| (H) Activity service space. Space for activity services
(e.g., music therapy, recreational therapy, art, dance, vocational
therapy, educational therapy, etc.) shall be provided at the rate
of 15 square feet per occupant of the room and a minimum area of not
less than 375 square feet, whichever is greater. Space shall include
provisions for hand washing, work counter(s), storage and displays.
Where facilities contain less than 25 beds, the activity services
therapy functions may be provided within the noisy activities area
as required in subparagraph (F) of this paragraph if a space of not
less than 485 square feet is available for both the noisy activity
area and activity services area.
(I) Service areas. Service areas shall be located in,
or readily available to, each nursing suite. Each service area may
be arranged and located to serve more than one nursing suite, but
at least one service area shall be provided on each nursing floor.
A service area is composed of the following:
(i) an administrative center or nurses station with
an adjacent but separate dictation space;
(ii) a nurses office;
(iii) an area for charting. The charting area shall
be provided with separation needed for acoustical privacy as well
as space required for the function. A view window to permit observation
of the patient area by the charting nurse or physician may be used
provided that it is so located that patient files cannot be read from
outside the charting space;
(iv) a medication room, medicine alcove area, or a
self-contained medicine dispensing unit under visual control of nursing
staff. The room shall have a minimum area of 30 square feet under
direct control of the nursing or pharmacy staff. The room, area or
unit shall contain a work counter, hand washing fixture with hands-free
operable controls, and refrigerator. Provisions for security against
unauthorized access shall be assured. Standard cup-sinks provided
in many self-contained units are not adequate for hand washing;
(v) a small kitchen for patient use. The room shall
contain a sink, refrigerator, ice dispenser, microwave, and storage
cabinets. This room is to provide nourishment for patients between
scheduled meals;
(vi) a multipurpose room for staff and patient conferences,
education and demonstrations. The room shall be conveniently accessible
to each nursing suite and may serve several nursing suites or departments.
The room may be located on another floor if convenient for regular
use;
(vii) an examination or treatment room. The room shall
have a minimum floor area of 120 square feet excluding space for
vestibule, toilet, and closets. The minimum room dimension shall be
10 feet. The room shall contain a lavatory or sink equipped for hand
washing, work counter, storage facilities, and a desk, counter, or
shelf space for writing. The emergency treatment room may be used
for this purpose if it is conveniently located on the same floor as
the patient rooms;
(viii) patient laundry facilities. An automatic washer
and an electric dryer shall be provided. This requirement may be omitted
in nursing units intended only for adolescents and gero-psychiatric
patients;
(ix) staff lounge with separate female and male dressing
areas containing lockers, showers, toilets and hand washing facilities.
These facilities may be on another floor;
(x) securable closets or cabinet compartments for personal
articles of nursing unit staff. The closets or lockers shall be located
at or near the nurse station. At a minimum, these shall be large enough
for purses and billfolds. Coats may be stored in closets or cabinets
on each floor or in a central staff locker area;
(xi) secured storage area for patients' effects determined
potentially harmful (razors, nail files, cigarette lighters, etc.).
This area shall be controlled by staff;
(xii) clean workroom or clean supply room. When used
for preparing patient care items, it shall contain a work counter,
hand washing facilities, 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;
(xiii) clean linen storage for each nursing unit. The
clean linen area shall contain a work counter and storage space for
clean linen. The area shall be a part of the storage and distribution
of clean linen. Minimum area for clean linen shall be three square
feet of room area per patient bed space. The required area may be
concentrated in one central room or divided in several rooms throughout
the facility;
(xiv) a soiled workroom or soiled holding room. The
room shall contain a clinical sink or equivalent flushing rim fixture,
hand washing facilities, both with hot and cold water. The room shall
have a work counter and space for separate covered containers for
soiled linen and waste. Minimum area for soiled linen shall be three
square feet of room area per patient bed space;
(xv) an equipment storage room and storage room for
administrative supplies located on each floor which may serve multiple
nursing suites;
(xvi) an emergency equipment storage room or alcove
under direct visual control of the nursing staff and out of normal
traffic;
(xvii) a housekeeping room which may also serve adjacent
nursing suites;
(xviii) stretcher and wheelchair storage space which
is located without restricting normal traffic. The space may be located
outside the nursing suite;
(xix) an accessible public toilet with hand washing
fixtures. The toilets shall be located on each floor containing a
nursing suite;
(xx) staff toilet conveniently located to each nursing
suite. At least one staff toilet shall be located on each patient
sleeping floor. Toilet may be unisex;
(xxi) an ice dispensing machine for each nursing suite
which is located at the nourishment station or the clean work room;
(xxii) adequate number of drinking fountain fixtures;
(xxiii) adequate number of telephones available for
patients' private conversations;
(xxiv) a visitor room for patients to meet with friends
or family with a minimum floor space of 100 square feet;
(xxv) a quiet room for a patient who needs to be alone
for a short period of time but does not require a seclusion room.
Each quite room shall be not less than 80 square feet. The visitor
room may serve this purpose;
(xxvi) separate consultation room. The room shall have
a minimum floor space of 100 square feet, and provided at a room-to-bed
ratio of one consultation room for each 12 patient beds. The room(s)
shall be designed for acoustical and visual privacy and constructed
to achieve a level of voice privacy of 50 STC (which in terms of vocal
privacy means that some loud or raised speech is heard only by straining,
but is not intelligible); and
(xxvii) a conference and treatment planning room for
use for patient care planning. This room may be combined with the
charting room or use of the multipurpose room.
(3) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title and this paragraph.
(A) Details.
(i) Egress. Means of egress from each patient suite
shall comply with the requirements of NFPA 101, §18-2.
(ii) Patient bathroom and toilet room doors. Door leaves
to all patient bathrooms and toilet rooms shall be at least 36 inches
wide and shall swing outward or be double acting so that nursing staff
may gain access to a patient. Doors lockable from the inside shall
have hardware that allows staff to open the door from the outside.
(iii) Vision panels. Vision panels shall be provided
in the door between an anteroom and an airborne infection isolation
room.
(iv) Windows. Each patient sleeping room shall have
an outside window. The windows shall be restricted. Where the operation
of windows requires the use of tools or keys, the tools or keys shall
be located at each nurses station, on the same floor, and easily accessible
to staff. The bottom of the window opening shall not exceed 36 inches
above the floor.
(v) Location of patient room windows. Windows shall
be located on an outside wall. Windows may face an atrium, an inner
court, or an outer court provided the following requirements are
met.
(I) Atria windows. Atria onto which the required windows
face shall comply with the requirements of NFPA 101, §8-2.5.6.
(II) Outer courts. Outer court (not enclosed by building
on one side) onto which the required windows face shall have a minimum
width, at all levels, of not less than three inches for each foot,
or fraction thereof, of the height (average height of enclosing walls)
of such court, but in no case shall the width be less than five feet.
An outer court shall have a horizontal cross sectional area not greater
than four times the square of its width.
Cont'd... |
