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<regulation prefix="Regulation" num=".04" citation="COMAR 10.27.21.04" title_num="10" subtitle_num="27" chapter_num="21" heading="Scope and Standards of Practice.">
  <paragraph num="A.">
    <text>An RN-FNE may perform the following tasks and functions with respect to the age group for which the RN-FNE is certified under Regulation .03 of this chapter:</text>
    <paragraph num="(1)">
      <text>Perform forensic evidentiary examinations on victims and alleged perpetrators in connection with physical, sexual, or domestic assaults, whether chronic or acute;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Before the forensic evidentiary examination, obtain consent from the individual being examined, from the parent or guardian of a minor individual, or from the proper authority for photographing and evidence collection;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Prepare and document the assault history interview;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Perform the forensic evidentiary physical assessment, which may include use of an ALS;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Complete the physical evidence kit provided by law enforcement;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Gather, preserve, handle, document, and label forensic evidence, including but not limited to:</text>
      <paragraph num="(a)">
        <text>Labeling evidence collection containers with the patient's identifying data per local jurisdiction requirements;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Placing evidence in the evidence collection container and sealing the container;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Signing the evidence collection container as the collector of the evidence;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Taking photographs; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Obtaining swabs, smears, and hair and body fluid samples;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Maintain the chain of custody;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Provide immediate health interventions using clinical practice guidelines;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Obtain consultations and make referrals to health care personnel and community agencies;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Provide immediate crisis intervention at the time of the examination;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Provide discharge instructions;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Participate in forensic proceedings including courtroom testimony;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Interface with law enforcement officials, crime labs, and State attorney's offices; and</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Assist the licensed physician in performing a forensic evidentiary examination.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Clinical Practice Guidelines. An RN-FNE may practice only in a clinical setting in which clinical policy and practice guidelines:</text>
    <paragraph num="(1)">
      <text>Have been approved by the facility's medical and nursing departments;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Designate the availability of qualified physician resources;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Identify the department in which an RN-FNE shall function; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Designate a program coordinator who has experience in forensic evidentiary examinations to administer the RN-FNE training program.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The program coordinator:</text>
    <paragraph num="(1)">
      <text>Is responsible for obtaining Board approval of the curriculum before conducting a training program;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has responsibility for oversight and administration of the facility’s RN-FNE training program and the practice of the facility’s RN-FNEs;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Verifies the qualifications and certifications of any RN-FNE practicing in the facility;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Administers and manages the RN-FNE practice;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Approves practice protocols and standards of care for RN-FNE practice;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Shall develop a peer review process that includes, but is not limited to:</text>
      <paragraph num="(a)">
        <text>Coordinating the peer review of cases;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Ensuring that the peer review is consistent with the standardized data collection process;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Ensuring that a peer reviewer meets the qualifications in Regulation .05 of this chapter; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Using the standardized form for peer review that is required by the Board;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Interfaces with law enforcement, the State's attorney, and community resource groups;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Implements the facility's Board-approved RN-FNE curricula; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Facilitates reimbursement for RN-FNE services by cooperating with the facility's billing department and interacting with the State reimbursement system.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>An RN-FNE shall comply with all State and federal statutes and regulations related to the RN-FNE practice.</text>
  </paragraph>
  <paragraph num="E.">
    <text>An RN-FNE shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.</text>
  </paragraph>
</regulation>