| (viii) Horizontal grab bars shall be constructed to
prevent looping or tying of cords, ropes, etc.
(ix) Where glass fragments may create a hazard, safety
glazing or other appropriate security features shall be incorporated.
(B) Finishes. Patient sleeping rooms, patient toilet
rooms and seclusion rooms shall have monolithic ceilings and bonded
walls for patient safety and security measures. The ceiling in the
soiled workroom shall be monolithic type as required by §133.162(d)(2)(B)(vi)(III)
of this title. Gero-psychiatric patient rooms and toilet rooms may
omit the monolithic ceiling requirement when hospital administration
provides a written statement (on hospital letterhead) that the type
and degree of security is appropriate for the patient areas.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with subsection (t)(3) of this section and
this paragraph.
(A) Special consideration shall be given to the type
of heating and cooling units, ventilation outlets, and appurtenance
installed in patient-occupied areas of mental health nursing units.
The following shall apply:
(B) All air grilles and diffusers shall be of a type
that prevents the insertion of foreign objects.
(C) All convector or HVAC enclosures exposed in the
room shall be constructed with rounded corners and shall have enclosures
fastened with tamper-resistant fasteners.
(D) HVAC equipment shall be of a type that minimizes
the need for maintenance within the room.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with subsection (t)(4)
of this section and this paragraph.
(A) Piping systems.
(i) Piped medical gas systems are not required.
(ii) Only tamper-proof sprinkler and tamper-proof showerheads
from which it is not possible to suspend any objects shall be installed.
(B) Plumbing fixtures.
(i) Faucet controls shall not be equipped with handles
that may be easily broken off.
(ii) Bedpan washers are not required in patient bathrooms.
(5) Electrical requirements. Electrical requirements
shall be in accordance with subsection (t)(5) of this section and
this paragraph.
(A) A nurses calling system is not required in patient
rooms. However, when a nurses calling system is provided, the system
shall meet the requirements of §133.162(d)(5)(L) and Table 7
of §133.169(g) of this title. Pull cords shall not exceed 18
inches in length, and provisions shall be made to permit removal of
call buttons and use of blank plates as required for security.
(B) Each patient room shall have duplex grounded receptacles.
There shall be one receptacle at each side of the head of each bed
and one on every other wall. Receptacles in areas intended for mental
health and chemical dependency patients of all ages shall be protected
by GFCI breakers installed in distribution panel enclosures serving
the unit.
(C) Fifteen-ampere and 20-ampere, 125-volt receptacles
intended to supply patient care areas shall be tamper-resistant as
permitted by NFPA 70, §517-18, or shall be protected by GFCI
breakers. A tamper-resistant receptacle is one that is constructed
to limit improper access to its energized contacts.
(r) Morgue.
(1) Architectural requirements.
(A) General. When a morgue or body-holding room is
provided, it shall be located to avoid the need for transporting bodies
of deceased patients through public areas. A body-holding room shall
be provided as a minimum for a general hospital.
(B) Autopsy performed within hospital. When autopsies
are performed within the hospital, the following rooms, areas, and
equipment shall be provided.
(i) Refrigerated facilities shall be provided for body-holding.
(ii) The autopsy room shall contain work counters,
hand washing facilities with hands-free operable controls, autopsy
table and storage space for supplies, equipment and specimens.
(iii) A deep sink shall be provided for washing specimens.
(iv) A clothing change area shall be provided with
shower, toilet, hand washing facilities and lockers.
(C) Service areas. The following service areas shall
be provided:
(i) a pathologist office;
(ii) staff toilets. Toilets may be outside the suite
but be convenient for staff use with hand washing fixture(s) with
hands-free operable controls; and
(iii) a housekeeping room. A housekeeping room which
meets the requirements of §133.162(d)(2)(A)(xxviii) of this title
shall be provided for the exclusive use of the morgue when autopsies
are performed.
(D) Minimum requirements. If autopsies are performed
outside the hospital, a well-ventilated, temperature-controlled, nonrefrigerated
body-holding room shall be provided.
(2) Details and finishes. Details and finishes shall
be in accordance with §133.162(d)(2) of this title and this paragraph.
(A) Flooring used in the autopsy room shall be the
seamless type as required by §133.162(d)(2)(B)(iii)(III) of this
title.
(B) Ceilings in the autopsy rooms shall be monolithic
as required by §133.162(d)(2)(B)(vi)(III) of this title.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with §133.162(d)(3) of this title and
this paragraph.
(A) The autopsy room shall be equipped with low exhaust
grilles.
(B) The body-holding room shall be ventilated in accordance
with Table 3 of §133.169(c) of this title.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §133.162(d)(4)
of this title.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §133.162(d)(5) of this title and
this paragraph. Refrigerators for body-holding in the autopsy room
shall be connected to the equipment branch of the essential electrical
distribution system.
(s) Nuclear medicine suite.
(1) Architectural requirements.
(A) General. When nuclear medicine services are provided,
the facilities may be in a separate suite or combined with an imaging
suite.
(i) When nuclear medicine requires radiation protection,
a medical physicist licensed under the Texas Medical Physics Practice
Act, Occupations Code, Chapter 602, shall specify the type, location,
and amount of radiation protection to be installed for the layout,
equipment selections and storage, handling and disposal of radioactive
material.
(ii) The nuclear medicine room shall be sufficiently
sized to house all fixed and moveable equipment and allow a minimum
of three feet of clear and unobstructed working space on all sides
of equipment accessible to staff and patient.
(B) Radioisotope room (Hot lab). When radiopharmaceutical
preparation is performed on site, the room shall include sufficient
space for equipment, storage of radionuclides, chemicals for preparation,
dose calibrators, and record keeping. When preprepared materials are
used, storage and calculation area may be smaller than for on-site
preparation.
(i) The room and isotope handling areas within the
room shall have appropriate radiation shielding.
(ii) There shall be a shielded area or enclosed shielded
cabinet for long-term storage of decaying radioisotopes.
(iii) When venting of radioactive gases is required,
a hood shall exhaust to the exterior.
(C) Positron emission tomography (PET). When PET services
are provided, scanner and cyclotron rooms shall be in compliance with
the manufacturer's recommendations and provide a minimum of three
feet of clear and unobstructed working space on all sides of equipment
accessible to staff and patient.
(i) A control alcove shall be provided with a view
window permitting view of the patient.
(ii) An equipment area large enough to contain necessary
electronic and electrical gear shall be provided.
(iii) A dose administration room(s) with radiation
shielding shall be located near the treatment room. Patients in route
to procedure rooms shall not pass through public corridors and waiting
rooms after injection with radioisotope.
(iv) A patient toilet with radiation shielding shall
be provided with or adjacent to dose administration room(s). The patient
toilet room shall contain a hand washing fixture with hands-free operable
controls.
(D) Service areas.
(i) Patient waiting area. The area shall be out of
traffic and under direct staff visual control. When the waiting area
serves both outpatients and inpatients, separate areas shall be provided
and include visual privacy between the waiting areas.
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