(a) The California Department of Corrections and Rehabilitation (CDCR) shall permit Registered Nurses (RNs) to make the determination and pronouncement of patient death when all of the following conditions are met:
- (1) A Primary Care Provider (PCP), or an Advanced Practice Provider (APP) has determined and documented that the patient has a condition or illness whose natural course is expected to end in death and the patient's life expectancy is six months or less.
- (2) The patient signed a CDCR 7465, Physician's Orders for Life Sustaining Treatment, as provided in section 3999.99, indicating “Do Not Resuscitate.” The CDCR 7465 must be signed and dated by a physician, or an APP acting under the supervision of the physician, and the patient or legally recognized health care decision maker.
- (3) The patient's PCP or an APP has documented in a progress note in the health record that death is expected and has completed an order in the Electronic Health Record System stating that an RN may pronounce death.
- (b) RNs shall receive death pronouncement training annually as part of their competency validation.
- (c) Assessment and determination of death. When a patient appears to have died, the RN on duty shall be physically present at the bedside to assess the patient for determination of death in accordance with standards of care.
- (d) Documentation of death. The RN shall document the assessment in the health record.
- (e) The physician on-call shall be notified if the PCP or an APP is not available in situations such as after business hours, weekends, and holidays.
- (f) Notification of the next of kin shall occur pursuant to section 3999.417, Incarcerated Person Deaths.
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
History
1. New section filed 5-22-2023; operative 7-1-2023 (Register 2023, No. 21).
2. Change without regulatory effect amending subsection (f) filed 7-1-2024 pursuant to section 100, title 1, California Code of Regulations (Register 2024, No. 27).