| (K) Nursery suite. One infant station for each LDRP
and each postpartum bed shall be provided in the nursery. Nurseries
shall be located and arranged convenient to the postpartum nursing
unit and near or part of the obstetrical suite. The nurseries shall
be located and arranged to preclude the need for nonrelated pedestrian
traffic. Each nursery unit shall meet the following requirements.
(L) Full-term nursery. A full-term nursery shall have
a maximum of 16 infant stations. The clearance between the side of
a bassinet and a wall/partition shall be a minimum of two feet six
inches. The clearance between sides of bassinets shall be a minimum
of four feet. The minimum distance at the foot of the bassinet shall
not be less than five feet for single load area/room or seven feet
for double load area/room. Three feet of the passage space at the
foot of the bassinet may be shared between two bassinets. The requirements
of this subparagraph are illustrated in Table 8, Diagram I of §133.169(h)
of this title. Additional area shall be provided to accommodate workroom
functions if these are located within the nursery area as specified
in subparagraph (N)(iv) of this paragraph.
(i) When a rooming-in program is used, the total number
of bassinets in full-term nursery units shall be not less than one
bassinet for every two LDRP and postpartum beds.
(ii) When a rooming-in program is used but all infants
are returned to the nursery at night, a reduction in bassinets shall
not be allowed.
(iii) There shall be one lavatory with hands-free operable
controls for each six infant stations or fraction thereof. Fixtures
shall be uniformly distributed but not in the clear floor area of
the infant stations.
(iv) An observation window to permit the viewing of
infants from public areas shall be provided. The public viewing areas
shall not encroach into the egress corridor.
(M) Continuing care nursery suite. Hospitals with 25
or more maternity beds shall provide a continuing care nursery for
infants requiring close observation. The suite shall have a maximum
of 16 infant stations. The clearance between the side of the bassinet
and a wall/partition shall be a minimum of three feet. The clearance
between sides of bassinets shall be a minimum of six feet. The minimum
distance at the foot of the bassinet shall not be less than six feet
for single load area/room or nine feet for double load area/room.
Three feet of the passage space at the foot of the bassinet may be
shared between two bassinets. The requirements of this subparagraph
are illustrated in Table 8, Diagram J of §133.169(h) of this
title. Additional area shall be provided to accommodate workroom functions
if these are located within the nursery area as specified in subparagraph
(N)(iv) of this paragraph.
(i) The continuing care nursery shall be located on
an exterior wall and shall have a window(s). In the nursery, one window
may serve more than one bassinet. The window sill height shall not
exceed five feet above the floor. Bassinets shall not be located more
than 50 feet from an exterior window. A newborn's view to outside
windows shall be direct. When partitions are used, the newborn's view
to the outside windows may be through no more than two separate clear
vision panels.
(ii) The continuing care nursery shall not be located
within a full-term nursery.
(iii) There shall be a minimum of one lavatory with
hands-free operable controls for each four infant stations or fraction
thereof. Fixtures shall be uniformly distributed but not in the clear
floor area of the infant stations.
(N) General requirements for nurseries. Each nursery
regardless of type shall meet the following requirements:
(i) Observation windows to permit the viewing of infants
from public areas for full-term nurseries and from workroom(s) into
adjacent nurseries shall be provided. Windows between nurseries may
be provided for the convenience of staff observation.
(ii) Ten square feet per bassinet shall be provided
for convenient, accessible storage for linens, infant supplies, and
equipment.
(iii) A room for consultation, demonstration, breast
feeding or breast pumping shall be provided convenient to the unit.
A counter with sink with hands-free operable controls, refrigeration
and freezer, storage for pump and attachments, and educational materials
shall be provided in or convenient to the room.
(iv) Each nursery room shall be served by a connecting
workroom(s). The workroom shall contain scrubbing and gowning facilities
at the entrance for staff and housekeeping personnel, work counter,
refrigerator, storage for supplies, and hand washing fixture with
hands-free operable controls. One workroom may serve no more than
two nursery rooms provided that required services are convenient to
each. No nursery shall open directly into another nursery.
(v) The workroom serving the full-term and continuing
care nurseries may be omitted if equivalent work and storage areas
and facilities, including those for scrubbing and gowning, are provided
within that nursery at the entrance. Space required for work areas
located within the nursery is in addition to the area required for
infant care. Adequate provisions shall be made for storage of emergency
carts and equipment, and for sanitary storage and disposal of soiled
waste for the nursery.
(vi) Charting and dictation facilities shall be provided
for physicians and nurses. This may be in a separate room or part
of the workroom.
(vii) An examination/treatment room or space shall
be provided and shall contain a work counter, storage, and lavatory
equipped for hand washing with hands-free operable controls. The examination/treatment
room or space shall have a minimum clear area of 80 square feet in
addition to the required area of each workroom exclusive of fixed
and movable cabinets and shelves. The examination treatment space
shall be located within the nursery.
(viii) An airborne infection isolation room is required
in at least one level of nursery care and the neonatal critical care
unit. The isolation room shall be enclosed and separated from the
nursery unit with provisions for observation of the infant from adjacent
nurseries or control area(s). The minimum size of the room shall be
120 square feet of clear floor area. The isolation room shall contain
cabinets, a work counter, and a hand washing fixture with hands-free
operable controls. Fixed and moveable cabinets and shelves shall not
encroach upon bed/gurney clear floor space/area. The isolation room
shall comply with the ventilation requirements in Table 3 of §133.169(c)
of this title.
(ix) A housekeeping room shall be provided for the
exclusive use of the nursery.
(O) Neonatal critical care unit (NCCU). When an NCCU
is provided, the unit shall comply with the following.
(i) The NCCU shall be conveniently located near the
obstetrical suite and be arranged to preclude unrelated traffic.
(ii) Each room and ward shall be located on an exterior
wall and shall have a window. In a ward, one window may serve more
than one patient. The window sill height shall not exceed five feet
above the floor. Patient beds shall not be located more than 50 feet
from an exterior window. Patients' views to outside windows shall
be direct. When partitions are used, the patient's direct view to
the exterior may be through no more than two separate clear vision
panels. Window shall be in accordance with subsection (t)(2)(A)(v)
of this section.
(iii) The NCCU shall have a clearly identified public
entrance and reception area arranged to permit visual observation
and contact with all traffic entering the unit. Gowning facilities,
lockers, and scrub area shall be provided at each public entrance
to the patient care area(s) of the NCCU. All scrub sinks shall be
provided with hands-free operable controls and large enough to contain
splashing.
(iv) A control station shall be provided in a central
area and shall have space for counters and storage, and shall have
convenient access to a hand washing fixture with hands-free operable
controls. The control station may be combined with or include centers
for reception, communication and patient monitoring.
(v) NCCU patients may be housed in private rooms or
a room with multiple bassinets or cribs. Each unit shall not exceed
24 bassinets or cribs. There shall be at least one enclosed private
room for every six bassinets or cribs.
(vi) A single-bassinet/crib patient NCC room shall
have a minimum clear floor area of 120 square feet per bassinet/crib
exclusive of work counter, vestibule, sink and aisle. A minimum of
12 feet width shall be provided for the head wall for each bed.
(vii) In a multiple-bassinet/crib room/ward the clearance
between the side of a sleeping unit and a wall/partition shall be
a minimum of five feet. The clearance between sides of sleeping units
shall be a minimum of eight feet. The minimum distance at the foot
of the bassinet shall not be less than ten feet for single load area/room
or sixteen feet for double load area/room. Four feet of the passage
space at the foot of the bassinet may be shared between two bassinets.
The fixed and Cont'd... |
