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Regulation of the hospice


CHAPTER I. GENERAL PROVISIONS
§ 1
The Home Children’s Hospice Promyczek operates on a base:

  • Statute of the Foundation Home Children’s Hospice Promyczek,
  • The decision to enter the health establishments in the register kept by the Mazovian Voivode,
  • Act of 15 April 2011 on Medical Activity and executive acts to the Act.
  • Other relevant provisions of generally applicable law.
    § 2
    The seat of the Promyczek Children’s Home Hospice is located in Otwock, at 80 G. Narutowicza Street.
    § 3
    The Promyczek Children’s Home Hospice is a therapeutic entity. The founding body of Promyczek Home Children’s Hospice is Foundation Home Children’s Hospice Promyczek
    § 4
    The Director of the Promyczek Home Children’s Hospice is responsible for the financial management of the Promyczek Home Hospice.
    CHAPTER II. SCOPE OF ACTIVITIES
    § 5
    The Promyczek Children’s Home Hospice operates in the City of Otwock and mazowieckie voivodship.

§ 6
The range of health services provided by the Home Children’s Hospice includes: home palliative and hospice care services for children
CHAPTER III. ORGANISATION AND OBJECTIVES OF THE HOSPICE
§ 7
There is an organisational unit at the Promyczek Home Children’s Hospice:

  1. The Children’s Home Hospice “Promyczek
    § 8
    Health services in a children’s home hospice are provided on the following basis:
    1.The staff of a children’s home hospice provide palliative care services to children at the end of their lives with cancer and other life-limiting diseases;
  2. The home hospice for children operates in an area with a radius of up to 80 km on average from the premises
  3. The home hospice doctor qualifies for treatment in the hospice;
  4. Patients are admitted for treatment on the basis of a referral from a health insurance doctor;
  5. Visits of the staff of the home hospice take place in accordance with the National Health Fund regulation.
  6. A patient is cared for by at least one permanent supervisor, who can provide 24-hour care;
  7. The hospital does not provide intravenous treatment.
  8. A child in a hospice cannot stay at the same time in two facilities with a contract with the National Health Fund. During each visit, patients and their families/carers receive: precise recommendations for further care and treatment, and are informed about other forms of palliative and hospice care and the rules of care. They are also informed about the telephone numbers of the staff of the home hospice, who are ready to give advice over the phone every day of the week and to visit the home if necessary;
  9. Dismissal from the hospice takes place in cases:
  • The patient does not require specialist palliative care,
  • The hospice services are provided exclusively at the patient’s home.
  • If a child is sent to a kindergarten or other unit, which makes it difficult for the staff to visit the hospice, they are obliged to discharge the patient due to their inability to fulfil their contract with the National Health Fund.
  • Violation of points 6, 8, 9, CHAPTER III
  • Change the decision of caregivers or patients to undertake experimental treatment (e.g. chemotherapy) or life extension (e.g. respirator),
  • Over the age of 18 if a patient previously treated by a children’s hospice wants to move to an adult hospice,
  • Change of residence outside the area of operation of the hospice,
  • On request of the patient/carers,
  • At the request of Hospice staff (lack of cooperation with the family, lack of consent for treatment offered by hospice doctors).
    § 9
    The health services provided by the Home Children’s Hospice Promyczek include in particular:
  1. 24-hour access to services 7 days a week (also on holidays) – at home;
  2. Treatment of pain and other somatic symptoms;
  3. Medical and nursing services;
  4. Provision of specialist medical consultations ordered by a hospice doctor;
  5. Provision of commissioned examinations;
  6. Provision of commissioned transport;
  7. Assistance in solving social problems;
    8 Satisfying spiritual needs;
  8. Renting free of charge patient care equipment and rehabilitation equipment and medical equipment (concerns a home hospice);
  9. Care of orphans;
  10. Psychological assistance;
  11. Rehabilitation;
  12. Access to paediatric treatment with the possibility of periodical hospitalization
    CHAPTER IV. MANAGEMENT OF THE NON-PUBLIC HEALTH CARE FACILITY
    § 10
    The director of the Promyczek Children’s Home Hospice defines the tasks and internal organisation of the hospice’s organisational units. The director of the hospice manages the hospice with the help of the Medical Director and the Head Nurse
    § 11
    The director of the Promyczek Children’s Home Hospice issues internal normative acts regulating the activity of the hospice.

