements to have the inpatient removed.
2002-28; 2003-49; 2008-97; 2016-28; 2019, c.12, s.14
19Repealed: 2016-28
2002-55; 2003-49; 2008-97; 2016-28
PATIENT RECORDS
2008-97
20(1)A regional health authority shall compile a clinical record for an inpatient and for a day surgery patient from the time of admission of the patient to the time of discharge of the patient, and the clinical record shall include the following:
(a) patient identification on each document, whether electronic or otherwise, that forms part of the record;
(b) history of present and previous illnesses;
(c) results of physical examination;
(d) questionnaire completed by the patient or his or her representative;
(e) provisional diagnosis;
(f) reports of
(i) consultations,
(ii) diagnostic tests,
(iii) operations and anaesthesia,
(iv) therapy, and
(v) obstetrical treatment;
(g) consents for care;
(h) orders for care;
(i) medication sheets and protocols;
(j) charts showing temperature, blood pressure, respiration, vital signs and fluid balance;
(k) nurses’ notes and notes from other health professionals involved in the care of a patient;
(l) progress notes by health professionals involved in the care of the patient;
(m) summary sheet with final diagnosis, secondary diagnosis, complications and interventions;
(n) transfer summary, if applicable;
(o) discharge summary;
(p) post mortem examination, if applicable; and
(q) any other information that is required by this Regulation or by the Minister.
20(1.1)A regional health authority shall compile a record for an outpatient that includes the following:
(a) patient identification that on each document, whether electronic or otherwise, that forms part of the record;
(b) history of present and previous illnesses;
(c) results of physical examination;
(d) reports of
(i) consultations,
(ii) diagnostic tests, and
(iii) therapy provided;
(e) vital signs;
(f) medication sheets and protocols;
(g) nurses’ notes and notes of all professionals involved in the care of the patient;
(h) final diagnosis;
(i) post mortem examination, if any;
(j) any information that is required by this Regulation or by the Minister.
20(2)A person who makes any part of a clinical record of an inpatient shall deliver it to the chief executive officer or a person designated by the chief executive officer within thirty days after the discharge of the inpatient.
93-6; 2002-28; 2003-49; 2008-97
21Repealed: 2017, c.29, s.4
2002-28; 2002-55; 2003-49; 2008-97; 2016-28; 2017, c.29, s.4
22Repealed: 2017, c.29, s.4
2002-28; 2008-97; 2017, c.29, s.4
23(1)A regional health authority shall retain a clinical record
(a) of an inpatient for a minimum of six years after the date of discharge of the inpatient, and
(b) of any other patient for a minimum of six years after the date on which the record was made.
23(2)Notwithstanding subsection (1), a regional health authority shall retain a clinical record of a patient who is under the age of nineteen years for a minimum of six years or until the anniversary of the patient’s twenty-first birthday, whichever is the longer period.
23(3)After the applicable period referred to in subsection (1) or (2), a regional health authority may, with respect to a clinical record, destroy the following:
(a) nurses’ notes;
(b) charts showing temperature, blood pressure, respiration, vital signs and fluid balance; and
(c) any other notes or reports made by health care personnel, other than a medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a midwife or a nurse practitioner.
23(4)A regional health authority may destroy those parts of a clinical record or those clinical records not destroyed under subsection (3) if the regional health authority prepares, by microfilming, by an electronic storage and retrieval system or by some other method approved by the board of directors, a copy or reproduction of those parts or those clinical records, as the case may be.
23(5)A regional health authority shall prepare a copy or reproduction referred to in subsection (4) in accordance with a practice established by the board of directors.
23(6)A regional health authority shall retain a copy or reproduction prepared under subsection (4)
(a) in the case of an inpatient, until thirty years after the date of discharge of the inpatient, and
(b) in the case of any other patient, until thirty years after the date on which the clinical record was made.
23(7)A regional health authority may destroy a copy or reproduction prepared under subsection (4) after the applicable thirty year period referred to in subsection (6).
23(8)Notwithstanding any other provision in this Regulation, a regional health authority may, after six years from the verified death of a patient, destroy a clinical record or any part of it and any copy or reproduction of the record or any part of it.
