We are also gearing up for a review next year and had a Mock survey last
month.  The surveyors consisted of a nurse and a physician.  I was required
to be a part of the NICU's review with the physician.  He focused on pain
assessment and documentation,
multi-disciplinary care and documentation and consult turn around times.
When I asked for specific areas of concern with regards to lactation he
asked about breastmilk storage and support coverage.  His concern with EBM
storage was in regards to in-advertent exposure potential.  His concern with
LC coverage is that we offer the same services 7 days a week.  If we do not
offer the same services over the weekend then what is the contingency plan,
i.e. how is a LC consult handled on Saturday.  If your institution allows a
24 hour response time for consults how do you handle a consult on Saturday
when you do not have a LC on staff.  You must have a protocol/procedure for
how to handle these consults.  Waiting until Monday will not get it.
Referrals to other resources will.  Hope that helps.

Janet Bryant, RN, BSN, IBCLC
Consultant, Lactation Support Service
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Arkansas Children's Hospital
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