| (iv) A refrigerated storage and warming facilities
for infant formula shall be provided and be accessible for use by
nursery personnel at all times.
(Q) Service areas. The following service areas shall
be provided to support an obstetrical suite unless otherwise noted.
(i) Control station. The control station shall be located
to permit direct visual surveillance of all traffic which enters the
obstetrical suite.
(ii) Office. A supervisor's office shall be provided.
(iii) Waiting room/area. A waiting room/area shall
be provided and contain toilet room(s) with hand washing facilities,
public telephone(s), and drinking fountain(s).
(iv) Scrub facilities. Two scrub stations shall be
within 5 feet of the entrance to each c-section operating room and
delivery room. Two scrub stations may serve two c-section operating
rooms or delivery rooms if the scrub stations are located adjacent
to the entrance of each c-section operating room or delivery room.
Scrub facilities shall be arranged to minimize any incidental splatter
on nearby personnel or supply carts. Viewing panels shall be provided
for observation of c-section operating rooms and delivery rooms from
the scrub area.
(v) Sterilizing facilities. Sterilizing facilities
with high speed sterilizers shall be conveniently located to serve
all c-section operating rooms and delivery rooms. A work space and
a hand washing fixture with hands-free operable controls shall be
included. High speed autoclaves should only be used in an emergency
situation (e.g. replacements unavailable for dropped instruments).
Sterilization facilities would not be necessary when spare instruments
are available.
(vi) Anesthesia workroom. An anesthesia workroom shall
be provided with work counter, sink with hands-free operable controls,
and storage space for small style D or E medical gas cylinders and
other anesthesia equipment.
(vii) Medication station. Storage and distribution
of medication may be done from a medicine preparation room, medicine
alcove area or from a self-contained medicine dispensing unit but
must be under visual control of nursing staff. A work counter, hand
washing fixture with hands-free operable controls, refrigerator, and
double-locked storage for controlled substances shall be provided.
Standard cup-sinks provided in many self-contained units are not adequate
for hand washing. The medication station may be shared with the clean
work room.
(viii) Nourishment station. The nourishment station
shall contain sink with hands-free operable controls, work counter,
self-dispensing ice machine, refrigerator, cabinets, and not located
in the clean work room. Space shall be included for temporary holding
of unused or soiled dietary trays. A nourishment station is not required
in the nursery suite.
(ix) General storage room(s). A minimum of 50 square
feet per operating room is required for general storage space(s).
The storage space is exclusive of soiled holding, sterile supplies,
clean storage, drug storage, locker rooms. In addition to general
storage, equipment storage shall be provided for labor, LDR and LDRP
rooms.
(x) Emergency storage. Equipment used for emergencies
shall be stored in a room or alcove under direct visual control of
the nursing staff.
(xi) Storage alcove. The alcove provided for stretcher
storage, portable X-ray equipment, warming devices, auxiliary lamps,
etc. shall be located out of direct line of traffic.
(xii) Obstetrical suite staff clothing change rooms.
Appropriately sized areas shall be provided for male and female personnel
working within the obstetrical suite. These areas shall contain lockers,
showers, toilets, hand washing fixtures with hands-free operable controls,
and space to change into scrub suits and boots. Separate locker/changing
rooms shall be provided for male and female staff. The shower and
toilet room(s) may be unisex. These areas shall be arranged to provide
a traffic pattern so that personnel entering from outside the obstetrical
suite can shower, change, and move directly into the restricted areas
of the obstetrical suite.
(xiii) Lounge. A lounge shall be provided in hospitals
with four or more obstetrical surgical and delivery rooms. The lounge
shall permit staff use without leaving the obstetrical surgical suite
or delivery suite and may be accessed from the obstetrical suite staff
clothing change rooms or staff changing room for delivery suite. The
lounge shall not have direct access from outside the surgical suite.
When the lounge is remote from the clothing change rooms, toilet facilities
and a hand washing fixture with hands-free operable controls accessible
from the lounge shall be provided.
(xiv) Staff toilet facilities. Toilet facilities located
in the obstetrical suite for exclusive staff use shall be provided
and contain hand washing facilities with hands-free operable controls.
The toilet room may be accessible from a staff lounge, when provided.
(xv) Nurses' toilet. A nurses' toilet room shall be
provided at the labor and recovery area(s) and shall include hand
washing fixture with hands-free operable controls.
(xvi) Dictation and report preparation area. This may
be accessible from the lounge area.
(xvii) On-call rooms. Physicians and staff on 24-hour
on-call work schedules shall be provided with sleeping rooms with
access to a toilet, lavatory and shower. If not contained within the
unit itself, the area shall have a telephone or intercom connection
to the obstetrical suite(s).
(xviii) Clean workroom or clean supply room. A clean
workroom is required. It shall contain a work counter, a hand washing
fixture with hands-free operable controls, storage facilities for
clean supplies, and a space to package reusable items. The storage
for sterile supplies must be in a separated room. When the room is
used only for storage and holding as part of a system for distribution
of clean and sterile supply materials, the work counter and hand washing
fixture may be omitted.
(xix) Soiled workroom. The soiled workroom shall be
for the exclusive use of the obstetrical suite and shall be in addition
to the soiled workroom required for the obstetrical surgical suite.
The soiled workroom for the obstetrical c-section operating room or
delivery room suite shall not have direct connection with operating
rooms or other sterile activity rooms. The soiled workroom shall contain
a clinical sink with hands-free operable controls or equivalent flushing
type fixture, work counter, sink equipped for hand washing, waste
receptacle, and linen receptacle. There shall be a designated soiled
workroom for the exclusive use of the NCCU.
(xx) Housekeeping rooms. A separate housekeeping room
containing a floor receptor or service sink and storage space for
housekeeping supplies and equipment shall be provided for the exclusive
use of the obstetrical suite, the c-section operating room, and nurseries
(one for each).
(xxi) Triage room. When triage services are provided,
there shall be a minimum of one triage room in the obstetrical suite.
(I) An obstetrical triage room shall be a minimum clear
floor area of 100 square feet with a minimum dimension of nine feet.
The obstetrical triage room shall contain cabinets, work counter,
examination light, and a hand washing fixture with hands-free operable
controls. The fixed and movable cabinets and shelves shall not encroach
upon the bed/gurney clear floor space/area.
(II) When a multiple-bed/gurney triage patient station
is provided, the clearance between the side of a bed/gurney and a
wall/partition shall be a minimum of three feet. The clearance between
sides of beds/gurneys shall be a minimum of six feet. The minimum
distance at the foot of the bed/gurney shall not be less than seven
feet for single load area/room or ten feet for double load area/room.
Four feet of the passage space at the foot of the bed may be shared
between two beds/gurneys. The multiple-bed/gurney triage room shall
contain cabinets, medication storage, work counter, examination light,
and a hand washing fixture with hands-free operable controls. The
fixed and movable cabinets and shelves shall not encroach upon the
bed/gurney clear floor space/area. Privacy shall be provided for each
patient with cubicle curtains or movable screens. The requirements
of this subclause are illustrated in Table 8, Diagram D of §133.169(h)
of this title.
(III) A patient in a triage bed shall have access to
a patient toilet room without entering the corridor.
(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) C-section operating rooms and delivery rooms shall
have ceiling heights not less than nine feet.
(ii) Recreation rooms, exercise rooms, equipment rooms,
and similar spaces where impact noises may be generated shall not
be located directly over operating rooms or delivery rooms, unless
special provisions are made to minimize such noise as contained in
Table 1 of §133.169(a) of this title.
Cont'd... |
