| (xi) clean workroom or clean supply room. When used
for preparing patient care items, it shall contain a work counter,
hand washing facilities with hands-free operable controls, and storage
facilities for clean and sterile supplies. When used only for storage
and holding as part of a distribution system of clean and sterile
supplies, the work counter and hand washing facilities may be omitted;
(xii) clean linen storage for each nursing unit. This
may be within a clean workroom, a separate closet, or an approved
distribution system on each floor. If a closed cart system is used,
storage may be in an alcove, but must be out of the path of normal
traffic and under staff control;
(xiii) a soiled workroom or soiled holding room. The
room shall contain a clinical sink or equivalent flushing rim fixture,
hand washing facilities with hands-free operable controls, both with
hot and cold water. The room shall have a work counter and space for
separate covered containers for soiled linen and waste. When facilities
for cleaning bedpans are provided elsewhere, the flushing rim clinical
sink may be omitted;
(xiv) an equipment storage room or alcove. The room(s)
or alcove(s) shall be located on the patient floor to keep the corridor
width free of all equipment and supplies. Ten square feet of equipment
storage or supplies shall be provided for each patient bed. Combustible
supplies shall not be stored in an alcove in the egress corridors;
(xv) an emergency equipment storage room or alcove
under direct visual control of the nursing staff;
(xvi) a housekeeping room which may also serve adjacent
nursing units;
(xvii) stretcher and wheelchair storage space which
is located without restricting normal traffic;
(xviii) public toilets with hand washing facilities.
The toilets shall be located on each floor containing a nursing unit;
(xix) staff toilet conveniently located to each nursing
unit. At least one staff toilet shall be located on each patient sleeping
floor. Toilet may be unisex; and
(xx) an ice dispensing machine for each nursing unit
which is located at the nourishment station or the clean work room.
(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) Egress. Means of egress from each patient suite
shall comply with the requirements of NFPA 101, §18.2.
(ii) Patient bathroom and toilet room doors. Door leaves
to all patient bathrooms and toilet rooms shall be at least 36 inches
wide and shall swing outward or be double acting so that nursing staff
may gain access to a patient who has collapsed against the door. Doors
lockable from the inside shall have hardware that allows staff to
open the door from the outside.
(iii) Vision panels. Vision panels shall be provided
in the door between an anteroom and an airborne infection isolation
room or a protective environment room.
(iv) Patient room windows. Each patient sleeping room
shall have an outside door or an outside window. When operable windows
are provided and the operation of windows requires the use of tools
or keys, the tools or keys shall be located at each nurses station,
on the same floor, and easily accessible to staff. The allowable window
sill height shall not exceed 36 inches above the floor.
(v) Location of patient room windows. Windows in patient
sleeping rooms shall be located on an outside wall. These windows
may face an atrium, an inner court, or an outer court provided the
following requirements are met.
(I) Patient room atria windows. When patient room windows
face an atrium, the atrium shall comply with the requirements of NFPA
101, §8.6.7. When windows are operable, an engineered smoke control
system shall be provided in accordance with National Fire Protection
Association 92B, Guide for Smoke Management Systems in Malls, Atria,
and Large Areas, 2000 edition.
(II) Outer courts. Outer court (not enclosed by building
on one side) onto which the required windows open shall have a minimum
width, at all levels, of not less than three inches for each foot,
or fraction thereof, of the height (average height of enclosing walls)
of such court, but in no case shall the width be less than five feet.
An outer court shall have a horizontal cross-sectional area not greater
than four times the square of its width.
(III) Inner courts. Inner court (enclosed by building
on all sides) onto which the required windows open shall have minimum
width, at all levels, of not less than one foot for each foot, or
fraction thereof, of the height (average height of enclosing walls)
of such courts, but in no case shall the width be less than 10 feet.
When operable windows are provided, a horizontal, unobstructed, and
permanently open air intake or passage having a cross-sectional area
of not less than 21 square feet shall be provided at or near the bottom
of the court. Metal decorative grilles not effectively reducing the
open area by more than 5.0% shall be permitted at the ends. Walls,
partitions, floor, and floor-ceiling assemblies forming intakes or
passages shall be noncombustible and shall be constructed in accordance
with NFPA 101, §18.3.1.1. An inner court shall have a horizontal
cross-sectional area of not less than one and one-half times the square
of its width.
(vi) Hand washing facilities. Hand washing facilities
shall be conveniently located near the nurses station and in the medication
area. One lavatory in an open medication area can meet this requirement.
(vii) Elevator lobbies. Elevator lobbies shall be provided
in accordance with §133.164 of this title (relating to Elevators,
Escalators, and Conveyors).
(viii) Patient's privacy. Cubicle curtains to assure
privacy for each patient shall be provided in all multi-bed patient
rooms.
(ix) Telephone access. Each patient shall have access
to a telephone directly from each bed.
(B) Finishes.
(i) Seamless floors with coved wall bases described
in §133.162(d)(2)(B)(iii)(III) of this title shall be provided
in soiled workrooms.
(ii) Wall bases in the soiled workroom shall be made
integral and coved with the floor, tightly sealed to the wall, constructed
without voids that can harbor insects, retain dirt particles, and
impervious to water.
(iii) Monolithic ceilings described in §133.162(d)(2)(B)(vi)(III)
of this title shall be provided in airborne infection isolation rooms,
protective environment rooms, and soiled workrooms.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with §133.162(d)(3) of this title and
this paragraph.
(A) Outside air shall be supplied to each patient room
by a central air handling unit to provide make-up air for air exhausted
from the bathroom in accordance with Note 3 of Table 3 of §133.169(c)
of this title.
(B) Each patient room bathroom shall be exhausted continuously
to the exterior in accordance with Table 3 of §133.169(c) of
this title.
(C) The isolation room exhaust shall be a dedicated
system which exhausts all air continuously to the exterior in accordance
with Table 3 of §133.169(c) of this title. Multiple isolation
rooms may be interconnected to the same exhaust system.
(4) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §133.162(d)(4)
of this title and this paragraph. Each patient bathroom shall contain
a water closet with a bedpan washer, bathtub or shower and a lavatory.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §133.162(d)(5) of this title and
this paragraph.
(A) Electric receptacles in nursing units.
(i) Each receptacle shall be grounded to the reference
grounding point by means of an insulated copper grounding conductor.
(ii) Each patient bed location shall be supplied by
at least two branch circuits, one from the critical branch of the
emergency system as required by NFPA 99, §3-4 and one from the
normal system. All branch circuits from the normal system shall originate
in the same panelboard.
(iii) One duplex receptacle connected to a normal branch
circuit and one duplex outlet connected to the critical branch circuit
shall be located on opposite sides of the head of each bed. In addition
at least one duplex outlet shall be located on each wall. A dedicated
outlet shall be provided at the television location.
(iv) Each examination table shall have access to two
duplex receptacles.
(v) Each work table or counter shall have access to
one duplex receptacle for every six feet of table or counter space
or fraction thereof.
(vi) One duplex receptacle protected with a GFCI shall
be installed in the bathroom to permit the use of electrical appliances
in front of the mirror.
Cont'd... |
