| (iv) Warning signs capable of indicating that the equipment
is in use shall be provided.
(B) Service areas. The following service areas shall
be provided.
(i) Patient waiting area. The area shall be out of
traffic and under direct staff visual control.
(ii) Patient toilet rooms. Toilet room(s) with hand
washing amenities shall be located convenient to the waiting area.
(iii) Patient dressing rooms. Dressing rooms shall
be convenient to the waiting areas and X-ray rooms.
(iv) Hand washing facilities. A freestanding hand washing
fixture with hands-free controls shall be provided in or near the
entrance to each diagnostic and procedure room unless noted otherwise.
Hand washing facilities shall be arranged to minimize any incidental
splatter on nearby personnel or equipment.
(v) Contrast media preparation. This room shall include
a work counter, a sink with hands-free operable controls, and storage.
One preparation room may serve any number of rooms. When prepared
media is used, this area may be omitted, but storage shall be provided
for the media.
(vi) Film processing room. A darkroom shall be provided
for processing film unless the processing equipment normally used
does not require a darkroom for loading and transfer. When daylight
processing is used, the darkroom may be minimal for emergency and
special uses. Film processing shall be located convenient to the procedure
rooms and to the quality control area.
(vii) Quality control area or room. An area or room
for film viewing shall be located near the film processor. All view
boxes shall be illuminated to provide light of the same color value
and intensity.
(viii) Film storage (active). A room shall include
a cabinet or shelves for filing patient film for immediate retrieval.
(ix) Film storage (inactive). A room for inactive film
storage shall be provided. It may be outside the imaging suite, but
must be under the administrative control of imaging suite personnel
and be properly secured to protect films against loss or damage.
(x) Storage for unexposed film. Storage amenities for
unexposed film shall include protection of film against exposure or
damage.
(xi) Storage of cellulose nitrate film. When used,
cellulose nitrate film shall be stored in accordance with the requirements
of National Fire Protection Association 40, Standard for the Storage
and Handling of Cellulose Nitrate Motion Picture Film, 1994 edition.
(xii) Housekeeping room. The room may serve multiple
departments when conveniently located.
(2) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title and this paragraph.
(A) Details.
(i) Radiation protection shall be designed, tested
and approved by a medical physicist licensed under the Texas Medical
Physics Practice Act, Occupations Code, Chapter 602.
(ii) The design and environmental controls associated
with licensable quantities of radioactive material in laboratories
and/or imaging rooms shall be approved by the Texas Department of
Health's Bureau of Radiation Control prior to licensed authorizations.
(iii) Where protected alcoves with view windows are
required, provide a minimum of 1 foot 6 inches between the view window
edge/frame and the outside partition edge.
(iv) Imaging procedure rooms shall have ceiling heights
not less than nine feet. Ceilings containing ceiling-mounted equipment
shall be of sufficient height to accommodate the equipment of fixtures
and their normal movement.
(B) Finishes.
(i) Flooring used in contrast media preparation and
soiled workroom shall be of the seamless type as required by §134.122(d)(2)(B)(iii)(III).
(ii) A lay-in type ceiling is acceptable for the diagnostic
room.
(3) Mechanical Requirements.
(A) Mechanical requirements shall be in accordance
with §134.122(d)(3) of this title and this paragraph.
(B) Air handling units serving the imaging suite shall
be equipped with filters having efficiencies equal to, or greater
than specified in Table 4 of §134.131(d) of this title.
(4) 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. When automatic film processors are
used, a receptacle of adequate size with hot and cold water for cleaning
the processor racks shall be provided.
(5) Electrical requirements. Electrical requirements
shall be in accordance with §134.122(d)(5) of this title and
this paragraph.
(A) General.
(i) Each imaging procedure room shall have at least
four duplex electrical receptacles.
(ii) A special grounding system in areas such as imaging
procedures rooms where a patient may be treated with an internal probe
or catheter shall comply with Chapter 9 of NFPA 99, and Article 517
of NFPA 70.
(iii) General lighting with at least one light fixture
powered from a normal circuit shall be provided in imaging procedures
rooms in addition to special lighting units at the procedure or diagnostic
tables.
(B) Nurses calling system.
(i) Nurses regular calling system. The nurses regular
calling system shall be provided for patient dressing room(s) in accordance
with §134.122(d)(5)(K)(i) of this title.
(ii) Nurses emergency calling system. In toilet room(s)
used by inpatients and outpatients, a nurses emergency call station
shall be provided in accordance with §134.122(d)(5)(K)(ii) of
this title.
(iii) Staff emergency assistance calling system. A
staff emergency assistance calling system (code blue) shall be provided
for staff to summon additional assistance for each imaging procedure
room in accordance with §134.122(d)(5)(K)(iii) of this title.
(k) Laboratory suite.
(1) Architectural requirements.
(A) General. The required laboratory testing shall
be performed on-site or provided through a contractual arrangement
with a laboratory service.
(i) Provisions for laboratory services shall be provided
within the facility for urinalysis, blood glucose and electrolytes.
(ii) Each laboratory unit shall meet the requirements
of Chapter 10 of NFPA 99 (relating to Laboratories), and Chapter 18
of NFPA 101 (relating to New Health Care Occupancies).
