2nd Ed of R&A (don't have the current Riordan at hand immediately), pg 714
(+/-), she discusses one full time LC per 1000 births annual as an absolute
minimum and "woefully understaffed and only provide(s) part-time service as
a result of partial shift coverage or coverage for fewer than seven days a
week."
I have heard the recommendation of 1 LC per 750 births annual, but can't
cite the source.
To my knowledge, JCAHO only requires a "lactation program" with no
specifics. But you may search the L'Net Archives to find a posting from an
LC in the state of CT who reported a very interesting Q&A with a JCAHO
surveyor. If that is the new standard for JCAHO, and not just the interest
of a very knowledgeable surveyor, my hosp will surely fail. We have 2 full
time for 4000+ births annual. And with the need to document in both charts,
being careful to NOT identify the "other patient" in each chart (either mom
or babe), plus documenting on the Interdisciplinary Plan Of Care (IPOC) in
both charts, and finding the charts, we spend as much time doing paperwork
- sometimes more - as we do actually seeing patients.
Check out AHWONN and other nursing professional organizations for their
recommended staffing ratios.
Mostly, LC services in my hospital are considered part of the capitated bed
charge for a Vag or CS delivery. It costs the hospital to have us. I think
we serve their PR and JCAHO needs. Our program was created solely because
certifying authorities require it.
I am beginning to learn that AHCCCS (AZ's Medicaid program) does minimally
cover LC services or perhaps only for pumps, but each provider is
different. In between patients, I need to contact the local AHCCCS Reps to
learn the process by which NICU moms can actually get some kind of pump.
Unfortunately, the pump provided is a "double electric pump". The term
"hospital grade" is not part of their vocabulary. Can ADHS work on that
with AHCCCS?
Phyllis Adamson, IBCLC, RLC
Glendale, AZ
[log in to unmask]
> I'm re-phrasing my question from a couple days ago, as I didn't receive a
> response - are there any guidelines on how many IBCLCs should be on staff
at
> a hospital? (ideally a number per OB hospital beds, or per NICU beds,
etc.)
>
> Does JCAHO look at lactation services at all?
>
> Any help is greatly appreciated!
>
> Melinda Johnson, MS RD
> Arizona Department of Health Services
>
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