| (xiii) Lounge. A lounge shall be provided in hospitals
with four or more obstetrical surgical and delivery rooms. The lounge
shall permit staff use without leaving the obstetrical surgical suite
or delivery suite and may be accessed from the obstetrical suite staff
clothing change rooms or staff changing room for delivery suite. The
lounge shall not have direct access from outside the surgical suite.
When the lounge is remote from the clothing change rooms, toilet facilities
and a hand washing fixture with hands-free operable controls accessible
from the lounge shall be provided.
(xiv) Staff toilet facilities. Toilet facilities located
in the obstetrical suite for exclusive staff use shall be provided
and contain hand washing facilities with hands-free operable controls.
The toilet room may be accessible from a staff lounge, when provided.
(xv) Nurses' toilet. A nurses' toilet room shall be
provided at the labor and recovery area(s) and shall include hand
washing fixture with hands-free operable controls.
(xvi) Dictation and report preparation area. This may
be accessible from the lounge area.
(xvii) On-call rooms. Physicians and staff on 24-hour
on-call work schedules shall be provided with sleeping rooms with
access to a toilet, lavatory and shower. If not contained within the
unit itself, the area shall have a telephone or intercom connection
to the obstetrical suite(s).
(xviii) Clean workroom or clean supply room. A clean
workroom is required. It shall contain a work counter, a hand washing
fixture with hands-free operable controls, storage facilities for
clean supplies, and a space to package reusable items. The storage
for sterile supplies must be in a separated room. When the room is
used only for storage and holding as part of a system for distribution
of clean and sterile supply materials, the work counter and hand washing
fixture may be omitted.
(xix) Soiled workroom. The soiled workroom shall be
for the exclusive use of the obstetrical suite and shall be in addition
to the soiled workroom required for the obstetrical surgical suite.
The soiled workroom for the obstetrical c-section operating room or
delivery room suite shall not have direct connection with operating
rooms or other sterile activity rooms. The soiled workroom shall contain
a clinical sink with hands-free operable controls or equivalent flushing
type fixture, work counter, sink equipped for hand washing, waste
receptacle, and linen receptacle. There shall be a designated soiled
workroom for the exclusive use of the NCCU.
(xx) Housekeeping rooms. A separate housekeeping room
containing a floor receptor or service sink and storage space for
housekeeping supplies and equipment shall be provided for the exclusive
use of the obstetrical suite, the c-section operating room, and nurseries
(one for each).
(xxi) Triage room. When triage services are provided,
there shall be a minimum of one triage room in the obstetrical suite.
(I) An obstetrical triage room shall be a minimum clear
floor area of 100 square feet with a minimum dimension of nine feet.
The obstetrical triage room shall contain cabinets, work counter,
examination light, and a hand washing fixture with hands-free operable
controls. The fixed and movable cabinets and shelves shall not encroach
upon the bed/gurney clear floor space/area.
(II) When a multiple-bed/gurney triage patient station
is provided, the clearance between the side of a bed/gurney and a
wall/partition shall be a minimum of three 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 seven
feet for single load area/room or ten 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 multiple-bed/gurney triage room shall
contain cabinets, medication storage, work counter, examination light,
and a hand washing fixture with hands-free operable controls. The
fixed and movable cabinets and shelves shall not encroach upon the
bed/gurney clear floor space/area. Privacy shall be provided for each
patient with cubicle curtains or movable screens. The requirements
of this subclause are illustrated in Table 8, Diagram D of §133.169(h)
of this title.
(III) A patient in a triage bed shall have access to
a patient toilet room without entering the corridor.
(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) C-section operating rooms and delivery rooms shall
have ceiling heights not less than nine feet.
(ii) Recreation rooms, exercise rooms, equipment rooms,
and similar spaces where impact noises may be generated shall not
be located directly over operating rooms or delivery rooms, unless
special provisions are made to minimize such noise as contained in
Table 1 of §133.169(a) of this title.
(iii) When vision panels are provided in labor rooms,
LDRs, and LDRPs, the windows shall be located, draped, or otherwise
arranged to preserve patient privacy from casual observation from
outside the labor room.
(iv) Shower controls shall be outside the wet area
for use by nursing staff for labor room showers. In the LDRP rooms
shower control outside of the wet area may be omitted.
(v) When viewing windows are provided in a NCCU, provision
shall be made to control casual viewing of infants.
(vi) Noise control and sound attenuation in a NCCU
shall be a design factor and meet the requirements contained in Table
1 of §133.169(a) of this title.
(B) Finishes.
(i) Finishes for LDR and LDRP rooms shall be selected
for ease of cleaning and resistance to strong detergents.
(ii) Flooring in c-section operating rooms, delivery
rooms, labor rooms, isolation room, and soiled workroom shall be of
the seamless type in accordance with the requirements of §133.162(d)(2)(B)(iii)(III)
of this title. LDR and LDRP rooms shall have seamless type flooring
below the bed and four feet at each side of the bed and foot of the
bed.
(iii) Ceilings and walls in c-section operating rooms,
delivery rooms, soiled workroom, isolation and anteroom, and sterile
processing room shall be of the monolithic type in accordance with §133.162(d)(2)(B)(vi)(III)
of this title. Acoustic lay-in ceiling is permissible in the LDR and
LDRP rooms.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with §133.162(d)(3) of this title and
this paragraph.
(A) The air supply for the c-section operating room
and delivery room shall be from ceiling outlets near the center of
the work area. Return air shall be from near the floor level. Each
c-section operating room and delivery room shall have at least two
return air inlets located as remotely from each other as practical.
(Design should consider turbulence and other factors of air movement
to minimize fall of particulate into a wound site).
(B) Air supply for LDRs, LDRPs, and nurseries shall
be from ceiling outlets or high wall outlets. Return air shall be
from near the floor level. Each LDR, LDRP, and nursery shall have
at least two return air inlets located diagonally opposite from each
other.
(C) The ventilation system for anesthesia storage rooms
shall conform to the requirements of NFPA 99, §4-3.1.1.2.
(D) Each c-section operating room, delivery room and
nursery shall have temperature and humidity indicating devices mounted
at eye level.
(E) Air handling units serving the obstetrical and
surgical suite shall be equipped with filter having efficiencies equal
to, or greater than specified in Table 4 of §133.169(d) of this
title.
(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.
(A) General.
(i) Drainage and waste piping shall not be installed
within the ceiling or installed in an exposed location in c-section
operating rooms and delivery rooms unless special precautions are
taken to protect the spaces below from leakage and condensation from
necessary overhead piping systems. Any required secondary protection
shall be labeled every 20 feet "code required secondary drain system."
The labeling shall be in highly visible print.
(ii) Floor drains shall not be installed in c-section
rooms and delivery rooms.
(iii) Bedpan-flushing devices shall be installed in
all patient toilet rooms serving LDRs and LDRPs.
(B) Medical gas systems. Medical gas systems shall
be provided in accordance with §133.162(d)(4)(A)(iii)-(vi) of
this title.
(i) Nonflammable medical gas and clinical vacuum outlets
shall be provided in accordance with Table 6 of §133.169(f) of
this title.
Cont'd... |
