| (v) The workroom serving the full-term and continuing
care nurseries may be omitted if equivalent work and storage areas
and facilities, including those for scrubbing and gowning, are provided
within that nursery at the entrance. Space required for work areas
located within the nursery is in addition to the area required for
infant care. Adequate provisions shall be made for storage of emergency
carts and equipment, and for sanitary storage and disposal of soiled
waste for the nursery.
(vi) Charting and dictation facilities shall be provided
for physicians and nurses. This may be in a separate room or part
of the workroom.
(vii) An examination/treatment room or space shall
be provided and shall contain a work counter, storage, and lavatory
equipped for hand washing with hands-free operable controls. The examination/treatment
room or space shall have a minimum clear area of 80 square feet in
addition to the required area of each workroom exclusive of fixed
and movable cabinets and shelves. The examination treatment space
shall be located within the nursery.
(viii) An airborne infection isolation room is required
in at least one level of nursery care and the neonatal critical care
unit. The isolation room shall be enclosed and separated from the
nursery unit with provisions for observation of the infant from adjacent
nurseries or control area(s). The minimum size of the room shall be
120 square feet of clear floor area. The isolation room shall contain
cabinets, a work counter, and a hand washing fixture with hands-free
operable controls. Fixed and moveable cabinets and shelves shall not
encroach upon bed/gurney clear floor space/area. The isolation room
shall comply with the ventilation requirements in Table 3 of §133.169(c)
of this title.
(ix) A housekeeping room shall be provided for the
exclusive use of the nursery.
(O) Neonatal critical care unit (NCCU). When an NCCU
is provided, the unit shall comply with the following.
(i) The NCCU shall be conveniently located near the
obstetrical suite and be arranged to preclude unrelated traffic.
(ii) Each room and ward 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 five 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. When partitions are used, the patient's direct view to
the exterior may be through no more than two separate clear vision
panels. Window shall be in accordance with subsection (t)(2)(A)(v)
of this section.
(iii) The NCCU shall have a clearly identified public
entrance and reception area arranged to permit visual observation
and contact with all traffic entering the unit. Gowning facilities,
lockers, and scrub area shall be provided at each public entrance
to the patient care area(s) of the NCCU. All scrub sinks shall be
provided with hands-free operable controls and large enough to contain
splashing.
(iv) A control station shall be provided in a central
area and shall have space for counters and storage, and shall have
convenient access to a hand washing fixture with hands-free operable
controls. The control station may be combined with or include centers
for reception, communication and patient monitoring.
(v) NCCU patients may be housed in private rooms or
a room with multiple bassinets or cribs. Each unit shall not exceed
24 bassinets or cribs. There shall be at least one enclosed private
room for every six bassinets or cribs.
(vi) A single-bassinet/crib patient NCC room shall
have a minimum clear floor area of 120 square feet per bassinet/crib
exclusive of work counter, vestibule, sink and aisle. A minimum of
12 feet width shall be provided for the head wall for each bed.
(vii) In a multiple-bassinet/crib room/ward the clearance
between the side of a sleeping unit and a wall/partition shall be
a minimum of five feet. The clearance between sides of sleeping units
shall be a minimum of eight feet. The minimum distance at the foot
of the bassinet shall not be less than ten feet for single load area/room
or sixteen feet for double load area/room. Four feet of the passage
space at the foot of the bassinet may be shared between two bassinets.
The fixed and moveable cabinets and shelves shall not encroach upon
the bassinet/crib clear floor space/area. The requirements of this
clause are illustrated in Table 8, Diagram K of §133.169(h) of
this title.
(viii) A minimum of one isolation room shall be provided
with a minimum clear floor area of 120 square feet per bassinet/crib
exclusive of work counter, vestibule, sink and aisle. A minimum of
12 feet width shall be provided for the head wall for each bed. A
toilet room is not required.
(ix) A lavatory equipped for hand washing with hands-free
operable controls shall be provided in each single-bed room. In rooms
with multiple beds, one lavatory with hands-free operable controls
for each four patient stations or fraction thereof shall be provided.
These lavatories shall be located convenient to infant stations.
(x) Each NCCU shall be served by a connecting workroom
containing gowning facilities at the entrance for staff and housekeeping
personnel, a work space with counter, storage facilities, a lavatory
or sink equipped for hand washing with hands-free operable controls,
and individual closet or lockers for personal effects of nursing personnel.
One workroom may serve not more than two NCCUs.
(xi) A storage space for infant formula shall be provided.
This functional space may be outside the NCCU but shall be available
for use at all times.
(xii) A breast feeding or pump room shall be provided
convenient to the unit. Provision shall be made, either within the
room or conveniently located nearby, for a sink with hands-free operable
controls, counter, refrigeration and freezer, storage for pump and
attachments, and educational materials.
(xiii) A room(s) shall be provided within the NCCU
for parents and infants for extended private time together and the
room is not considered a patient room. The room(s) shall have direct
access to toilet facilities and a hand washing fixture with hands-free
operable controls. The room(s) shall have a sleeping area for at least
one parent, and sufficient space for the infant's bassinet/crib and
equipment. The room(s) shall have electrical and medical gas outlets
as specified for NCCU bassinet/cribs. This room(s) shall have direct
communication with the NCCU staff.
(xiv) Twenty square feet of equipment storage shall
be provided for each patient station. The storage areas shall be out
of the way of the corridor traffic.
(xv) Charting and dictation space shall be provided
for physicians and nurses.
(xvi) A respiratory therapy work area and storage room
shall be provided.
(xvii) Blood gas lab facilities shall be immediately
accessible to the NCCU.
(xviii) A staff lounge shall include toilet facilities
with a hand washing fixture with hands-free operable controls. The
lounge(s) shall be located so that staff may be recalled quickly to
the patient area in emergencies. Toilet facilities may be shared as
long as privacy is maintained for changing areas.
(xix) Physicians and other staff on 24-hour on-call
work schedules shall be provided with sleeping rooms with access to
a shower(s), toilet(s), and lavatory(ies). If on-call room(s) are
not within the NCCU served, a dedicated telephone or intercom system
shall connect the on-call room(s) to the NCCU.
(xx) A waiting room/area shall be provided and contain
toilet room(s) with hand washing facilities. Waiting room/area maybe
shared with other waiting room/areas if conveniently located.
(xxi) A consultation room shall be provided, if not
provided elsewhere in the suite.
(xxii) A housekeeping room shall be provided exclusively
within or immediately adjacent to the NCCU. It shall not be shared
with other nursing units or departments.
(P) Infant formula facilities. Infant formula facilities
shall meet the following requirements.
(i) When infant formula is prepared on site, the infant
formula preparation room shall contain a lavatory equipped for hand
washing with hands-free operable controls, warming facilities, refrigerator,
work counter, formula sterilizer, and storage facilities. The formula
room may be located near the nurseries or at another appropriate place
within the hospital. Direct access from the formula preparation room
to any nursery room is prohibited.
(ii) An infant formula clean-up room shall be provided
and include a hand washing fixture with hands-free operable controls,
facilities for bottle washing, a work counter, and sterilization equipment.
(iii) When commercial infant formula is used, the separate
clean-up and formula preparation rooms may be omitted. The storage
and handling may be done in the nursery workroom or in another appropriate
room in the hospital that is conveniently accessible at all hours.
Cont'd... |