23(9)A regional health authority shall destroy a clinical record or any part of it and a copy or reproduction of a clinical record or any part of it in accordance with a practice established by the board of directors.
93-6; 2002-28; 2002-55; 2003-49; 2008-97; 2016-28; 2019, c.12, s.14
24A regional health authority shall retain an imaging film of a patient for a minimum of two years from the date the imaging film was taken and may destroy the imaging film after that period in accordance with a practice established by the board of directors.
2002-28; 2008-97
MEDICAL ADVISORY COMMITTEE
Repealed: 2002-28
2002-28
25Repealed: 2002-28
93-6; 2002-28
MEDICAL STAFF
26Repealed: 2002-28
93-6; 2002-28
27Repealed: 2002-28
93-6; 2002-28
28Repealed: 2002-28
2002-28
29Repealed: 2002-28
2002-28
30Repealed: 2002-28
2002-28
31Repealed: 2002-28
96-64; 2002-28
32Repealed: 2002-28
93-6; 2002-28
33Repealed: 2002-28
2002-28
34Repealed: 2002-28
93-6; 2002-28
35Repealed: 2002-28
2002-28
36Repealed: 2002-28
93-6; 2002-28
37Repealed: 2002-28
93-6; 2002-28
38Within forty-eight hours after the admission of a patient as an inpatient, an attending medical practitioner, attending oral and maxillofacial surgeon or attending midwife shall
(a) write the medical history of the patient,
(b) perform a physical examination of the patient and record the findings,
(c) write any orders for care, and
(d) make and record a provisional diagnosis of the patient’s condition.
96-64; 2003-49; 2008-97; 2016-28; 2019, c.12, s.14
39Repealed: 2002-28
2002-28
40Where a medical practitioner performs a post-mortem examination on the body of a patient, the medical practitioner shall make and sign an interim report of the examination and shall deliver the report to the chief executive officer or a person designated by the chief executive officer within forty-eight hours after the post-mortem examination.
2008-97
41(1)Subject to subsection (2), no surgical operation, including an oral and maxillofacial surgical operation, shall be performed on a patient unless a consent in writing for the performance of the operation has been signed by
(a) the patient,
(b) if the patient is unable to sign by reason of physical or mental disability, the spouse or one of the next of kin or parents of the patient or any person designated by the patient before the disability to give consent on the patient’s behalf,
(c) the parent or guardian of an unmarried minor who has not, according to the terms of the Medical Consent of Minors Act, attained majority.
41(2)Where a surgeon or an oral and maxillofacial surgeon believes that the delay caused by obtaining the consent referred to in subsection (1) would endanger the life of the patient, the consent is not necessary and the surgeon or the oral and maxillofacial surgeon, as the case may be, shall write and sign a statement that a delay would endanger the life of the patient.
41(3)The statement referred to in subsection (2) shall become part of the patient’s clinical record.
99-4; 2003-49; 2008-97; 2019, c.12, s.14
42Except in case of an emergency, no major surgery under a general or spinal anaesthetic shall be performed unless the surgeon, oral and maxillofacial surgeon or dental practitioner is assisted at the operation by a medical practitioner, a nurse who is properly trained or a member of the medical intern staff of the regional health authority who is not the anaesthetist.
93-6; 2002-28; 2002-55; 2003-49; 2019, c.12, s.14
43(1)Before a surgical operation is performed on a patient, a surgeon shall
(a) perform a physical examination of the patient sufficient to enable the surgeon to make a diagnosis, and
(b) enter or cause to be entered on the patient’s clinical record a signed statement of the findings on the physical examination and the diagnosis.
43(1.01)Before an oral and maxillofacial surgical operation is performed on a patient, an oral and maxillofacial surgeon shall
(a) perform a physical examination of the patient sufficient to enable the oral and maxillofacial surgeon to make a diagnosis, and
(b) enter or cause to be entered on the patient’s clinical record a signed statement of the findings on the physical examination and the diagnosis.
43(1.1)Before a dental operation is performed on a patient, a medical practitioner shall
(a) perform a physical examination of the patient sufficient to enable the medical practitioner to make a diagnosis, and
(b) enter or cause to be entered on the patient’s clinical record a signed statement of the findings on the physical examination and the diagnosis.
