| medical or surgical nursing care.
(B) Patient room suites. A patient room suite shall
consist of the patient room and a bathroom. Patient room suites shall
comply with the following requirements.
(i) Maximum patient room capacity. The maximum patient
room capacity shall be two patients. In existing facilities where
renovation work is undertaken and the present capacity is more than
two patients, the maximum room capacity shall be no more than the
present capacity with a maximum of four patients.
(ii) Single-bed patient room. In a single-bed patient
room, the minimum clear floor area shall be 120 square feet.
(iii) Multi-bed (two) patient room. The clearance between
the side of a bed and a wall/partition shall be a minimum of three
feet. The clearance between sides of beds shall be a minimum of five
feet. The minimum distance at the foot of the bed shall not be less
than four feet for a single load area/room or seven feet for a double
load area/room. Four feet of the passage space at the foot of the
bed may be shared between two beds. The requirements of this clause
are illustrated in Table 8, Diagram G of §133.169(h) of this
title.
(iv) Multi-bed (two) accessible patient room. The clearance
between the side of a bed and a wall/partition shall be a minimum
of five feet. The clearance between sides of beds shall be a minimum
of four feet. The minimum distance at the foot of the bed shall not
be less than four feet for a single load area/room or seven feet for
a double load area/room. Four feet of the passage space at the foot
of the bed may be shared between two beds. The requirements of this
clause are illustrated in Table 8, Diagram H of §133.169(h) of
this title.
(v) Arrangement of patient rooms. Minor encroachments
including columns and wall hung lavatories that do not interfere with
functions may be ignored when determining space requirements for patient
rooms.
(I) Required clear floor space in patient rooms shall
be exclusive of toilet rooms, closets, lockers, built-in cabinets,
wardrobes, alcoves, or vestibules.
(II) Visual privacy shall be provided each patient
in multi-bed rooms. Design for privacy shall not restrict independent
patient access to the corridor, lavatory, or bathroom.
(vi) Patient bathroom. Each patient shall have access
to a bathroom without having to enter the general corridor area. Each
bathroom shall contain a toilet with bed pan washers, hand washing
fixture with hands-free operable controls, bathing facilities, and
storage shelf or cabinet and serve not more than two patient rooms.
Hand washing facilities shall be located in the patient room and in
the patient bathroom. The hand washing fixture in the room shall be
located outside of the patient's cubicle curtain in multi-bed patient
room.
(vii) Patient storage. Each patient shall have a separate
wardrobe, locker, or closet that is suitable for hanging full-length
garments and for storing personal effects. A minimum of 12 lineal
inches of hanging space shall be provided per patient.
(C) Airborne infection isolation suites. A minimum
of one isolation suite shall be provided for each 30 acute care beds
or fraction thereof. The suite may be located within a nursing unit
or in a separate isolation unit. When a pediatric patient suite is
located in an adult nursing unit and is not part of a pediatric or
adolescent nursing unit, a minimum of one isolation room shall be
designated for pediatric patient care. Each airborne infection isolation
suite shall consist of a work area, a patient room, and a patient
bathroom.
(i) The work area may be a separately enclosed anteroom
or a vestibule that is open to and is located immediately inside the
door to the patient room. It shall have facilities for hand washing,
gowning, and storage of clean and soiled materials. One enclosed anteroom
may serve multiple isolation rooms.
(ii) Each patient room shall have a clear floor area
of 120 square feet exclusive of the work area and shall contain only
one bed. A patient bathroom shall be provided in accordance with subparagraph
(B)(vi) of this paragraph.
(iii) At least one airborne infection isolation suite
with an enclosed anteroom shall be provided.
(iv) A door(s) from an anteroom to an airborne infection
isolation room(s) and a door(s) from an egress corridor into an anteroom
shall be provided with a self-closing device(s). When an isolation
room does not have an anteroom, the door from the egress corridor
into the isolation room shall be provided with a self-closing device.
When sliding doors are used in isolation rooms in CCU suites and in
surgical suite post-anesthesia care units, the self-closing device
may not be required as long as assurances of negative air pressure
are met when sliding doors are opened.
(v) Pressure differential monitors or air flow devices
shall be installed outside the isolation room and anteroom. Devices
shall be installed in corridors, passageways, etc.
(D) Protective environment suite. When specialized
services for patients with extreme susceptibility to infection are
provided, spatial requirements for the suite shall be identical to
those for airborne infection isolation suites contained in subparagraph
(C) of this paragraph with the exception that an enclosed anteroom
shall be provided.
(E) Room for disturbed medical patients. Each general
hospital shall provide at least one private patient room for patients
needing close supervision for medical and/or psychiatric care. The
room may be part of the mental health and chemical dependency nursing
suite described in subsection (q) of this section. If the room is
part of a nursing suite, the provisions of subparagraph (B)(ii) of
this paragraph shall apply. Each room shall be designed in accordance
with subsection (q)(2)(A) and (B) of this section.
(F) Service areas. Service areas shall be located in,
or readily available to, each nursing unit. Each service area may
be arranged and located to serve more than one nursing unit, but at
least one service area shall be provided on each nursing floor. The
following service areas shall be provided:
(i) an administrative center or nurses station with
an adjacent but separate dictation space;
(ii) a nurses office;
(iii) an area for charting. The area may be combined
with the nurses station when adequate space is provided for both;
(iv) a medication room, medicine alcove area, or a
self-contained medicine dispensing unit under visual control of nursing
staff. The medication alcove area may be located in the clean workroom.
The self-contained medicine dispensing unit may be located in an alcove
at the nurse station. The room, area or unit shall contain a work
counter, hand washing fixture with hands-free operable controls, refrigerator,
and double-locked storage for controlled substances. Standard cup-sinks
provided in many self-contained units are not adequate for hand washing;
(v) a nourishment station containing a work counter
with sink, microwave, refrigerator and storage cabinets and not located
in the clean workroom;
(vi) a multipurpose room for staff and patient conferences,
education, demonstrations, and consultation. The room shall be conveniently
accessible to each nursing unit and may serve several nursing units
or departments. The room may be located on another floor if convenient
for regular use;
(vii) a conveniently located examination/treatment
room which may serve several nursing units located on the same floor.
The room shall have a minimum clear floor area of 100 square feet
and contain a counter for writing and hand washing facilities with
hands-free operable controls. This room may be omitted if all patient
rooms on the floor are single-bed patient rooms;
(viii) special assisted bathing facilities, including
space for attendant, for patients on stretchers, carts, and wheelchairs
at the ratio of one per 100 beds or a fraction thereof. This may be
on another floor if convenient for use. The central bathing room shall
contain a bathtub which is accessible to a patient in a wheelchair
or a shower that can accommodate a gurney. The room shall have space
for drying and dressing and be provided with a hand washing fixture
with hands-free operable controls and a toilet with three feet of
clear space on sides and front of the water closet;
(ix) staff lounge with unisex dressing cubicles, lockers,
toilets and hand washing facilities. These facilities may be on another
floor;
(x) securable closets or cabinet compartments for personal
articles of nursing unit staff. The closets or lockers shall be located
at or near the nurse station. At a minimum, these shall be large enough
for purses and billfolds. Coats may be stored in closets or cabinets
on each floor or in a central staff locker area;
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