| (iii) When medical, surgical, and coronary critical
care services are combined in one CCU suite, at least 50% of the beds
shall be located in private rooms. (Note: Medical/surgical patients
may utilize open areas or private critical care rooms as needed and
available but, insofar as possible, coronary patients should not be
accommodated in open ward areas.)
(D) PCCU. When a PCCU is provided, the unit shall comply
with the requirements contained in subparagraph (B) of this paragraph
and the following.
(i) The PCCU may be an open ward, private rooms, or
combination of both. When an open ward plan is used, one private room
is required for each 10 beds or fraction thereof.
(ii) In a multiple-bassinet/crib (sleeping unit) room/ward
the clearance between the side of the 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 requirement 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.
(iii) A sleeping space shall be provided for parents
who spend long hours with the patient. This space may be within the
patient room or separate from the patient area but shall be in communication
with the PCCU staff.
(iv) Hand washing fixtures with hands-free operable
controls shall be provided in each room near the entrance of the room,
and in open wards at a minimum ratio of one fixture to each three
cribs, beds or bassinets. Hand washing fixtures shall be sized to
contain splashing.
(v) A room shall be provided for private discussions
and shall be located within, or convenient to, the PCCU. The multipurpose
room noted in subparagraph (F)(v) of this paragraph will meet this
requirement if conveniently located.
(vi) Storage space for infant formula shall be provided.
This functional space may be outside the PCCU but shall be available
for use at all times.
(vii) Storage cabinets or closets for toys and games
shall be provided within the unit.
(viii) Storage area for cots, bed linens, and other
items needed for overnight accommodation of parents shall be provided
in the general location of sleeping accommodations.
(ix) An examination/treatment room with a minimum of
120 square feet of clear floor area shall be located in or near the
PCCU suite. The room shall contain a hand washing fixture with hands-free
operable controls, storage facilities, counter, or shelf space for
writing. This requirement does not apply when all patient rooms are
private rooms.
(E) Additional service spaces. The following additional
service spaces shall be immediately available within each type of
CCU(s). These may be shared by more than one CCU (unless otherwise
noted) provided that direct access is available from each.
(i) Securable closets. Securable closets or cabinet
compartments for the personal effects of nursing personnel, located
in or near the nurse station, shall be provided. 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.
(ii) Charting and dictation area(s) for physicians.
Space for recording, record storage and reviews shall be provided
near cribs, beds or bassinets. Dictation space may be in a separate
room or alcove. Suitable space shall be provided when computers are
used for the clinical records.
(iii) X-ray viewing area. Each type of CCU shall be
provided with an X-ray viewing area and film illuminators for handling
at least four films simultaneously. When the entire CCU suite is provided
with digital imaging system capabilities, a minimum of two X-ray film
illuminator viewers shall be provided. The film illuminators shall
be mounted within the central area of the suite.
(iv) Nourishment station. The nourishment station shall
contain a sink with hands-free operable controls, work counter, refrigerator,
cabinets, and not be located in the medication room or the clean workroom.
Space shall be included for temporary holding of unused or soiled
dietary trays.
(v) Ice machine. The ice machine shall provide ice
for treatment and patient use. Ice-making equipment for treatment
may be in the clean workroom or the nourishment station.
(vi) Equipment storage. In addition to above, twenty
square feet of equipment storage shall be provided for each patient
station. These storage areas shall be out of the way of the corridor
traffic.
(vii) Stretcher storage alcove. The alcove provided
for stretcher or bassinet storage shall be located out of direct line
of traffic.
(viii) Clean workroom. The room shall contain a work
counter, a hand washing fixture with hands-free operable controls,
and storage facilities for clean and sterile supplies.
(ix) Clean linen storage. There shall be a designated
area for clean linen storage. This may be within a clean workroom,
a separate closet, or an approved distribution system. If a closed
cart system is used, storage of the cart may be in an alcove.
(x) Soiled workroom. The soiled workroom shall contain
a work counter, a clinical sink with hands-free operable controls
or equivalent flushing rim type fixture with hot and cold mixing faucet,
separate hand washing facilities, and separate waste and soiled linen
receptacles.
(xi) Soiled holding room. When provided, soiled holding
rooms used only for temporary holding of soiled material may omit
the clinical sink and work counter.
(xii) Housekeeping room. A housekeeping room shall
be provided within or immediately adjacent to the CCU. It shall not
be shared with other nursing units or departments.
(F) Other required areas/rooms. The following areas/rooms
shall be provided and may be located outside the unit if conveniently
accessible.
(i) Waiting space. A visitors' waiting space shall
be provided with toilet facility(ies), public telephone(s), and drinking
fountain(s). One waiting space may serve other CCUs.
(ii) Offices. Room(s) shall be provided for critical
care medical and nursing management and administrative personnel.
The offices shall be large enough to permit consulting with members
of the critical care team and visitors. The offices shall be linked
with the unit by telephone or an intercommunications system.
(iii) Staff lounge. 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. One lounge may serve multiple
CCUs when the lounge is adjacent to the units. Toilet facilities may
be shared as long as privacy is maintained for changing areas.
(iv) On-call rooms. 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 CCU served, a dedicated telephone or intercom system
shall connect the on-call room(s) to the CCU(s).
(v) Multipurpose room(s). A multipurpose room for staff,
patients, and patients' families for patient conferences, reports,
education, and training sessions shall be provided. This room(s) must
be accessible to each nursing unit.
(vi) A consultation room shall be provided, if not
provided elsewhere in the unit.
(2) Details and finishes. Details and finishes shall
be in accordance with §133.162(d)(2) of this title and this paragraph.
(A) Details.
(i) At least one door to a CCU room shall be not less
than four feet wide (41.5 inches clear width) and arranged to minimize
interference with movement of beds and large equipment.
(ii) Sliding doors in CCUs shall not have floor tracks
at the latch side of the sliding panel, have hardware that minimizes
jamming possibilities, and be in accordance with §133.162(d)(2)(A)(vi)
of this title.
(iii) Glazing in viewing panels shall be safety glass,
wire glass, or clear plastic.
(iv) Noise control and sound attenuation in an open
ward environment shall be a design factor and meet the requirements
contained in Table 1 of §133.169(a) of this title.
(v) Recreation rooms, exercise rooms, equipment rooms,
and similar spaces where impact noises may be generated shall not
be located directly over CCU(s), unless special provisions are made
to minimize such noise.
(B) Finishes.
(i) Flooring used in soiled workrooms shall be of the
seamless type as required by §133.162(d)(2)(B)(iii)(III) of this
title.
Cont'd... |
