| (iii) Imaging procedure rooms shall have ceiling heights
not less than nine feet. Ceilings containing ceiling-mounted equipment
shall be of sufficient height to accommodate the equipment of fixtures
and their normal movement.
(B) Finishes.
(i) Flooring used in contrast media preparation and
soiled workroom shall be of the seamless type as required by §133.162(d)(2)(B)(iii)(III)
of this title.
(ii) A lay-in type ceiling is acceptable for the diagnostic
and procedure rooms.
(3) Mechanical Requirements. Mechanical requirements
shall be in accordance with §133.162(d)(3) of this title and
this paragraph.
(A) The cryogen gas venting from the MRI unit shall
be exhausted to the exterior. When a cryogen storage room is provided
to replenish supplies, the storage room shall be vented and exhausted
to the exterior.
(B) Self-contained air conditioning to supplement the
cooling capacity in computer rooms is permitted.
(C) Air handling units serving the imaging suite shall
be equipped with filters 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. When automatic film processors are
used, a receptacle of adequate size with hot and cold water for cleaning
the processor racks shall be provided.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §133.162(d)(5) of this title and
this paragraph.
(A) General.
(i) Each imaging procedure room shall have at least
four duplex electrical receptacles.
(ii) A special grounding system in areas such as imaging
procedures rooms where a patient may be treated with an internal probe
or catheter shall comply with Chapter 9 of NFPA 99, and Article 517
of NFPA 70.
(iii) General lighting with at least one light fixture
powered from a normal circuit shall be provided in imaging procedures
rooms in addition to special lighting units at the procedure or diagnostic
tables.
(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.
(m) Intermediate care suite (Step down suite).
(1) Architectural requirements.
(A) General. The requirements in this subsection apply
to intermediate care units for acute care patients who require frequent
monitoring that exceed the level of care for nursing units and less
than that provided in critical care units. The suite may share services
with an adjacent suite.
(B) Intermediate care services and facilities. The
following services and facilities shall apply to all classifications
of intermediate care unless otherwise noted.
(i) In a single-bed patient room, the minimum clear
floor area shall be 150 square feet exclusive of anterooms, vestibules,
toilet rooms, closets, lockers, wardrobes, and/or alcoves. A minimum
of 12 feet width shall be provided for the head wall for each bed.
A hand washing fixture with hands-free operable controls shall be
located in the patient room and in the patient bathroom.
(ii) In a multi-bed intermediate care patient room
the maximum capacity shall be no more than four patients per room.
In a multiple-bed open ward patient room, the clearance between the
side of a bed and a wall/partition shall be a minimum of four feet.
The clearance between sides of beds shall be a minimum of eight feet.
The minimum distance at the foot of the bed 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. The ward shall contain cabinets, work counter, and
washing fixture with hands-free operable controls located centrally
to the beds. 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 P of §133.169(h)
of this title.
(iii) Each single-bed or multi-bed open ward patient
room shall have access to a bathroom without having to enter the general
corridor area. Each bathroom shall contain a toilet, a hand washing
fixture with hands-free operable controls, bathing facilities, and
a storage shelf or cabinet.
(iv) Each single and open ward patient room shall be
located on an exterior wall and shall have a window. In a ward, one
window may serve more than one patient. The window sill height shall
not exceed three feet above the floor. Patient beds shall not be located
more than 50 feet from an exterior window. Patients' views to outside
windows shall be direct and not through other clear vision panels.
Windows shall be in accordance with subsection (t)(2)(A)(iv) and (v)
of this section.
(v) The nurse station shall be located to permit direct
visual observation of each patient served. Video cameras or mirrors
shall not be substituted for direct visual observation. The nurse
station shall have space for counters and storage. The counter height
shall not exceed 42 inches. The nurse station may be combined with
or include centers for reception and communication. In multi-bed intermediate
care patient room the nurse station shall be located within the room
and have space for counters and storage.
(vi) When individual nurse substations are provided
and located at each patient room(s), they shall be located to permit
direct visual observation of each patient served. The nurse substation
shall have space for counter, storage space and a recessed sitting
space. The substation shall be at a minimum recessed from the egress
corridor one foot six inches.
(vii) Visual privacy shall be provided each patient
in multi-bed rooms. Design for privacy shall not restrict independent
patient access to the corridor, lavatory, or bathroom.
(viii) Each patient shall have a separate wardrobe,
locker, or closet that is suitable for hanging full-length garments
and for storing personal effects. A minimum of 12 lineal inches of
hanging space shall be provided per patient.
(C) Service areas. Service areas shall be located in,
adjacent to, or readily available to, each nursing unit. Each service
area may be arranged and located to serve more than one nursing unit.
The following service areas shall be provided.
(i) A visitors' waiting space shall be provided with
a toilet facility(ies), public telephone(s), and drinking fountain(s).
One waiting space may serve other units on the floor.
(ii) A nurses station with a hand washing fixture with
hands-free operable controls and an adjacent but separate dictation
space shall be provided when the single-bed intermediate care patient
rooms concept is used. An adjacent nurse station may be used and shared
when feasible.
(iii) Storage space shall be provided for emergency
equipment in the suite.
(iv) 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, 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 located with the clean work room.
(v) A soiled workroom shall be provided. The room shall
contain a clinical sink or equivalent flushing rim type fixture with
hot and cold mixing faucet, separate hand washing facilities with
hands-free operable controls, and separate waste and soiled linen
receptacles. When facilities for cleaning bedpans are provided elsewhere,
the flushing rim clinical sink may be omitted.
(vi) A clean workroom or clean supply room shall be
provided. A clean workroom when used for preparing patient care items
shall contain a work counter, hand washing facilities with hands-free
operable controls, and storage facilities for clean and sterile supplies.
When used only for storage and holding as part of a distribution system
of clean and sterile supplies, the work counter and hand washing facilities
may be omitted.
(vii) A nourishment station containing a work counter
with sink, microwave, refrigerator and storage cabinets and not located
in the clean workroom shall be provided.
(viii) A conveniently located examination room shall
be provided and have a minimum clear floor area of 100 square feet
and contain a counter for writing and hand washing facilities with
hands-free operable controls. This room may be omitted if all patient
rooms on the floor are single-bed patient rooms.
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