| (D) Diagnostic facilities. Services shall be available
to the outpatient suite. When separate radiology units are located
within the outpatient suite, the requirements in subsection (l) of
this section shall be met.
(E) Laboratory. Services shall be made available to
the outpatient suite. When a separate laboratory unit is installed
within the outpatient suite, the requirements in subsection (n) of
this section shall be met. All laboratory services provided within
the outpatient suite or by a written contractual arrangement shall
comply with the requirements of §133.41(h) of this title.
(F) Surgical facilities. Outpatient surgical facilities
may be provided separately or may be shared with the inpatient facilities.
(i) When a separate outpatient surgery suite is provided,
it shall meet the requirements in subsection (ee) of this section.
(ii) The following additional rooms and areas shall
be provided in each surgical suite wherever outpatient surgical procedures
are performed. A preoperative area for outpatient use shall be provided.
The area shall include a waiting room, public toilet facilities, sitting
space for ambulatory patients, and at least one or more of the following:
a single patient preoperative room, multiple-bed/gurney preoperative
patient stations, single patient preoperative/recovery room, or multiple-bed/gurney
preoperative/recovery patient stations. Traffic patterns shall be
arranged for patients to enter the preoperative area from outside
the surgical suite, prepare for surgical procedure and then move directly
into the restricted corridor of the operating suite.
(I) When a single patient preoperative room is provided
the minimum clear area is 100 square feet exclusive of aisles and
fixed and moveable cabinets and shelves. The room shall contain cabinets,
work counter, and a hand washing fixture with hands-free operable
controls.
(II) When a multiple-bed/gurney preoperative patient
station is provided, the clearance between the side of the 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 preoperative patient
room shall contain cabinets, medication storage, and work counter.
The fixed and movable cabinets and shelves shall not encroach upon
the bed/gurney clear floor space/area. One hand washing fixture with
hands-free operable controls shall be provided for every four stations
or fraction thereof. 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) When a single patient preoperative/recovery room
is provided the minimum clear area is 120 square feet exclusive of
aisles and fixed and moveable cabinets and shelves. The room shall
contain cabinets, work counter, and hand washing fixture with hands-free
operable controls.
(IV) When a multiple-bed/gurney preoperative/recovery
patient station is provided, the clearance between the side of a bed/gurney
and a wall/partition shall be a minimum of four 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 multiple-bed/gurney preoperative/recovery
patient station shall contain cabinets, medication storage, and work
counter. The fixed and movable cabinets and shelves shall not encroach
upon the bed/gurney clear floor space/area. One hand washing fixture
with hands-free operable controls shall be provided for every four
stations or fraction thereof. Privacy shall be provided for each patient
with cubicle curtains or movable screens. The requirements of this
subclause are illustrated in Table 8, Diagram M of §133.169(h)
of this title.
(iii) A secondary recovery lounge (for outpatients
requiring additional observation) with a nurse's station and a hand
washing fixture with hands-free operable controls shall be provided.
One hand washing fixture with hands-free operable controls shall be
provided for every four secondary recovery stations or fraction thereof.
In each secondary recovery station, the clearance between a side of
lounger/gurney and a wall/partition shall be a minimum of three feet.
The clearance between sides of lounger/gurney shall be a minimum of
six feet. The minimum distance at the foot of the lounger/gurney shall
not be less than six feet for single load area/room or nine feet for
double load area/room. Three feet of passage space requirement at
the foot of the lounger/gurney may be shared between two loungers/gurneys.
The fixed and movable cabinets and shelves shall not encroach upon
the lounger/gurney clear floor space/area. Privacy shall be provided
for each patient with cubicle curtains or movable screens. The requirements
of this clause are illustrated in Table 8, Diagram D of §133.169(h)
of this title.
(iv) A toilet room for use by outpatients shall be
provided directly accessible from the outpatient preoperative, recovery
and secondary recovery lounge areas. The toilet room shall contain
a water closet and a hand washing fixture with hands-free operable
controls. There shall be one outpatient toilet room for every ten
patient stations or fraction thereof. Toilet rooms may be shared if
convenient to the outpatient preoperative, recovery and secondary
recovery lounge areas.
(G) Special procedure room(s). When outpatient special
procedures services are provided within the outpatient suite, the
special procedure room(s) shall comply with the requirements in subsection
(dd) of this section.
(H) Service areas. The following service areas and
facilities shall be provided within the outpatient suite unless noted
otherwise.
(i) Nurse station(s). The nurse station shall contain
a work counter, communication system, space for supplies, and provisions
for charting.
(ii) Hand washing fixtures. Hand washing fixtures with
hands-free operable controls shall be available at all patient care
areas.
(iii) Patient toilet room(s). Toilet room(s) shall
be conveniently located to treatment room(s), examination room(s),
and diagnostic room(s) and shall include hand washing fixture(s) with
hands-free operable controls.
(iv) Staff toilet facilities. Toilet rooms equipped
with hand washing fixtures with hands-free operable controls shall
be provided for the exclusive staff use. Toilet facilities may be
provided in conjunction with the staff lounge.
(v) Staff lounge. A staff lounge with separate male
and female staff clothing change rooms and toilets with hand washing
fixtures with hands-free operable controls shall be provided in hospitals
having a total of six or more diagnostic and treatment rooms.
(vi) Medication station. Storage and distribution of
medication may be done from a medicine preparation room, medicine
alcove area or from a self-contained medicine dispensing unit but
must be under visual control of nursing staff. A work counter, a hand
washing fixture with hands-free operable controls, refrigerator, and
double-locked storage for controlled substances shall be provided.
Standard cup-sinks provided in many self-contained units are not acceptable
for hand washing. The medication station may be shared with the clean
workroom.
(vii) Dictation and report preparation area. This area
may be accessible from the lounge.
(viii) Cast room. When a cast room is provided, it
shall be equipped with hand washing facilities, plaster sink, storage,
and other provisions required for cast procedures.
(ix) Wheelchair and stretcher storage. Wheelchair and
stretcher storage space or alcove shall be provided and located out
of direct line of traffic.
(x) Storage. Storage facilities shall be provided for
office supplies, sterile supplies, pharmaceutical supplies, splints
and other orthopedic supplies, and housekeeping supplies and equipment.
(xi) Ice machine. A self-dispensing ice machine shall
be provided.
(xii) Clean workroom. A clean workroom or clean supply
room shall be provided.
(xiii) Storage room. A storage room for the outpatient
services shall be provided at least equal to 5.0% of the total area
of the outpatient suite. This required storage room area may be combined
with general stores.
(xiv) Soiled workroom. A soiled workroom shall be provided.
It shall not have direct access to any patient treatment, examination,
diagnostic rooms, or sterile rooms. The room shall contain a clinical
sink or equivalent flushing rim fixture, work counter, hand washing
fixture with hands-free operable controls, waste receptacle, and linen
receptacle.
Cont'd... |
