| (III) Inner courts. Inner court (enclosed by building
on all sides) onto which the required windows open shall have minimum
width, at all levels, of not less than one foot for each foot, or
fraction thereof, of the height (average height of enclosing walls)
of such courts, but in no case shall the width be less than 10 feet.
If operable windows are provided, a horizontal, unobstructed, and
permanently open air intake or passage having a cross-sectional area
of not less than 21 square feet shall be provided at or near the bottom
of the court. Metal decorative grilles not effectively reducing the
open area by more than 5.0% shall be permitted at the ends. Walls,
partitions, floor, and floor-ceiling assemblies forming intakes or
passages shall be noncombustible and shall be constructed in accordance
with NFPA 101, §18-3.1(b) and (c). An inner court shall have
a horizontal cross sectional area of not less than one and one-half
times the square of its width.
(vi) Visibility. All areas of the nursing suite, including
entrances to patient rooms, shall be visible from the nurse station(s).
Observation by video cameras of seclusion rooms, entrances, hallways,
and activity areas shall be acceptable.
(vii) Special fixtures, hardware, and tamper-proof
screws. Special fixtures, hardware, and tamper-proof screws shall
be used throughout the patient nursing suites.
(I) All exposed and accessible fasteners shall be tamper-resistant.
(II) Suitable hardware shall be provided on doors to
toilet rooms so that access to these rooms can be controlled by staff.
Hardware shall be utilized which is appropriate to prevent patient
injury.
(III) Only break-away or collapsible clothes bars in
wardrobes, lockers, towel bars, and closets and shower curtain rods
shall be permitted. Wire coat hangers shall not be permitted in nursing
suites.
(IV) When grab bars are provided, the space between
the grab bar and the wall should be filled to prevent a cord being
tied around it for hanging. Bars, including those which are part of
such fixtures as soap dishes, shall be sufficiently anchored to sustain
a concentrated load of 250 pounds.
(viii) Detention screens.
(I) When operable windows are provided in patient sleeping
rooms, it may be necessary to provide detention screens on windows
or limit the amount of window operation in order to inhibit possible
tendency for suicide or elopement. The type and the degree of security
required shall be determined by the facility administration.
(II) When detention screens are provided, windows shall
be capable of opening with the screens in place. Where glass fragments
may create a hazard, safety glazing or other appropriate security
features shall be incorporated.
(III) In building housing for certain types of patients,
detention rooms, or a security section, the facility shall provide
detention screens to confine or protect building inhabitants, when
necessary.
(ix) Hand washing amenities. Hand washing amenities
shall be conveniently located near the nurses station and in the medication
area. One lavatory in an open medication area can meet this requirement.
(x) Elevator lobbies. Elevator lobbies shall be physically
separated from the required means of egress with one hour fire rated
construction which resist the passage of smoke on all floors containing
patient rooms.
(B) Finishes.
(i) Seamless floors with coved wall bases described
in §134.122(d)(2)(B)(iii)(III) of this title shall be provided
in soiled workrooms.
(ii) Wall bases in the soiled workroom shall be made
integral and coved with the floor, tightly sealed to the wall, constructed
without voids that can harbor insects, retain dirt particles, and
impervious to water.
(iii) Monolithic ceilings described in §134.122(d)(2)(B)(vi)(III)
of this title shall be provided in airborne infection isolation rooms,
seclusion rooms, and security rooms.
(iv) Ceilings of patient rooms may be acoustically
treated; however, they shall be monolithic as described in §134.122(d)(2)(B)(vi)(III)
of this title.
(v) Acoustical ceilings shall be provided for corridors
in patient areas, nurses' stations, dayrooms, recreation rooms, dining
areas, and waiting areas.
(4) Mechanical requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph.
(A) Special consideration shall be given to the type
of heating and cooling units, ventilations outlets, and appurtenances
installed in patient-occupied areas of nursing suites. The following
shall apply:
(B) All air grilles and diffusers shall be of a type
that prevents the insertion of foreign objects.
(C) All convector or HVAC enclosures exposed in the
room shall be constructed with rounded corners and shall have enclosures
fastened with tamper-resistant fasteners.
(D) HVAC equipment shall be of a type that minimizes
the need for maintenance within the room.
(E) Outside air shall be supplied to each patient room
by a central air handling unit to provide make-up air for air exhausted
from the bathroom in accordance with Note 3 of Table 3 of §134.131(c)
of this title.
(F) Each patient room bathroom shall be exhausted continuously
to the exterior in accordance with Table 3 of §134.131(c) of
this title.
(5) Piping systems and plumbing fixtures. Piping systems
and plumbing fixtures shall be in accordance with §134.122(d)(4)
of this title and this paragraph.
(A) Each patient bathroom shall contain a water closet
and a lavatory. The lavatory may be located in a single bed patient
room instead of in the bathroom.
(B) An additional lavatory shall be placed in each
patient room proper where the bathroom serves more than two beds.
(C) Hand washing fixtures shall be located near the
nurses' station and the drug distribution station. One lavatory may
serve both areas.
(D) Faucet controls shall not be equipped with handles
that may be easily broken off in the patient care areas.
(E) Bedpan washers are not required in patient bathrooms.
(F) Piped medical gas systems are not required unless
otherwise noted.
(G) Only special, tamper proof sprinkler heads from
which it is not possible to suspend any objects shall be installed.
(6) Electrical requirements. Electrical requirements
shall be in accordance with §134.122(d)(5) of this title and
this paragraph.
(A) Electric receptacles in nursing units.
(i) Each receptacle shall be grounded to the reference
grounding point by means of an insulated copper grounding conductor.
(ii) Each patient bed location shall be supplied by
at least two branch circuits, one from the critical branch of the
emergency system as required by NFPA 99, §3-4 and one from the
normal system. All branch circuits from the normal system shall originate
in the same panelboard.
(iii) One duplex receptacle connected to a normal branch
circuit and one duplex outlet connected to the critical branch circuit
shall be located on opposite sides of the head of each bed. In addition
at least one duplex outlet shall be located on each wall. A dedicated
outlet shall be provided at the television location.
(iv) Each examination table shall have access to two
duplex receptacles.
(v) Each work table or counter shall have access to
two duplex receptacles.
(vi) One duplex receptacle shall be installed in the
bathroom to permit the use of electrical appliances in front of the
mirror.
(vii) Receptacles shall be protected by GFCI breakers
installed in distribution panel enclosures serving the nursing suite.
(viii) Duplex receptacles shall be installed not more
than 50 feet apart in corridors and within 25 feet of corridor ends.
(ix) When mobile x-ray equipment is provided, special
receptacles marked for X-ray use shall be installed in corridors so
that mobile equipment may be used anywhere within a patient room using
a cord length of 50 feet or less. Where capacitive discharge or battery
powered X-ray units are used, special X-ray receptacles will not be
required in corridors.
(x) Additional duplex receptacles shall be installed
as required to satisfy operational needs of the nursing unit.
(B) Nurses calling systems. When a nurses calling system
is provided in a nursing suite, a nurses regular calling system, nurses
emergency calling system, and a staff emergency assistance calling
system shall comply with §134.122(d)(5)(K) of this title. Provisions
shall be made for easy removal of all call buttons or for covering
call buttons as required for security. Pull cords shall not exceed
18 inches in length.
Cont'd... |
