| (D) Seclusion suite. There shall be a seclusion suite
in each nursing suite intended for short-term occupancy by a single
person requiring security and protection from self or others. The
seclusion suite shall consist of seclusion room(s), an anteroom or
a vestibule, a toilet, and hand washing fixtures.
(i) Each seclusion room shall be located and designed
in a manner affording direct visual supervision by nursing staff and
shall be constructed to prevent patient hiding, escape, injury, or
suicide. There shall be a minimum of one seclusion room for each 24
beds or any portion thereof.
(I) The floor area of each seclusion room shall be
not less than 60 square feet. The minimum room dimension shall be
six feet.
(II) The seclusion room shall have a minimum ceiling
height of nine feet.
(III) The door to each seclusion room shall have no
hardware on the room side and shall open out. A vision panel shall
be provided in each door to permit staff observation of the entire
room while maintaining privacy from the public and other patients.
The seclusion room door shall swing out.
(IV) Each seclusion room shall have natural light (skylight
or window) in order to maintain a therapeutic environment. Skylight
wells or windows shall be not less than 400 square inches in area.
(ii) Access to the seclusion room from any public space
such as a corridor shall be through an anteroom. When the seclusion
suite is directly accessible from the nurse station, a vestibule
may be provided in place of an anteroom. A cased opening to the vestibule
in lieu of a door may be provided as long as the arrangement assures
privacy from the public and other patients.
(I) The minimum dimension of the anteroom or vestibule
shall be eight feet.
(II) The door to the anteroom shall swing in.
(iii) There shall be at least one toilet room directly
accessible from the anteroom or vestibule.
(I) The toilet room shall be large enough to safely
manage the patient.
(II) The toilet room door shall swing out into the
anteroom or vestibule.
(III) A water closet and hand washing fixtures shall
be provided in the toilet room. An unbreakable wall hung mirror may
be provided.
(IV) Doors for the seclusion room and anteroom shall
be not less than 3 feet 8 inches in width.
(V) When the interior of the seclusion room is padded,
the padding shall be a Class "A." The flame spread rating shall be
0-25 and the smoke development rating shall be 0-450 in accordance
with NFPA 101, Chapter 8.
(E) Airborne infection isolation suites. When an isolation
suite is provided, the suite may be located within a nursing suite
or in a separate isolation unit. Each airborne infection isolation
suite shall consist of a work area, a patient room, and a patient
bathroom.
(i) The work area may be a separately enclosed anteroom
or a vestibule that is open to and is located immediately inside the
door to the patient room. It shall have amenities for hand washing,
gowning, and storage of clean and soiled materials. One enclosed anteroom
may serve multiple isolation rooms.
(ii) Each patient room shall have a clear floor area
of 120 square feet exclusive of the work area and shall contain only
one bed.
(iii) Each bathroom shall be designed for the use of
the handicapped and shall contain bathing fixtures, toilet fixtures
and hand washing fixtures. Each bathroom shall be arranged to provide
access from the patient room without entering or passing through the
work area.
(iv) At least one airborne infection isolation suite
with an enclosed anteroom shall be provided.
(v) Ventilation requirements for the isolation rooms
shall be in accordance with Table 3 of §134.131(c) of this title.
(vi) Doors to airborne infection isolation rooms shall
be provided with self-closing devices.
(F) Social spaces. A minimum of two separate social
spaces, one appropriate for noisy activities and the other for quiet
activities, shall be provided. The combined total area shall be not
less than 40 square feet per bed space with not less than 160 square
feet for each of the two spaces, whichever is greater. This space
may be shared with the dining area or room.
(G) Group therapy room. A room for group therapy shall
be included. The room shall not be less than 250 square feet. The
group therapy room may be combined with the quiet space required in
subparagraph (F) of this paragraph provided that a space of not less
than 370 square feet is available for both the quiet activity room
and group therapy activities.
(H) Activity service space. Space for activity services
(e.g., music therapy, recreational therapy, art, dance, vocational
therapy, educational therapy, etc.) shall be provided at the rate
of 15 square feet per occupant of the room and a minimum area of not
less than 375 square feet, whichever is greater. Space shall include
provisions for hand washing, work counter(s), storage and displays.
Where facilities contain less than 25 beds, the activity services
therapy functions may be provided within the noisy activities area
as required in subparagraph (F) of this paragraph if a space of not
less than 485 square feet is available for both the noisy activity
area and activity services area.
(I) Service areas. Service areas shall be located in,
or readily available to, each nursing suite. Each service area may
be arranged and located to serve more than one nursing suite, but
at least one service area shall be provided on each nursing floor.
A service area is composed of the following:
(i) an administrative center or nurses station with
an adjacent but separate dictation space;
(ii) a nurses office;
(iii) an area for charting. The charting area shall
be provided with separation needed for acoustical privacy as well
as space required for the function. A view window to permit observation
of the patient area by the charting nurse or physician may be used
provided that it is so located that patient files cannot be read from
outside the charting space;
(iv) a medication room, medicine alcove area, or a
self-contained medicine dispensing unit under visual control of nursing
staff. The room shall have a minimum area of 30 square feet under
direct control of the nursing or pharmacy staff. The room, area or
unit shall contain a work counter, hand washing fixture with hands-free
operable controls, and refrigerator. Provisions for security against
unauthorized access shall be assured. Standard cup-sinks provided
in many self-contained units are not adequate for hand washing;
(v) a small kitchen for patient use. The room shall
contain a sink, refrigerator, ice dispenser, microwave, and storage
cabinets. This room is to provide nourishment for patients between
scheduled meals;
(vi) a multipurpose room for staff and patient conferences,
education and demonstrations. The room shall be conveniently accessible
to each nursing suite and may serve several nursing suites or departments.
The room may be located on another floor if convenient for regular
use;
(vii) an examination or treatment room. The room shall
have a minimum floor area of 120 square feet excluding space for
vestibule, toilet, and closets. The minimum room dimension shall be
10 feet. The room shall contain a lavatory or sink equipped for hand
washing, work counter, storage facilities, and a desk, counter, or
shelf space for writing. The emergency treatment room may be used
for this purpose if it is conveniently located on the same floor as
the patient rooms;
(viii) patient laundry facilities. An automatic washer
and an electric dryer shall be provided. This requirement may be omitted
in nursing units intended only for adolescents and gero-psychiatric
patients;
(ix) staff lounge with separate female and male dressing
areas containing lockers, showers, toilets and hand washing facilities.
These facilities may be on another floor;
(x) securable closets or cabinet compartments for personal
articles of nursing unit staff. The closets or lockers shall be located
at or near the nurse station. 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;
(xi) secured storage area for patients' effects determined
potentially harmful (razors, nail files, cigarette lighters, etc.).
This area shall be controlled by staff;
(xii) clean workroom or clean supply room. When used
for preparing patient care items, it shall contain a work counter,
hand washing facilities, and storage facilities for clean and sterile
supplies. When used only for storage and holding as part of a distribution
system of clean and sterile supplies, the work counter and hand washing
facilities may be omitted;
Cont'd... |
