S.L. 458.23 Art. 9Duties incumbent on licensee.

(1) It shall be the duty of the licensee to ensure that there are present at all times at the clinic a sufficient number of nurses to ensure proper care of the patients in the clinic taking into consideration the following:

(a) the number and category of patients accommodated;

(b) the number of floors and the number of patients on each foor;

(c) the overall layout of the building;

(d) the facilities provided;

(e) the number of additional part time staff and of other staff capable of providing nursing support.

(2) (a) Without prejudice to the generality of the above and to the provisions of subregulation (5), there shall be at least one registered nurse on duty in each ward or special unit at all times patients are receiving a service in such ward or special unit. For the purposes of this paragraph, no ward or special unit shall be considered as one such ward or unit unless it is wholly situated on one floor.

(b) If a children’s ward or special unit is incorporated within the clinic there shall be, at all times children are receiving treatment, a registered sick children’s nurse or a registered nurse with significant experience in the nursing of children.

(c) Where, in any clinic, surgery is carried out there must additionally be present at all times such surgery is carried out and for a reasonable period before and after such event, a registered nurse with operating theatre experience: Provided that patients recovering from an anesthetic shall be attended to by a qualified anesthetist or by a suitably trained registered or enrolled nurse.

(3) (a) No patient may be left in the sole charge of a person who is not authorised to practise as a nurse.

(b) The number of temporary or casual nurses on duty shall not exceed the number of permanently employed nurses on duty and no temporary or casual nurse shall be in sole charge of a patient unless a permanently employed registered nurse is present on the premises and can be called upon immediately.

(4) The person in charge of a clinic shall maintain a roster of duties of nurses and such roster shall be available to nurses and on request to an authorised person.

(5) It shall be the duty of the licensee, having regard to the number, age, sex and condition of patients treated at the clinic, to -

(a) provide adequate professional, technical, ancillary and other supporting staff;

(b) provide for each patient in the clinic adequate accommodation and space, including, where appropriate, day room facilities;

(c) provide adequate furniture, bedding, curtains and, where indicated, suitable bed screens and door coverings in rooms occupied or used by patients;

(d) provide adequate medical, surgical and nursing equipment and adequate treatment facilities, including an efficient nurse/patient call system;

(e) provide for the use of patients adequate wash hand basins and baths or, where acceptable, showers, supplying hot and cold water and a suitable number of water closets and sluicing facilities;

(f) provide adequate lighting, heating and ventilation in all parts of the clinic occupied or used by patients;

(g) keep all parts of the clinic in good structural repair, clean and reasonably decorated;

(h) ensure that adequate facilities exist, and take adequate precautions, against the risk of fire, including the provision of adequate means of escape in the event of a fire, as well as make adequate arrangements for detecting, containing and extinguishing a fire, for notices regarding procedure to be used in case of fire and for the giving of warnings, for the evacuation of the patients and staff, for the maintenance of fire fighting equipment, and for such other arrangements as may in any case be required by law, and, in the absence of any such law, as may, at any time, be directed by the Commissioner of Police;

(i) provide adequate kitchen equipment, crockery and cutlery and adequate facilities for the preparation and storage of food;

(j) supply adequate food for every patient in accordance with such patient’s dietary requirements;

(k) arrange appropriate laundering facilities;

(l) make adequate arrangements for the disposal of swabs, soiled dressings, instruments and similar substances and materials as well as for any other hazardous wastes;

(m) make adequate arrangements, as may be indicated, in respect of long stay patients;

(n) make adequate arrangements for the recording, safekeeping, handling and disposal of drugs;

(o) provide adequate arrangements for the prevention of infection, toxic condition, or the spread of infection in the clinic;

(p) take adequate precautions against the risks of accidents;

(q) provide for adequate insurance coverage of patients treated, and of employees working, at the clinic and for insurance of third parties in each case in respect of accident or other mishap.

(6) The number at domestic staff shall be sufficient to ensure a high standard of cleanliness in all parts of the premises and the licensee shall ensure that such staff is supervised by a person with knowledge of cleaning methods and materials applicable to a clinic.

(7) There shall be a supply of wholesome drinking water at suitable points.

(8) Every clinic shall be provided with adequate telephone facilities. Similar facilities shall also be available for private use by patients.

(9) (a) In respect of operations listed under Part I of the Second Schedule, the facilities and resources as well as the condition or medical fitness of the patient shall be such as to enable such operations to be carried out under conditions of good surgical and medical practice, as recommended by academic colleges of anesthesiologists and of surgeons recognised by the Superintendent.

(b) No surgical operations as are listed or referred to in Part II of the Second Schedule may be carried out at a clinic unless there are adequate operating theatre facilities, as are specified in the Third Schedule, to the satisfaction of the Superintendent.

(c) Where in any clinic, surgical operations are undertaken or a life support system is used, there shall be available adequate facilities for immediate electrical supply in case of interruption of the public supply as is needed to safeguard the lives of the patients.

(10) In this regulation -

(a) "to provide" includes, where applicable, to maintain; and

(b) where any question arises as to suitability, acceptability or adequacy, it shall be deemed to be suitable, acceptable or adequate, as the case may be, if so considered in the opinion of the Superintendent.