| (vii) Duplex receptacles shall be installed not more
than 50 feet apart in corridors and within 25 feet of corridor ends.
(viii) The isolation exhaust system shall be connected
to the emergency essential electrical system.
(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.
(C) Illumination requirements.
(i) General illumination requirements. Nursing unit
corridors shall have general illumination with provisions for reducing
light levels at night. Illumination of corridors for egress purposes
shall comply with NFPA 101, §18.2.8 and §18.2.9.
(ii) Illumination of the nurses station. Illumination
of the nurses station and all nursing support areas shall include
fixtures powered from the critical branch of the emergency electrical
system NFPA 99, §4.4.2.2.2.3(3)(d).
(iii) Patient suite lighting.
(I) Each patient room shall be provided with general
lighting and night lighting. General lighting and night lighting shall
be controlled at the room entrance. All controls for lighting in patient
areas shall be of the quiet operating type. Control of night lighting
circuits may be achieved by automatic means and in such instances
control of night lighting at the room entrance shall not be required.
At least one general light fixture and night lighting shall be powered
from the critical branch of the essential electrical system.
(II) A reading light shall be provided for each patient.
Reading light control shall be readily accessible from each patient
bed. Flexible light arms, if used, shall be mechanically controlled
to prevent the bulb from coming in contact with bed linen. High heat-producing
light sources such as incandescent and halogen shall be avoided to
prevent burns to patients and/or bed linen. Light sources shall be
covered by a diffuser or a lens.
(III) A wall or ceiling-mounted lighting fixture shall
be provided above each lavatory.
(IV) A ceiling-mounted fixture shall be provided in
patient bathrooms where the lighting fixture above the lavatory does
not provide adequate illumination of the entire bathroom. Some form
of fixed illumination shall be powered from the critical branch.
(u) Obstetrical suite.
(1) Architectural requirements.
(A) General. When obstetrical services are provided,
the obstetrical suite shall be located and arranged to preclude unrelated
traffic through the suite. Regardless of the clinical model used for
labor, delivery, recovery and postpartum, a hospital offering such
services shall be able to demonstrate the availability of one room
designed, equipped and held in reserve for emergency, caesarean section
deliveries. This room shall be located either in the labor and delivery
suite or surgical suite.
(B) Caesarean section (c-section) operating room(s).
A minimum of one dedicated c-section operating room shall be located
in either the obstetrical or surgical suite. This room shall have
a minimum clear floor area of 360 square feet with a minimum dimension
of 18 feet exclusive of built-in shelves or cabinets. There shall
be no direct access between operating rooms.
(C) Delivery room(s). A minimum of one delivery room
shall be provided in every obstetrical suite. The delivery room shall
have a minimum clear floor area of 300 square feet with a minimum
dimension of 16 feet exclusive of fixed and moveable cabinets and
built-in shelves. In facilities having only one c-section operating
room, the delivery room shall be designed to function as an emergency
c-section operating room. When two c-section operating rooms are provided,
the delivery room requirement may be omitted.
(D) Infant resuscitation area. An infant resuscitation
space shall be provided within the c-section operating room; delivery
room; labor, delivery, and recovery room (LDR); and labor, delivery,
recovery and postpartum room (LDRP) with a minimum clear floor area
of 40 square feet in addition to the required area of each room or
may be provided in a separate but immediately accessible room with
a clear floor area of 150 square feet.
(E) Labor room(s). A minimum of two labor beds shall
be provided for each delivery room. Each labor room shall be designed
for one or two beds with a minimum clear floor area of 120 square
feet per bed.
(i) An LDR or LDRP may be substituted for a labor room.
(ii) In facilities having only one delivery room, one
of the two required labor beds shall be in a separate room with a
minimum clear floor area of 160 square feet to serve as an emergency
vaginal delivery room. Medical gas outlets shall be the same as for
delivery room.
(iii) Each labor room shall contain a lavatory equipped
with hands-free operable controls. Each labor room shall have direct
access to a toilet room. One toilet room may serve two labor rooms.
(iv) Labor rooms shall be arranged so that doors are
visible from a nurses work station.
(v) A minimum of one shower shall be provided for each
four labor beds. Each shower room shall contain a toilet and hand
washing fixture with hands-free operable controls.
(F) Recovery room(s). Recovery room(s) shall contain
not less than two beds. There shall be enough space for baby and crib
and a chair for the support person. Visual privacy of the new family
shall be provided. LDRs or LDRPs may be substituted for recovery rooms.
(i) In multiple recovery patient stations, the clearance
between the side of a bed/gurney and a wall/partition shall be a minimum
of five feet. The clearance between sides of beds/gurneys shall be
a minimum of six feet. The minimum distance at the foot of the bed/gurney
shall not be less than eight feet for single load area/room or twelve
feet for double load area/room. Four feet of the passage space at
the foot of the bed may be shared between two beds/gurneys. The fixed
and movable cabinets and shelves shall not encroach upon the bed/gurney
clear floor space/area. The requirements of this clause are illustrated
in Table 8, Diagram N of §133.169(h) of this title.
(ii) A nurse station and charting area shall be provided
and arranged to permit staff visual observation of recovery beds.
(iii) A work counter, facilities for dispensing medicine,
storage for supplies and equipment, and a clinical sink with bedpan-flushing
device shall be provided.
(iv) One hand washing fixture with hands-free operable
controls shall be provided for every three recovery beds or fraction
thereof. Fixtures shall be uniformly distributed.
(v) There shall be cubicle curtains at each station
for patient privacy.
(G) Postpartum and antepartum suite. Postpartum and
antepartum patient suites shall be provided in accordance with subsection
(t)(1)(B) of this section.
(H) LDR.
(i) When provided, each LDR room shall have controlled
access and shall be located so that a patient may be transported to
the c-section operating room without the need to pass through other
functional areas.
(ii) Each LDR room shall be designed for single occupancy
and have a minimum clear floor area of 200 square feet exclusive of
the infant resuscitation area, built-in shelves or cabinets, alcove,
vestibule or other adjoining rooms. The minimum clear room dimension
shall not be less than 11 feet.
(iii) A hand washing fixture with hands-free operable
controls shall be provided in each LDR room.
(iv) Each LDR shall have direct access to and exclusive
use of a bathroom with a shower, or tub with shower, hand washing
fixture with hands-free operable controls and a toilet.
(I) LDRP. When provided, each LDRP room shall have
controlled access and shall be located on an exterior wall and have
a window in accordance with subsection (t)(2)(A)(iv) and (v) of this
section.
(i) Each room shall be designated for single occupancy
and have a minimum clear floor area of 260 square feet exclusive of
the infant resuscitation area, built-in shelves or cabinets, alcove,
vestibules, or other adjoining rooms. The minimum clear room dimension
shall not be less than 11 feet.
(ii) A hand washing fixture with hands-free operable
controls shall be provided in each LDRP room.
(iii) Each LDRP shall have direct access to and exclusive
use of a bathroom with a shower, or tub with shower, hand washing
fixture with hands-free operable controls and a toilet.
(J) Isolation rooms. When patients who have airborne
infectious diseases are treated, an isolation room shall be provided
in the obstetrical suite which complies with the functional space
requirements as specified in subparagraphs (G) - (I) of this paragraph,
and with the ventilation requirements for infection isolation rooms
in Table 3 of §133.169(c) of this title.
Cont'd... |