43(2)Where a surgeon or an oral and maxillofacial surgeon is of the opinion that the delay caused by obtaining the examination and diagnosis required in subsections (1) or (1.01) would be detrimental to the patient, the surgeon or oral and maxillofacial surgeon, as the case may be, shall write and sign a statement that the delay would be detrimental to the patient.
43(3)Notwithstanding subsection (2), a surgeon or an oral and maxillofacial surgeon shall prepare and sign a provisional diagnosis before performing a surgical operation or an oral and maxillofacial surgical operation on the patient, as the case may be.
43(4)Where a surgeon performs a surgical operation, an oral and maxillofacial surgeon performs an oral and maxillofacial surgical operation or a dental practitioner performs a dental operation in a hospital facility, the surgeon, oral and maxillofacial surgeon or dental practitioner shall prepare or cause to be prepared by a medical practitioner who has observed the entire operation, a written description of the operative procedures and findings and the diagnosis made at the operation.
43(5)The surgeon, oral and maxillofacial surgeon or dental practitioner shall deliver the written description referred to in subsection (4) to the chief executive officer or a person designated by the chief executive officer after the operation.
43(6)The statements and diagnoses referred to in this section shall become part of the patient’s clinical record.
93-6; 2003-49; 2008-97; 2019, c.12, s.14
44A surgeon, oral and maxillofacial surgeon or dental practitioner who performs an operation on a patient is responsible for directing the post-operative care of the patient.
93-6; 2003-49; 2008-97; 2019, c.12, s.14
45(1)A surgeon, oral and maxillofacial surgeon or dental practitioner shall not dispose of any human tissue or foreign body removed from a patient during an operation or curettage.
45(2)A surgeon, oral and maxillofacial surgeon or dental practitioner shall not provide to a third party any human tissue or foreign body removed from a patient during an operation or curettage.
45(3)Subsections (1) and (2) do not apply to human tissues and foreign bodies set out in Schedule A.
93-6; 2003-49; 2008-97; 2019-16; 2019, c.12, s.14
46(1)Except in the case of an emergency,
(a) a general anaesthetic shall be administered only by a medical practitioner, and
(b) the medical practitioner administering the anaesthetic shall be a medical practitioner other than the surgeon or the medical practitioner assisting the surgeon, oral and maxillofacial surgeon or dental practitioner.
46(2)Before an anaesthetic is administered to a patient, an anaesthetist shall make a written record of the patient’s condition that includes
(a) a history of the present condition and any previous illness of the patient, and
(b) the findings of a physical examination of the patient,
which history and findings shall be sufficient to enable the anaesthetist to choose a suitable anaesthetic for the patient.
46(3)Where a surgeon, oral and maxillofacial surgeon or dental practitioner is of the opinion that the delay caused by preparing the record referred to in subsection (2) would be detrimental to the patient and delivers to the anaesthetist a statement to this effect, the anaesthetist may prepare the record referred to in subsection (2) after the operation is completed.
46(4)The statement referred to in subsection (3) shall become part of the patient’s clinical record.
46(5)Each time an anaesthetist administers an anaesthetic to a patient, the anaesthetist shall prepare a report showing the type of anaesthetic given, the amount used, the length of time the anaesthetic was given and the condition of the patient before, during and after the operation.
93-6; 2003-49; 2008-97; 2019, c.12, s.14
GENERAL
47The board of directors of a regional health authority shall include in the by-laws of the regional health authority provisions specified by the Minister to ensure the preservation in a hospital facility owned in whole or in part by a religious order of the philosophy, values and mission that have been associated with the delivery of hospital services in that hospital facility.
94-10; 2002-28
48Repealed: 2002-28
2002-28
49The Minister may
(a) inspect and inquire with respect to the premises, management and operation of a hospital facility,
(a.1) Repealed: 2002-28
(b) require a chief executive officer
(i) to furnish any information possessed or controlled by the chief executive officer, and
(ii) to make returns, reports or statements in writing relating to the regional health authority,
(c) examine and audit all books, accounts and records of the regional health authority, and
(d) investigate and require information from a person in possession of information in respect of any hospital matter.
