| (vii) A patient holding area shall be provided and
shall be located near the MRI unit and be large enough to accommodate
stretchers.
(viii) A hand washing fixture with hands-free controls
shall be provided near the entrance to the MRI room and shall be recessed
out of the main traffic areas or corridor.
(ix) A 3T or larger magnetic strength MRI shall be
secured behind locked doors. The patient and staff entrance to the
MRI shall have a traffic pattern from the waiting, dressing, holding
and work areas through a lockable control station before entering
the MRI. At no time shall patients or nonpatients be allowed to enter
this restricted area without MRI staff present when the magnet is
active.
(G) Ultrasound room. When ultrasound services are provided,
the room(s) size shall be in compliance with the manufacturer's recommendations.
A patient toilet room shall be provided convenient to the procedure
room and a corridor. The toilet room shall have a hand washing fixture
with hands-free operable controls.
(H) Cardiac catheterization laboratory. The cardiac
catheterization laboratory is normally a separate suite, but may be
within the imaging suite. If provided, a cardiac catheterization laboratory
shall comply with the requirements of subsection (dd)(1)(C) of this
section.
(I) Service areas. The following common service areas
shall be provided.
(i) Patient waiting area. The area shall be out of
traffic and under direct staff visual control. When the waiting area
serves both outpatient and inpatients, separate areas shall be provided
and include visual privacy between the waiting areas.
(ii) Control desk and reception area. A control desk
and reception area shall be provided.
(iii) Holding area. The holding area shall be out of
direct traffic patterns and under visual control by staff. A minimum
of one stretcher station shall be provided for each three diagnostic
and procedure rooms or fraction thereof. The minimum clear floor space
in the holding area shall be 80 square feet exclusive of aisles and
fixed and moveable cabinets and shelves. The area shall contain cabinets,
a work counter, and a hand washing fixture with hands-free operable
controls. The holding area may be reduced to 50 square feet exclusive
of aisles and fixed and moveable cabinets and shelves for mammography,
bone density and other similar procedures.
(iv) Post-procedure observation room. When invasive
diagnostic X-ray services for outpatients are provided with anesthesia,
a room for extended post-procedure observation of patients shall be
provided. The minimum clear floor space for the observation space
shall be 100 square feet exclusive of aisles and fixed and moveable
cabinets and shelves. The room shall contain cabinets, a work counter,
and a hand washing fixture with hands-free operable controls.
(v) Patient toilet rooms. Toilet room(s) with hand
washing facilities shall be located convenient to the waiting area.
(vi) Patient dressing rooms or cubicles. Dressing rooms
or cubicles shall be convenient to the waiting areas and X-ray rooms.
Each room shall include a seat or bench, mirror, and provisions for
hanging patients' clothing and for securing valuables. At least one
dressing room shall be provided to accommodate wheelchair patients.
(vii) Hand washing facilities. A hand washing fixture
with hands-free controls shall be provided in or near the entrance
to each diagnostic and procedure room unless noted otherwise. When
a hand washing fixture is provided in the room, the fixture shall
be located near the entrance to the room or near the staff entrance.
When a hand washing fixture is located outside the room, the fixture
shall be recessed in the egress corridor and located within five feet
of the entrance to the room. Hand washing facilities shall be arranged
to minimize any incidental splatter on nearby personnel or equipment.
(viii) Staff facilities. Toilets may be outside the
suite and may be shared with other departments but shall be convenient
for staff use. When four or more diagnostic or procedure imaging rooms
are provided, a staff toilet is required with a hand washing fixture
with hands-free controls.
(ix) X-ray film illuminator viewers. When all the diagnostic
and imaging procedures are provided with digital imaging, two mounted
X-ray film illuminator viewers shall be provided in the central viewing
area/room.
(x) Contrast media preparation. This room shall include
a work counter, a sink with hands-free operable controls, and storage.
One preparation room may serve any number of rooms. When prepared
media is used, this area may be omitted, but storage shall be provided
for the media.
(xi) Film processing room. A darkroom shall be provided
for processing film unless the processing equipment normally used
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 procedure
rooms and to the quality control area.
(xii) Quality control area or room. An area or room
for film viewing shall be located near the film processor. All view
boxes shall be illuminated to provide light of the same color value
and intensity.
(xiii) Film storage (active). When X-ray film is used,
it shall be stored in a room with a cabinet or shelves for filing
patient film for immediate retrieval.
(xiv) Film storage (inactive). When X-ray film is used,
a room for inactive film storage shall be provided. It may be outside
the imaging suite, but must be under the administrative control of
imaging suite personnel and be properly secured to protect films against
loss or damage.
(xv) Storage for unexposed film. When X-ray film is
used, storage facilities for unexposed film shall include protection
of film against exposure or damage.
(xvi) Storage of cellulose nitre film. When used, cellulose
nitrate film shall be stored in accordance with the requirements of
National Fire Protection Association 40, Standard for the Storage
and Handling of Cellulose Nitrate Motion Picture Film, 1994 edition.
(xvii) Additional spaces. When four or more diagnostic
or procedure rooms are provided in the hospital, the following shall
be required:
(I) office(s) for radiologist(s) and assistant(s);
(II) clerical office spaces, as necessary for the functional
program;
(III) consultation area/room;
(IV) medication station. Storage and preparation of
medication shall be done from a room, alcove area, or from a self-contained
dispensing unit but must be under visual control of nursing staff.
A work counter, hand washing fixture with hands-free operable controls,
refrigerator, and double-locked storage for controlled substances
shall be provided. Standard cup-sinks are not acceptable for hand
washing;
(V) clean storage room. Clean storage room shall be
provided for clean supplies and linens. A hand washing fixture shall
be provided with hands-free operable controls. When conveniently located,
the clean storage room may be shared with another department; and
(VI) soiled workroom. The soiled workroom shall not
have direct connection to the diagnostic and procedure rooms. The
room shall contain a clinical sink or equivalent flushing type fixture,
work counter, hand washing fixture with hands-free operable controls,
waste receptacle, and soiled linen receptacle. When contaminated soiled
material or fluid waste is not handled, only a soiled holding room
shall be required.
(xviii) Housekeeping room. The room may serve multiple
departments when conveniently located.
(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) Radiation protection shall be designed, tested
and approved by a medical physicist licensed under the Texas Medical
Physics Practice Act, Occupations Code, Chapter 602.
(I) Room shielding calculations for linear accelerators,
teletherapy units and remote control brachytherapy units must be submitted
to the Department of State Health Services' Radiation Control (RC)
for approval prior to use. Shielding in diagnostic radiographic rooms
will be reviewed by RC inspectors, in the field, subsequent to use.
Any changes in design or shielding which affects radiation exposure
levels adjacent to those rooms, requires prior approval by RC. The
RC mailing address is: Radiation Control, Department of State Health
Services, 1100 West 49th Street, Austin, Texas 78756.
(II) Facility design and environmental controls associated
with licensable quantities of radioactive material in laboratories
and/or imaging rooms shall be approved by RC prior to licensed authorizations.
(ii) Where protected alcoves with view windows are
required, provide a minimum of one foot six inches from the edge where
the glazing and the frame connect and the outside partition edge.
Cont'd... |
