| (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.
(i) Each patient room shall be served by at least one
nurses regular calling station for two-way voice communication. Each
patient bed shall be provided with a call button. Two call buttons
serving adjacent beds may be served by one calling station. In rooms
containing two or more calling stations, indicating lights shall be
provided at each station. Nurses calling systems shall be equipped
with an indicating light at each calling station which remains lighted
as long as the voice circuit is operating.
(ii) A nurses emergency calling system shall be provided
at each inpatient water closet, bathtub and shower in accordance
with §134.122(d)(5)(K)(ii) of this title. When conveniently located
one emergency call station may serve one bathroom.
(iii) A staff emergency assistance calling system for
staff to summon additional assistance shall be provided in central
bathing facility rooms and exam/treatment rooms in accordance with
§134.122(d)(5)(K)(iii) of this title.
(iv) All nurse call hardware shall have tamper resistant
fasteners.
(v) A call system shall be provided at all seclusion
anterooms.
(C) Illumination requirements.
(i) General illumination requirements. Nursing suite
corridors shall have general illumination with provisions for reducing
light levels at night. Illumination of corridors for egress purposes
shall comply with NFPA 101, §§18-2.8 and 18-2.9.
(ii) Illumination of the nurses station. Illumination
of the nurses station and all nursing support areas shall be with
fixtures powered from the critical branch of the emergency electrical
system NFPA 99, §3-4.2.2.2(c).
(iii) Patient suite lighting.
(I) Each patient room shall be provided with general
lighting and night lighting. General lighting and night lighting shall
be controlled at the room entrance. All controls for lighting in patient
areas shall be of the quiet operating type. Control of night lighting
circuits may be achieved by automatic means and in such instances
control of night lighting at the room entrance shall not be required.
At least one general light fixture and night lighting shall be powered
from the critical branch of the essential electrical system.
(II) A reading light shall be provided for each patient.
Reading light control shall be readily accessible from each patient
bed. High heat producing light sources such as incandescent and halogen
shall be avoided to prevent burns to patients and/or bed linen. Light
sources shall be covered by a diffuser or a lens.
(III) A wall or ceiling mounted lighting fixture shall
be provided above each lavatory.
(IV) A ceiling mounted fixture shall be provided in
patient bathrooms where the lighting fixture above the lavatory does
not provide adequate illumination of the entire bathroom. Some form
of fixed illumination shall be powered from the critical branch.
(o) Pharmacy suite.
(1) Architectural requirements.
(A) General. The pharmacy room or suite shall be located
for convenient access, staff control, and security for drugs and personnel.
(B) Dispensing area. The pharmacy room or suite shall
include the following functional spaces and facilities:
(i) area(s) for pickup, receiving, reviewing and recording;
(ii) extemporaneous compounding area with sufficient
counter space for drug preparation and sink with hands-free operable
controls;
(iii) work counter space for automated and manual dispensing
activities;
(iv) storage or areas for temporary storage, exchange,
and restocking of carts; and
(v) security provisions for drugs and personnel in
the dispensing counter area.
(C) Manufacturing. The pharmacy room or suite shall
provide the following functional spaces and facilities.
(i) When bulk compounding area is required, work space
and counters shall be provided.
(ii) When packaging, labeling and quality control is
required, an area(s) shall be provided.
(D) Storage. The following spaces shall be provided
in cabinets, shelves, and/or separate rooms or closets:
(i) space for bulk storage, active storage, and refrigerated
storage;
(ii) storage in a fire safety cabinet or storage room
that is constructed under the requirements for protection from hazardous
areas in accordance with NFPA 101, Chapter 12, for alcohol or other
volatile fluids, when used; and
(iii) storage space for general supplies and equipment
not in use.
(E) Administrative area(s). An administrative area
for the pharmacy is optional for crisis stabilization units. The following
functional spaces and facilities shall be included for the administrative
area(s):
(i) office area for the chief pharmacist and any other
offices areas required for records, reports, accounting activities,
and patients profiles;
(ii) poison control center with storage facilities
for reaction data and drug information centers; and
(iii) a room or area for counseling and instruction
when individual medication pick-up is available for inpatients or
outpatients.
(F) Service areas. The following service areas and
items shall be provided.
(i) Intravenous (IV) solutions area. When IV solutions
are prepared in a pharmacy, a sterile work area with a laminar-flow
workstation designed for product protection shall be provided.
(ii) Satellite pharmacy. When provided, the room(s)
shall include a work counter, a sink with hands-free operable controls,
storage facilities, and refrigerator for medications.
(iii) Hand washing amenities. A hand washing fixture
with hands-free operable controls shall be located in each room where
open medication is handled.
(iv) Staff toilets. Toilets may be outside the suite
but shall be convenient for staff use.
(2) Mechanical Requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph. When IV solutions are prepared, the required laminar-flow
system shall include a non-hygroscopic filter rated at 99.97% (HEPA).
A pressure gauge shall be installed for detection of filter leaks
or defects.
(3) 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) Material used for plumbing fixtures shall be non-absorptive
and acid-resistant.
(B) Water spouts used at lavatories and sinks shall
have clearances adequate to avoid contaminating utensils and the contents
of carafes, etc.
(4) Electrical requirements. Electrical requirements
shall be in accordance with §134.122(d)(5) of this title and
this paragraph.
(A) Under-counter receptacles and conduits shall be
arranged (raised) to not interfere with cleaning of the floor below
or of the equipment.
(B) Exhaust hoods shall have an indicator light indicating
that the exhaust fan is in operation.
(C) Electrical circuit(s) to equipment in wet areas
shall be provided with five milliampere GFCI.
(p) Rehabilitation therapy suite.
(1) Occupational therapy. When occupational therapy
services are provided, the following shall be included:
(A) an activity room with work areas, counters and
a hand washing fixture. Counters shall be wheel chair accessible;
(B) a storage room for supplies and equipment;
(C) secured storage for potential harmful supplies
and equipment; and
(D) remote electrical switching for potentially harmful
equipment.
(2) Physical therapy. When physical therapy services
are provided, the following rooms shall be included.
(A) When services required by the narrative program
for thermotherapy, diathermy, ultrasonics, and hydrotherapy, individual
treatment areas shall be provided.
(B) An individual treatment area(s) shall be a minimum
of 70 square feet of clear floor area exclusive of four foot aisle
space. Privacy screens or curtains shall be provided at each treatment
station.
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