| (VIII) In a special hospital, comprehensive medical
rehabilitation hospital, or pediatric and adolescent hospital, the
emergency treatment room and facilities may be located anywhere in
the hospital.
(ii) Additional requirements for a general hospital.
Except for comprehensive medical rehabilitation hospitals and pediatric
and adolescent hospitals that generally provide care that is not administered
for or in expectation of compensation, a general hospital shall also
meet the following requirements.
(I) Emergency entry signage. An emergency sign shall
be provided at the entry from the public road(s) or street(s) serving
the site. The emergency sign at the entry to the site shall be illuminated
and connected to the emergency essential electrical system. Additional
sign(s) on-site may be required to direct patients to the emergency
treatment area entrance when the emergency treatment area is not visible
from the site entry. The letters on the entry sign shall be red with
a contrasting background, all capitalized, at least eight inches in
height, and an arrow indicating direction.
(II) Entrances. Separate ambulance and pedestrian entrances
at grade level shall be well-illuminated, identified by signs, and
protected from inclement weather. The ambulance entry shall have a
drive under canopy for protection from inclement weather. The emergency
access to permit discharge of patients from automobile and ambulances
shall be paved. Parking shall be provided near and convenient to the
pedestrian entrance.
(III) Control station. A registration, reception, discharge
or control station shall be located to permit staff observation and
control of access to treatment room(s), pedestrian and ambulance entrances,
and public waiting area(s). When a dedicated triage space is provided,
it shall include a counter with a hand washing fixture with hands-free
operable controls.
(IV) Public waiting room. A public waiting room shall
be provided.
(V) Public facilities. Toilet facilities, public telephone(s),
and drinking fountain(s) shall be provided for the exclusive use of
the waiting room.
(VI) Diagnostic radiographic (X-ray) room. Imaging
facilities for diagnostic services shall be readily available to the
emergency suite. If a separate radiographic (X-ray) room is installed
within the emergency suite, it shall comply with the requirements
in subsection (l)(1)(A) of this section. When the diagnostic X-ray
room is exclusively used for the emergency treatment area, the dressing
rooms may be omitted.
(VII) Laboratory unit. Laboratory services shall be
made available to the emergency suite. If a separate laboratory workroom
is installed within the emergency suite, it shall comply with the
requirements in subsection (n)(1)(C)(i) of this section. All laboratory
services provided on site or by contractual arrangement shall comply
with §133.41(h) of this title (relating to Hospital Functions
and Services).
(VIII) Medical staff work area and charting area(s).
A medical staff work area and charting area(s) shall be provided.
The area may be combined with the reception and control area.
(IX) Clean storage room. A clean storage room shall
be provided for clean supplies, linens and medications as needed.
A hand washing fixture shall be provided with hands-free operable
controls.
(X) Soiled workroom. The workroom shall contain a work
counter, a clinical sink or equivalent flushing type fixture, hand
washing fixture with hands-free operable controls, waste receptacles,
and soiled linen receptacles.
(XI) Housekeeping room. The housekeeping room shall
contain a floor receptor or service sink, storage space for housekeeping
supplies and equipment, and be located within the suite. When automatic
film processors are used, a receptacle of adequate size with hot and
cold water for cleaning the processor racks shall be provided.
(XII) Staff toilets. Toilets may be outside the suite
but shall be convenient for staff use and include hand washing fixtures
with hands-free operable controls. When a department has four or more
treatment or examination rooms, toilet facilities shall be in the
suite.
(iii) Other rooms. If a hospital provides the following
rooms, the rooms shall meet these requirements.
(I) Examination room. When provided, the examination
room for a single patient shall have a minimum clear area of 100 square
feet clear floor area exclusive of fixed and movable cabinets and
shelves. The minimum clear room dimension exclusive of fixed cabinets
and built-in shelves shall be 9 feet. The examination room shall contain
cabinets, medication storage, work counter, examination light, and
a hand washing fixture with hands-free operable controls.
(II) Multi-bed examination room. In a multiple-bed
examination room 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 the 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 examination room
shall contain cabinets, work counters, and a hand washing fixture
with hands-free operable controls. One hand washing fixture shall
be provided for every four beds/gurneys or fraction thereof. Fixtures
shall be uniformly distributed. The fixed and moveable cabinets and
shelves shall not encroach upon the bed/gurney clear floor space/area.
(III) Isolation room. The need for an airborne infection
isolation room in the emergency suite shall be determined by the hospital
and the infection risk assessment. When the hospital provides treatment
rooms to perform procedures on persons who are known or suspected
of having an airborne infectious disease, these procedures shall be
performed in a designated treatment room meeting airborne infection
isolation ventilation requirements. The isolation room shall have
functional space in accordance with clause (i)(I) of this subparagraph,
and meet the ventilation requirements contained in Table 3 of §133.169(c)
of this title.
(IV) Secured holding room. When provided, this room
shall be constructed to allow for security, patient and staff safety,
patient observation, and sound mitigation. The secure holding room
shall have a minimum clear area of 100 square feet clear floor area
exclusive of fixed cabinets. The minimum clear room dimension exclusive
of fixed cabinets shall be 10 feet.
(V) Orthopedic and cast room. The room(s) may be in
separate room(s) or in the trauma room. The room(s) shall contain
a work counter, storage for splints and orthopedic supplies, traction
hooks, medication storage, examination light, and a hand washing fixture
with hands-free operable controls. When a cast room is provided it
shall be equipped with hand washing facilities, plaster sink, storage,
and other provisions required for cast procedures.
(VI) Film processing room. When a radiographic (X-ray)
room is provided, a darkroom for processing film shall be provided
unless the processing equipment does not require a darkroom for loading
and transfer. When daylight processing is used, the darkroom may be
minimal for emergency and special uses. Film processing shall be located
convenient to the darkroom.
(VII) Decontamination room. A decontamination room
shall have an exterior entry point and as far as practical from any
other entry point to the emergency treatment area. The internal door
from the decontamination room shall open directly to the corridor
into the emergency treatment area. The door shall swing into the room
and be lockable against ingress from the corridor. The room shall
be a minimum of 80 square feet of clear floor area with a hand washing
fixture with hands-free operable controls.
(B) Holding or observation room/area.
(i) When a holding or observation room/area is provided
within or adjacent to the emergency suite, it shall comply with the
following.
(I) A single holding/observation room shall have a
minimum clear area of 100 square feet exclusive of fixed and movable
cabinets and shelves. The holding/observation room shall contain a
work counter and hand washing fixture with hands-free operable controls.
(II) The single holding/observation room shall be near
the nurses station and near a patient toilet room which contains a
hand washing fixture with hands-free operable controls.
(III) In a multiple-bed holding/observation room/area,
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 the
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. One hand washing fixture shall be provided Cont'd... |
