What's happening
This bill allows hospitals to establish standing orders so registered nurses can provide standardized care to healthy newborns until discharge.
Why it matters
Empowers nurses to act quickly for healthy newborns. By allowing registered nurses to follow hospital-approved standing orders, the bill enables timely, standardized care for healthy babies—especially when a physician or other practitioner isn’t immediately available—helping avoid care delays in busy maternity units.
Protects newborn safety through built-in checks. The bill requires standing orders to outline when nurses must alert practitioners and when deviations are required for a baby’s or mother’s safety. Orders must be reviewed, approved, and regularly reassessed by hospital leadership and be evidence-based, minimizing risks of inappropriate or outdated care.
Clarifies legal responsibility and scope of practice. Standing orders must fit within a nurse’s legal scope and be authenticated in the medical record by the responsible practitioner, defining clear roles and responsibilities and reducing liability uncertainty for both nurses and hospitals.
Could improve hospital workflow and efficiency. Standardizing care for healthy newborns frees up doctors and advanced practitioners to focus on higher-risk cases, potentially reducing bottlenecks and improving patient flow, while still maintaining safeguards for special circumstances (like preterm or low birth weight infants).
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Who cares
Headline styles
Let Nurses Care for Newborns
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Substituted by A9950B
- Amended on third reading 8774b
- Advanced to third reading
- 2nd report cal.
- Amended (t) 8774a
- 1st report cal.1508
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Allow Nurse Newborn Care Orders
Signed by Governor · Sponsor Richard Gottfried
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8774--B Cal. No. 1508
IN SENATE
May 15, 2018
Introduced by Sen. HANNON -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- reported favorably from said committee, ordered to first report, amended on first report, ordered to a second report and ordered reprinted, retaining its place in the order of second report -- ordered to a third reading, amended and ordered reprinted, retaining its place in the order of third reading
AN ACT to amend the public health law and the education law, in relation to hospital standing orders for the care of newborns
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The public health law is amended by adding a new section 2803-v to read as follows:
§ 2803-v. Standing orders for newborn care in a hospital. 1. A hospital may establish standing orders for the care of newborns in the hospital until the discharge of the newborn from the hospital following the birth, which may authorize an attending nurse to provide services and care to healthy newborns.
2. As used in this section, unless the context clearly requires otherwise:
(a) "Hospital" means a hospital that routinely provides perinatal care to newborns.
(b) "Attending practitioner" means the physician, nurse practitioner, physician assistant or midwife, acting within his or her lawful scope and terms of practice, attending the birth or postnatal care of a newborn in a hospital.
(c) "Attending nurse" means a registered nurse attending the postnatal care of a newborn, acting within his or her lawful scope of practice.
(d) "Standing order" means a non-patient specific order for the care of healthy newborns in the hospital, established under this section.
3. A standing order may be implemented in the case of any newborn when (a) directed by the attending practitioner, or (b) in the absence of a specific direction by the attending practitioner, the attending nurse determines, in his or her professional judgment, that implementing the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14792-05-8
S. 8774--B 2
standing order for the newborn is clinically appropriate and consistent with the standing order, the hospital's policies and applicable regulations. The standing order shall not be implemented in a specific situation where the hospital's policies, the standing order, or applicable regulations provide otherwise.
4. (a) A standing order shall provide for the circumstances in which the condition or change in condition of the newborn or the newborn's mother, or other circumstances relating to providing services and care to the newborn, require departure from the terms of the standing order.
(b) Where an attending nurse implementing a standing order becomes aware of circumstances that, in his or her professional judgment, reasonably indicate a need to depart from the terms of the standing order, he or she shall so advise the attending practitioner. In such circumstances, if the attending nurse determines, in his or her professional judgment, that the health of the newborn requires departing from the standing order prior to receiving direction from the attending practitioner, the attending nurse may do so, consistent with his or her lawful scope of practice, the hospital's policies and applicable regulations.
(c) The standing order shall provide, including the times and manner, that an attending practitioner shall review and acknowledge in writing the services and care provided to the newborn under the standing order and the condition of the newborn.
5. (a) A standing order may provide for circumstances in which it shall not be implemented, or implemented only at the order of an attending practitioner, which may include but not be limited to:
(i) lack of or inadequate prenatal care;
(ii) a birth not attended by an attending practitioner;
(iii) a birth not occurring in a hospital; or
(iv) a premature or low birth weight birth.
(b) A standing order shall be dated, timed, and authenticated promptly in the patient's medical record by the attending practitioner acting in accordance with law, including scope-of-practice laws, hospital policies, and medical staff bylaws, rules and regulations.
