| (ii) Nonflammable medical gas and clinical vacuum outlets
for the infant resuscitation area or room shall be provided in addition
to the required medical gas and vacuum for the mother in accordance
with Table 6 of §133.169(f) of this title.
(iii) When a labor room is intended to function as
an emergency delivery room the nonflammable medical gas and clinical
vacuum outlets shall be provided in accordance with Table 6 of §133.169(f)
of this title.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §133.162(d)(5) of this title and
this paragraph.
(A) General.
(i) X-ray film illuminators for handling at least four
films simultaneously shall be provided in each c-section operating
room, labor, and delivery room. When the entire obstetrical suite
is provided with digital imaging system capabilities, a minimum of
two X-ray film illuminator viewers shall be provided. The film illuminators
shall be mounted within the central area of the suite.
(ii) Each c-section operating room shall have at least
eight duplex hospital grade receptacles.
(iii) Each delivery room, LDR and LDRP shall have at
least six duplex hospital grade receptacles.
(iv) Operating rooms and delivery rooms shall have
at least three of the required duplex hospital grade receptacles located
convenient to the head of the procedure table.
(v) Newborn and continuing care nurseries shall have
one normal and one critical duplex outlet for every two bassinets.
(vi) In the infant resuscitation area or room, three
duplex hospital grade receptacles shall be provided for the infant
in addition to those required for the mother.
(vii) The electrical circuit(s) to equipment in wet
areas shall be provided with five milliampere GFCI. GFCI circuits
shall not be used in c-section operating rooms and delivery rooms.
When GFCIs are used in critical areas, provisions shall be made to
ensure that other essential equipment is not affected by activation
of one interrupter.
(viii) C-section operating rooms and delivery rooms
shall have general lighting in addition to that provided by special
lighting units at the surgical and obstetrical tables. Each fixed
special lighting unit at the operating or delivery table shall be
connected to an independent circuit powered by the critical branch
of the essential electrical system. Portable units may share circuits.
(ix) Indirect lighting and high-intensity lighting
shall be provided in the NCCU(s). The lighting shall be able to be
adjusted over individual patient care spaces. No direct ambient lighting
shall be permitted in the infant care spaces, and any direct ambient
lighting used outside the infant care area shall be located or framed
so as to avoid any infant's direct line of sight to the fixture. This
does not exclude the use of direct procedure lighting.
(x) Receptacles at each bed location in a NCCU shall
be served by two branch circuits, one or more from the critical branch
panel of the emergency electrical system and one or more from the
normal system. One critical branch circuit shall serve only one bed
location. All branch circuits from the normal system shall be from
a single panelboard. All branch circuits from the emergency electrical
system shall be from a single panelboard.
(xi) A minimum of seven hospital grade duplex outlets
shall be conveniently located at the head of each NCCU bed, crib or
bassinet. At least three of these duplex outlets shall be on the critical
branch of the emergency electrical system.
(B) Nurses calling system. The nurse call shall be
in accordance with §133.162(d)(5)(L) and Table 7 of §133.169(g)
of this title.
(v) Outpatient suite.
(1) Architectural requirements.
(A) General. Outpatient services that the hospital
provides to patients under the hospital license shall be within the
hospital. Outpatient services and facilities (diagnostics, imaging,
surgical, etc.) may be provided throughout the hospital within other
suites, departments or units within the hospital. When an organized
outpatient suite is provided for the hospital, it shall be in one
identifiable contiguous location within the hospital and meet all
the elements described in this subsection. To be included in the hospital
license, an outpatient suite located in an office building or other
building shall be physically connected to the hospital and become
contiguous to the hospital. In no case may one leave the hospital,
traverse the other occupancies, and then reenter the hospital to access
the remaining portion of the hospital. A hospital may not occupy two
or more noncontiguous areas of nonhospital occupancies, which contain
intervening space of the nonhospital occupancies even if on the same
floor or other floors. Outpatient facilities physically connected
to the hospital with a common wall or an enclosed connection shall
comply with the requirements of NFPA 101, Chapter 18.
(B) Site, administration and public areas. The following
shall be provided.
(i) Parking. When an outpatient suite is provided,
four parking spaces shall be required for each surgical procedure
room, treatment room, and diagnostic room, plus additional spaces
for each staff member.
(ii) Entrance. When an established outpatient suite
in one identifiable location provides surgical services, an illuminated
covered drive through entrance shall be provided.
(iii) Public waiting area. Toilet facilities, public
telephone, and drinking fountain shall be provided. When pediatric
services are provided, pediatric and adult patients waiting areas
shall be separate.
(iv) Control station. A control station shall be located
to permit staff observation of waiting area and control of access
to treatment rooms, procedure rooms, diagnostic rooms, and the surgical
suite.
(v) Wheelchair storage alcove. The alcove provided
for wheelchair storage shall be located out of line of traffic.
(vi) Interview space. Interview spaces shall be provided
for social services, credit, and admissions. Provisions shall be made
for privacy and dignity of the patient during interview, examination,
and treatment.
(vii) Offices. General or individual offices shall
be provided for business transaction, records, and administrative
and professional staff.
(viii) Multipurpose rooms. Multipurpose rooms for conferences,
meetings, and health education purposes shall be provided.
(C) Examination, treatment, and observation rooms.
When examination, treatment, or observation facilities are provided,
the following shall be included.
(i) Examination room. The room shall have a minimum
clear floor area of 100 square feet exclusive of fixed cabinets and
shelves. Each examination room shall contain a work counter, cabinets,
examination light and hand washing fixture with hands-free operable
controls. A clearance of three feet shall be provided at each side
and the foot of the examination table.
(ii) Special purpose examination rooms. The special
purpose examination room shall comply with the requirements of an
examination room as described in clause (i) of this subparagraph,
but room size and configuration may be modified for specialized equipment.
(iii) Treatment room. The room shall have a minimum
clear floor area of 120 square feet exclusive of fixed and movable
cabinets and shelves. The minimum clear dimension between fixed cabinets
and built-in shelves shall be 10 feet. The treatment room shall contain
a work counter, cabinets, medication storage, examination light and
a hand washing fixture with hands-free operable controls.
(iv) Observation room. The room shall be located to
permit close observation from either a nurse station or the control
station. The room shall have a minimum clear area of 80 square feet
exclusive of fixed and movable cabinets and shelves. Patients shall
have access to a toilet room without entering the general corridor
area.
(v) Multiple-bed holding/observation room/area. In
a multiple-bed holding/observation room/area, 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
holding/observation room/area shall contain cabinets, work counters,
and a hand washing fixture with hands-free operable controls. The
fixed and moveable 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 D of §133.169(h) of this
title.
Cont'd... |
