| (ii) Control desk and reception area. A control desk
and reception area shall be provided.
(iii) Dictation and report preparation area. The dictation
and report preparation area may be incorporated with the control station.
(iv) Holding area. The holding area shall be under
direct staff control, out of the direct line of traffic, and have
space for stretchers. The holding area shall accommodate two stretchers
for the first procedure room with one additional station for each
additional procedure room.
(v) Patient toilet facilities. A toilet room with a
hand washing fixture with hands-free operable controls shall be provided
convenient to the waiting room and procedure room.
(vi) Staff toilet facilities. Toilets and hand washing
fixtures with hands-free operable controls may be outside the suite
but shall be convenient for staff use.
(vii) Patient dressing rooms or cubicles. Dressing
rooms or cubicles shall be provided convenient to the waiting areas
and procedure rooms. Each room or cubicle shall include a seat or
bench, mirror, and provisions for hanging patients' clothing and for
securing valuables. At least one dressing room shall be provided to
accommodate wheelchair patients.
(viii) Exam room(s). When examination rooms are provided,
each room shall have a minimum of 100 square feet of clear floor area
exclusive of built-in shelves or cabinets. Each exam room shall be
equipped with a work counter and a hand washing fixture with hands-free
operable controls.
(ix) Dose administration area. When a dose administration
area is provided, the area shall be located near the preparation area
and include visual privacy for the patients.
(x) Computer control area/room. Computer control area
shall be located within or adjacent to the treatment room(s). When
a centralized computer area is provided, it shall be a separate room
with access terminals available within the treatment rooms.
(xi) Film processing room. A darkroom shall be provided
for film processing unless the processing equipment normally used
does not require a darkroom for loading and transfer. When daylight
processing is used, the darkroom may be minimal for emergency and
special uses. Film processing shall be located convenient to the treatment
room(s) and to the quality control area.
(xii) Quality control area or room. A quality control
area shall include view boxes illuminated with light of the same color
value and intensity.
(xiii) Film storage room (active). A room with cabinet
or shelves for filing patient film for immediate retrieval shall be
provided.
(xiv) Film storage room (inactive). A room for inactive
film storage may be located outside the nuclear medicine suite, but
must be under the administrative control of nuclear medicine personnel
and properly secured to protect films against loss or damage.
(xv) If digital imaging is utilized throughout the
suite, the darkroom film processing area and film viewers may be omitted.
(xvi) Storage for unexposed film. Storage facilities
for unexposed film shall include protection of film against exposure
or damage.
(xvii) Offices for physicians, oncologist, physicists,
and assistants. Offices shall include provisions for individual consultation,
viewing, and charting of film.
(xviii) Clerical office(s) spaces. Clerical office(s)
spaces shall be provided.
(xix) Consultation room. A consultation room shall
be provided.
(xx) Clean storage room. A clean storage room shall
be provided for clean supplies and linens. A hand washing fixture
shall be provided with hands-free operable controls. When conveniently
located, the clean storage room may be shared with another department.
(xxi) Soiled workroom. The soiled workroom shall not
have direct connection to the nuclear medicine procedure or diagnostic
rooms or sterile activity rooms. The room shall contain a clinical
sink or equivalent flushing type fixture, work counter, hand washing
fixture with hands-free operable controls, waste receptacle, and soiled
linen receptacle. When contaminated soiled material or fluid waste
is not handled, only a soiled holding room is required.
(xxii) Housekeeping room. The housekeeping room shall
be located within the suite.
(2) Details and finishes. Details and finishes shall
be in accordance with §133.162(d)(2) of this title and this paragraph.
(A) Details.
(i) Radiation protection shall be designed, tested
and approved by a medical physicist licensed under the Texas Medical
Physics Practice Act, Occupations Code, Chapter 602.
(I) Room shielding calculations for the stipulated
rooms within the nuclear medicine suite must be submitted to the Department
of State Health Services, Radiation Control (RC) for approval prior
to use. Shielding in diagnostic radiographic rooms will be reviewed
by RC inspectors, in the field, subsequent to use. Any changes in
design or shielding which affects radiation exposure levels adjacent
to those rooms, requires prior approval by RC.
(II) Facility design and environmental controls associated
with licensable quantities of radioactive material in laboratories
or procedure rooms must be approved by RC prior to licensed authorizations.
(ii) The nuclear medicine treatment rooms shall have
ceiling heights not less than nine feet. Ceilings containing ceiling-mounted
equipment shall be of sufficient height to accommodate the equipment
of fixtures and their normal movement.
(B) Finishes.
(i) Flooring used in the nuclear medicine procedure
room, any work or treatment areas where radioactive material is handled,
and soiled workroom shall be of the seamless monolithic type as required
by §133.162(d)(2)(B)(iii)(III) of this title.
(ii) Ceilings in radiopharmacy, hot laboratory, and
soiled workrooms 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) When radiopharmaceutical preparations are performed,
vents and traps for radioactive gases shall be provided.
(B) Direction of air flow of the HVAC system shall
be from nonradioactive spaces into the radioactive spaces. A minimum
of two return air inlets located diagonally opposite from one another
and near floor level shall be provided.
(C) In the PET suite, special ventilation systems together
with monitors, sensors, and alarm systems shall be required to vent
gases and chemicals. The ventilation shall be directly to the exterior.
(D) Filtration requirements for air handling units
serving the nuclear medicine suite shall be equipped with filters
having efficiencies equal to, or greater than specified in Table 4
of §133.169(d) of this title.
(E) Where fume hoods are used, the design should consider
the placement and types of air distribution devices to avoid the disturbance
of a uniform velocity across the face of the hood. Fume hoods shall
be exhausted directly to the exterior.
(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.
(A) General.
(i) Each nuclear medicine procedure room shall have
at least four duplex electrical hospital grade receptacles.
(ii) Nuclear medicine procedures rooms shall have general
lighting in addition to that provided by special lighting units at
the procedure tables.
(B) Nurses calling systems. The nurse call shall be
in accordance with §133.162(d)(5)(L) and Table 7 of §133.169(g)
of this title.
(t) Nursing unit. The requirements in this subsection
apply to nursing units in hospitals for all types of inpatient care.
Facilities providing care to less than 15 pediatric inpatients may
be included with an adult nursing unit. Additional requirements for
a nursing unit providing care to 15 or more pediatric patients are
contained in subsection (w) of this section.
(1) Architectural requirements. Architectural requirements
shall be in accordance with §133.162(d)(1) of this title and
this paragraph.
(A) Handicapped accessibility requirements. At least
10% of each patient room type, isolation room, bathing units and toilets
in medical/surgical, intermediate care, universal care, antepartum,
postpartum, mental health, chemical dependency, and pediatric nursing
units and all public and common use areas shall be designed and constructed
to be handicapped accessible. These requirements shall apply in all
new construction and when an existing nursing unit or a portion thereof
is converted from one service to another, i.e. mental health care
to Cont'd... |