6. A standing order may be implemented only if the implementing hospital:
(a) establishes that the order has been reviewed and approved by the hospital's medical staff and nursing and pharmacy leadership, and signed by a physician affiliated with the hospital or, in the case of a midwifery birth center, by a midwife affiliated with the hospital;
(b) demonstrates that the order is consistent with nationally recognized evidence-based guidelines; and
(c) ensures that the periodic and regular review of the order is conducted by the hospital's medical staff and nursing and pharmacy leadership to determine the continuing usefulness and safety of the order.
7. A standing order is a medical regimen; it shall be consistent with the lawful scope of practice of a registered nurse.
8. The commissioner may make regulations governing the terms, procedures and implementation of standing orders.
§ 2. Section 6909 of the education law is amended by adding a new subdivision 9 to read as follows:
9. A registered professional nurse may execute a standing order for newborn care in a hospital established under section twenty-eight hundred three-v of the public health law, as provided in that section. The commissioner may make regulations relating to implementation of this subdivision.
S. 8774--B 3
§ 3. This act shall take effect on the one hundred twentieth day after it shall have become a law. Effective immediately, the commissioner of health and the commissioner of education may make regulations and take other actions reasonably necessary to implement this act on that date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law and the educa- tion law, in relation to hospital standing orders for the care of newborns
Purpose
To amend the Public Health Law and the Education Law, in relation to allowing hospitals to establish non-patient specific orders for the care of healthy newborns by an attending registered nurse.
Summary of provisions
Section 1 creates a new section 2803-v in the public health law, author- izing hospitals to create standing orders for newborn care.
Read the full memo (781 words)
Subdivision 1 authorizes a hospital to establish standing orders for the care of newborns.
Subdivision 2 defines terms.
Subdivision 3 provides that a standing order may be implemented either when directed by the attending practitioner, or when the attending nurse determines that implementing the standing order is clinically appropri- ate and consistent with the order, the hospital's policies, and applica- ble regulations.
Subdivision 4 requires that a standing order provide for the circum- stances in which departure from the order is required, and that an attending nurse shall advise the attending practitioner if the nurse becomes aware of circumstances that reasonably indicate a need to depart from the standing order. The order must also provide that the attending practitioner shall review and acknowledge in writing the care provided under the standing order.
Subdivision 5 allows a standing order to provide for circumstances in which it shall not be implemented or shall only be implemented at the order of an attending practitioner. A standing order shall also be dated, timed, and authenticated promptly in the patient's medical record by the attending practitioner.
Subdivision 6 requires that in order to implement a standing order, a hospital must: establish that the order has been reviewed and approved by the hospital's medical staff and nursing and pharmacy leadership; demonstrate that the order is consistent with nationally recognized evidence-based guidelines; and ensure that the hospital's medical staff and nursing and pharmacy leadership conduct periodic and regular reviews of the order to determine its continuing usefulness and safety.
Subdivision 7 provides that a standing order is a medical regimen and shall be consistent with the lawful scope of practice of a registered nurse.
Subdivision 8 allows the commissioner to make regulations governing the terms, procedures, and implementation of standing orders.
Section two of the bill amends section 6909 of the Education Law in relation to allowing registered professional nurses to execute a stand- ing order for newborn care in a hospital established under section twen- ty-eight hundred three-v of the Public Health Law.
Section three of the bill establishes the effective date.
Justification
Until recently, it was common for hospitals to establish non-patient specific orders for the care of infants delivered within their facili- ties These orders enabled registered nurses (RNs) to carry out standard procedures following deliveries of healthy babies, without a specific order from the attending obstetric or pediatric practitioner. They were initiated by the RN, were evidence-based, and included state-mandated treatments that must be performed within specified time limits for all healthy newborns, such as antibiotic eye prophylaxis, administration of vitamin K, and HIV and metabolic disorder testing. Such treatments and services are well within the scope of practice of a registered nurse. Since births often occur when the attending physician, nurse practition- er, physician assistant, or midwife is unavailable, an RN's ability to initiate the routine care of a healthy newborn is an important part of ensuring timely care.
New York law authorizes "non-patient specific regimens" to allow RNs to do such things as administer certain treatments and tests, including immunizations and HIV tests, to patients without a patient-specific order from a physician for each individual. Since the law does not explicitly include standing orders for the care of healthy newborns, some authorities interpret hospital standing orders for newborn care to be illegal.
The bill maintains the authority of the attending practitioner, the hospital, and Health Department regulations, and protects the role and scope of practice of RNs.
This bill will allow hospitals to establish non-patient specific stand- ing orders for RNs to initiate upon the birth of a healthy newborn in their facility. Each hospital will establish the circumstances in which its order will and will not be implemented without a patient-specific order from the attending practitioner, and all orders will comply with an RN's scope of practice and all applicable regulations.
Legislative history
New bill.
Effective date
This act shall take effect on the one hundred twentieth day after it shall have become a law. Effective immediately, the commissioner of health and the commissioner of education may make regulations and take other actions reasonably necessary to implement this act on that date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.