(B) Minimum laboratory. When laboratory services are
provided off-site by contract, the following minimum areas or rooms
shall be provided within the facility.
(i) Laboratory work room. The laboratory workroom shall
include a counter and a sink with hands-free operable controls.
(ii) General storage. Cabinets or closets shall be
provided for supplies and equipment used in obtaining samples for
testing. A refrigerator or other similar equipment shall be provided
for specimen storage waiting for transfer to off-site testing.
(iii) Specimen collection room. A blood collection
room shall be provided with a counter, space for seating, and hand
washing fixture with hands-free operable controls. A toilet and lavatory
with hands-free operable controls shall be provided for specimen collection.
This room may be outside the laboratory suite if conveniently located.
(C) On-site laboratory. When the facility provides
on-site laboratory services, the following areas or rooms shall be
provided in addition to the requirements in paragraph (1)(A) and (B)
of this subsection.
(i) Laboratory workroom(s). The laboratory work room
shall include counter(s), space appropriately designed for laboratory
equipment, sink(s) with hands-free operable controls, vacuum, gases,
air, and electrical services as needed.
(ii) General storage. Storage, including refrigeration
for reagents, standards, supplies, and stained specimen microscope
slides, etc. shall be provided. Separate spaces shall be provided
for such incompatible materials as acids and bases, and vented storage
shall be provided for volatile solvents.
(iii) Chemical safety. When chemical safety is a requirement,
provisions shall be made for an emergency shower and eye flushing
devices.
(iv) Flammable liquids. When flammable or combustible
liquids are used, the liquids shall be stored in approved containers,
in accordance with National Fire Protection Association 30, Flammable
and Combustible Liquids Code, 1996 edition.
(v) Radioactive materials. When radioactive materials
are employed, storage amenities shall be provided.
(D) Service areas or rooms. The following service areas
or rooms shall be provided.
(i) Hand washing amenities. Each laboratory room or
work area shall be provided with a hand washing fixture(s) with hands-free
operable controls.
(ii) Office spaces. The scope of laboratory services
shall determine the size and quantity for administrative areas including
offices as well as space for clerical work, filing, and record maintenance.
At a minimum, an office space shall be provided for the use of the
laboratory service director.
(iii) Staff facilities. Lounge, locker, and toilet
amenities shall be conveniently located for male and female laboratory
staff. These may be outside the laboratory area and shared with other
departments.
(iv) Housekeeping room. A housekeeping room shall be
located nearby.
(2) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title. Floors in
laboratories shall comply with the requirements of §134.122(d)(2)(B)(iii)
of this title except that carpet flooring shall not be used.
(3) Mechanical requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph.
(A) No air from the laboratory areas shall be recirculated
to other parts of the facility. Recirculation of air within the laboratory
suite is allowed.
(B) When laboratory hoods are provided, they shall
meet the following general requirements.
(i) The average face velocity of each exhaust hood
shall be at least 75 feet per minute.
(ii) The exhaust shall be connected to an exhaust system
to the outside which is separate from the building exhaust system.
(iii) The exhaust fan shall be located at the discharge
end of the system.
(iv) The exhaust duct system shall be of noncombustible
and corrosion resistant material.
(C) Filtration requirements for air handling units
serving the laboratory suite shall be equipped with filters having
efficiencies equal to, or greater than specified in Table 4 of §134.131(d)
of this title.
(D) Duct linings exposed to air movement shall not
be used in ducts serving any laboratory room and clean room unless
terminal filters of at least 80% efficiency are installed downstream
of linings. This requirement shall not apply to mixing boxes and acoustical
traps that have special coverings over such lining.
(4) 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) General.
(i) Faucet spouts at lavatories and sinks shall have
clearances adequate to avoid contaminating utensils and the contents
of beakers, test tubes, etc.
(ii) Drain lines from sinks used for acid waste disposal
shall be made of acid-resistant material.
(iii) Drain lines serving some types of automatic blood-cell
counters must be of carefully selected material that will eliminate
potential for undesirable chemical reactions (and/or explosions) between
sodium azide wastes and copper, lead, brass, and solder, etc.
(B) Medical gas systems. When provided, medical gas
systems shall comply with §134.122(d)(4)(A)(iii) of this title.
The number of outlets in the laboratory for vacuum, gases, and air
shall be determined by the functional program requirements.
(l) Laundry suite. Laundry amenities may be provided
on-site or off-site. On-site laundry services may be within the facility
or in a separate building.
(1) Architectural requirements.
(A) General. The following amenities are required for
both on-site or off-site commercial laundry services.
(i) The laundry room shall be equipped and ventilated
so as to minimize the dissemination of contaminants.
(ii) Soiled and clean linen processing areas shall
be physically separated.
(iii) An adequate amount of hand washing fixtures shall
be provided in both the soiled and clean processing areas.
(B) On-site laundry processing. When linen is processed
within the facility or in a separate building located on-site, the
following minimum requirements shall be provided.
(i) A receiving, holding, and sorting room for control
and distribution of soiled linen shall be provided. This area may
be combined with the soiled linens processing room. Discharge from
soiled linen chutes may be received within this room or in a separate
dedicated room.
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