96-64; 2002-28
50Repealed: 2002-28
2002-28
51Repealed: 2002-28
2002-28
52(1)A regional health authority shall
(a) take possession of all human tissue and foreign bodies removed from any person during an operation or curettage in a hospital facility, and
(b) obtain a statement from the surgeon, oral and maxillofacial surgeon or dental practitioner who removed the human tissue and foreign bodies, setting out the reason for the removal of the human tissue and foreign bodies together with relevant clinical data.
52(2)The statement obtained under paragraph (1)(b) shall be suitably identified and kept with the human tissue and foreign bodies at all reasonable times.
52(3)A regional health authority shall ensure that any human tissue or foreign body obtained under paragraph (1)(a)
(a) is identified at the time of the removal by a member of the medical staff,
(b) is sent to a hospital laboratory
(i) for a preliminary examination to determine if any further examination is required, and
(ii) for further examination, if required.
52(3.1)Subsections (1) to (3) do not apply to human tissues and foreign bodies set out in Schedule A.
52(4)Repealed: 2019-16
93-6; 2002-28; 2002-55; 2003-49; 2008-97; 2019-16; 2019, c.12, s.14
53(1)Where blood is taken from a person for a transfusion, the person taking the blood shall make a record showing
(a) the name, address, blood grouping and Rh factor typing of the person from whom the blood is taken,
(b) the date of taking the blood,
(c) the amount of blood taken, and
(d) the result of any Wasserman, Kahn, hepatitis or human immunodeficiency virus tests made on a sample of the blood taken for the transfusion.
53(2)The person making the record required under subsection (1) shall deliver it to the chief executive officer or a person designated by the chief executive officer.
54Repealed: 2002-28
96-64; 1999, c.11, s.5; 2002-28
55(1)Repealed: 2002-28
55(2)A regional health authority shall have at least one nurse on duty at all times in each hospital facility and shall ensure that there is a nurse in the hospital facility designated as the Senior Nurse Manager.
2002-28
56Repealed: 2016-2
2002-28; 2016-2
57An employee shall undergo any clinical tests that a regional health authority considers necessary for the protection of patients and other hospital personnel.
2002-28; 2008-97
EXEMPTIONS
58Repealed: 96-64
96-64
REPEAL AND COMMENCEMENT
59New Brunswick Regulations 84-211, 84-212 and 91-32 under the Public Hospitals Act are repealed.
60This Regulation comes into force on July 1, 1992.
SCHEDULE A
 Human Tissues and Foreign Bodies
1.
Ear, nose and throat surgery: myringotomy tubes, normal tissues from ear cosmetic surgery, otologic devices and appliances
2.
General surgery: bezoars, medical devices and hardware, other foreign bodies
3.
Gynecology: intrauterine devices, normal placentas from uncomplicated pregnancies
4.
Ophthalmology: corneas removed for bullous keratopathy, extraocular muscles and tendons, lenses for cataracts, normal tissues from ophthalmic plastic surgery
5.
Oral surgery: dental appliances, material used in dental restoration
6.
Orthopaedic: bone provided to the bone bank, orthopaedic hardware and appliances
7.
Plastic surgery: fat from liposuction, prosthetic implants not causing disease
8.
Urology: foreskins from infants less than three months old, prosthetic implants not causing disease, vas deferens removed for sterilization
9.
Vascular and cardiac surgery: prosthetic heart valves, pacemaker devices, excess veins or arteries intended to be used in a graft
10.
Other: radioactive material used in internal radiation therapy
 
 
For the purpose of section 1., the surgeon or oral and maxillofacial surgeon shall determine whether tissues from ear cosmetic surgery are normal.
For the purpose of section 3., the surgeon or oral and maxillofacial surgeon shall determine whether a placenta is normal and a pregnancy is uncomplicated.
For the purpose of section 4., the surgeon or oral and maxillofacial surgeon shall determine whether tissues from ophthalmic plastic surgery are normal.
For the purpose of section 7., the surgeon or oral and maxillofacial surgeon shall determine whether prosthetic implants are not causing disease.
For the purpose of section 8., the surgeon or oral and maxillofacial surgeon shall determine whether prosthetic implants are not causing disease.
2019-16
N.B. This Regulation is consolidated to June 14, 2019.