§ 12
The director of the Promyczek Children’s Home Hospice approves the detailed scope of duties, responsibilities and powers of the hospice’s employees.
§ 13
The Medical Director is in charge:

  • organization and course of doctors’ specialization,
  • the organisation and course of post-graduate medical training,
  • medical records,
  • the management of medications and medical supplies.
    § 14
    The Director of a hospice shall be replaced in his absence by the the Medical Director or, in his absence, a member of staff designated by the Director. In the event of temporary absence, substitution should be carried out in order to ensure, that the person substituted is familiarised with and introduced to the issues and tasks at work.
    § 15
    The Head Nurse supervises the work of the nursing team.
    § 16
    All employees of the hospice carry out their tasks in accordance with the applicable regulations and instructions of their immediate superiors, and are responsible for the content of their cases and ensuring confidentiality.
    § 17
    They shall be authorised to provide information to the outside world on matters concerning the activities of the hospice: The President of the Foundation, the Director of the hospice and the Medical Director. Employees of the hospice may provide external information on the matters assigned to them only with the consent of the Director of the hospice.
    CHAPTER V. TERMS OF REFERENCE FOR HOSPICE STAFF
    § 18
    The Director within the scope of his duties:
  1. Directs and represents the Children’s Home Hospice Promyczek
  2. Implements the Statute of the Children’s Home Hospice Promyczek
  3. He/She is the superior of all employees and performs his/her tasks with the assistance of the medical director, the head nurse and, in their absence, the designated deputy.
  4. Ensures proper organisation of work and order of the process of providing health services, in accordance with the scope of duties of the medical director, head nurse, chief accountant, administrative manager and staff of the Children’s Home Hospice Promyczek
  5. Is responsible for ensuring that health services are provided only by personshave appropriate professional qualifications and meet the health requirements specified in the relevant legislation
  6. Employs employees, defines their scope of activities and responsibilities and sets their salaries in accordance with the applicable laws.
  7. Determines the holidays, days off of staff and, in exceptional cases, dismisses staff from holidays or days off, informing the Foundation’s Board of Directors of such decision no later than one day after the decision is made.
  8. It establishes the Organisational Regulations of the Children’s Home Hospice and issues internal orders.
    9 The Director cooperates with the founding body, local government bodies and governmental, self-government and non-governmental organisations.
  9. He concludes contracts with the National Health Fund and other legal entities for providing health services.
  10. Runs financial management of the hospice
  11. Draws up a financial, business and investment plan.
    § 19
    The Medical Director shall direct the work of his subordinate staff and shall in particular be in charge of :
  12. Medical supervision of the provision of palliative and hospice care services,
  13. Initiating forms of training activities aimed at the professional development of subordinate employees,
  14. Set up a schedule of monthly duty for the medical team,
  15. Approve the list of on-call duty,
  16. Supervises the work of doctors and nurses in medical terms,
  17. Is responsible for the conduct of medical orders,
  18. Is responsible for medical and nursing descriptions,
  19. Is responsible for the management of medications and medical supplies.

The Medical Director is responsible to the Director of the hospice.
Medical team:

  1. On-call duty on the telephone with the possibility of immediate arrival at the Hospice to provide round-the-clock medical care,
  2. Maintenance of medical records,
  3. Providing detailed recommendations (also in writing) to the patient’s carers regarding treatment,
    4.Execution of visits ordered by the medical director and the board of the hospice.
    § 20
    The head nurse carries out the following assignments:
  4. Providing conditions for the delivery of nursing services,
  5. Functional authority over the nursing team,
  6. Organisation of work of subordinate nursing staff, coordinating and supervising the work,
  7. Analysing and assessing the quality of staff work
  8. Ordering pharmaceuticals, medical equipment etc. according to medical orders,
  9. Keeping records in accordance with applicable regulations,
  10. Preparation of reports on the performance of services under the contract with the National Health Fund,
  11. Once a year, it shall issue a written report on the condition of the warehouse, together with a nurse co-responsible for the equipment.
    Nursing team is obliged to:
  12. Is obliged to make regular visits to the patients in accordance with the schedule and to perform the care activities resulting from their competence,
  13. Providing recommendations to the child’s parents/carers regarding the child’s care,
  14. Cooperation with other members of the hospice in the scope of the therapeutic care provided,
  15. Taking care of cleanliness and technical efficiency of tools, equipment and devices necessary for the performance of care treatments,
  16. Reporting on special situations and needs concerning patients and their families during the briefing,
  17. Careful maintenance of medical records,
  18. 24-hour nursing duty on the telephone with the possibility of immediate arrival to hospice patients in order to provide 24-hour nursing care,
  19. Making an annual statement of all equipment in the warehouse and used by the patients.
    Physiotherapist is obliged to:
  20. Carrying out rehabilitation procedures in the home of a sick child according to the schedule established by the attending doctor,
  21. Instruction of parents/carers of a sick child in the elements of rehabilitation they can carry out,
  22. Care for cleanliness and technical efficiency of rehabilitation equipment,
  23. Cooperation with other employees of the hospice in the scope of the therapeutic care provided,
  24. Reporting the situation and needs concerning patients and their families to the management of the hospice during the briefing,
  25. Careful maintenance of medical records,
  26. Performing visits ordered by the medical director and the board of the hospice.
    Nursing team is obliged to:
  27. Making regular visits to the patients in accordance with the schedule and to perform the care activities resulting from their competence,
  28. Providing recommendations to the child’s parents/carers regarding the child’s care,
  29. Cooperation with other members of the hospice in the scope of the therapeutic care provided,
  30. Takeing care of cleanliness and technical efficiency of tools, equipment and apparatus necessary for the performance of care treatments,
  31. Reporting on special situations and needs concerning patients and their families during the briefing,
  32. Maintenance of medical records,
  33. 24-hour nursing duty on the telephone with the possibility of immediate arrival to hospice patients in order to provide 24-hour nursing care,
  34. Making an annual statement of all equipment in the warehouse.
    Physiotherapist is obliged to:
  35. Carrying out rehabilitation procedures at home of a sick child according to the schedule set by the attending doctor,
  36. Instruction of parents/carers of a sick child regarding possible elements of rehabilitation,
  37. Care for cleanliness and technical efficiency of rehabilitation equipment,
  38. Cooperation with other employees of the hospice in the scope of the therapeutic care provided,
  39. Reporting the situation and needs concerning patients and their families to the board of the hospice during the briefing,
  40. Maintenance of medical records,
  41. performing visits ordered by the medical director and board of the hospice.
    § 21
    Psychologist:
  42. providing psychological care according to the needs of the patient and his family,
  43. providing care for orphans and assistance during mourning,
  44. cooperation with other members of the hospice in the scope of the therapeutic care provided,
  45. report to the hospice team the specific situations and needs of patients and their families,
  46. maintenance of medical records.
    § 22
    Office workers are obliged to:
  47. Running administrative matters of a hospice,
  48. Drawing up and registering documentation related to the work of the hospice,
  49. Drawing up lists for accounting settlements.
    § 23
    The other staff of the hospice shall perform the tasks entrusted to them in accordance with their respective areas of responsibility.
    § 24
    All employees of the hospice are obliged to meet once a month at the so-called evening briefing designated in advance by the director.
    CHAPTER VI. RESPONSIBILITIES OF THE HOSPICE IN THE EVENT OF A PATIENT’S DEATH
    § 25
    In the event of the death of a patient under the care of the Home Children’s Hospice Promyczek, which took place in the patient’s place of permanent residence, it is the doctor’s duty to declare the death and issue a death certificate. A patient’s corpse may be autopsyed unless the person concerned has expressed his or her objection during his or her lifetime or is legally represented by him or her.
    subject to the situations set out in the Code of Criminal Procedure and where the cause of death cannot be established with certainty. The autopsy shall be performed not earlier than 12 hours after the death is established.
    The nurse shall assist the parents in the care of the deceased child, shall assist in dressing the child unless the parents wish to do so themselves.

CHAPTER VII. RIGHTS AND OBLIGATIONS OF THE PATIENT
§ 26
The patient has a right to:

  1. Health services that meet the requirements of medical knowledge, and in the case of limited possibilities of providing appropriate benefits to benefit from a reliable procedure, based on medical criteria, establishing the order of access to those benefits,
  2. Information about it’s health,
  3. Consent to the provision of certain benefits or their refusal, once the relevant information has been obtained,
  4. Medical, nursing and care services,
  5. Intimacy and respect for dignity when providing health services,
  6. Dying in peace and dignity,
    7 Psychological and pastoral care,
  7. Leaving the hospice on their own request,
  8. Obtaining own medical records in the form of statements or copies. The Hospice does not charge for providing documentation in the above mentioned forms,
  9. Submitting complaints and requests to the Director of the hospice.
    § 27
    The duties of the patient under the care of the hospice include following the recommendations of the medical personnel with regard to the medical services provided and respecting the principles of hygiene. If the patient is released at their own request, they are obliged to declare in writing or orally in the presence of two witnesses that they have been warned of the possible consequences of termination of treatment.
    CHAPTER VIII. FINAL PROVISIONS
    § 28
    Knowing and complying with the provisions of these Regulations is a basic duty of every employee of the hospice.
    § 29
    All changes and additions to the Regulation shall be introduced by the Director of the hospice after consultation with the Foundation Board.
    § 30
    In matters not regulated by the Rules of Procedure, the relevant provisions referred to in §1 shall apply.
    § 31
    These Rules of Procedure shall enter into force as soon as they are entered in the register of health care institutions.