| (xiii) clean linen storage for each nursing unit. The
clean linen area shall contain a work counter and storage space for
clean linen. The area shall be a part of the storage and distribution
of clean linen. Minimum area for clean linen shall be three square
feet of room area per patient bed space. The required area may be
concentrated in one central room or divided in several rooms throughout
the facility;
(xiv) a soiled workroom or soiled holding room. The
room shall contain a clinical sink or equivalent flushing rim fixture,
hand washing facilities, both with hot and cold water. The room shall
have a work counter and space for separate covered containers for
soiled linen and waste. Minimum area for soiled linen shall be three
square feet of room area per patient bed space;
(xv) an equipment storage room and storage room for
administrative supplies located on each floor which may serve multiple
nursing suites;
(xvi) an emergency equipment storage room or alcove
under direct visual control of the nursing staff and out of normal
traffic;
(xvii) a housekeeping room which may also serve adjacent
nursing suites;
(xviii) stretcher and wheelchair storage space which
is located without restricting normal traffic. The space may be located
outside the nursing suite;
(xix) an accessible public toilet with hand washing
fixtures. The toilets shall be located on each floor containing a
nursing suite;
(xx) staff toilet conveniently located to each nursing
suite. At least one staff toilet shall be located on each patient
sleeping floor. Toilet may be unisex;
(xxi) an ice dispensing machine for each nursing suite
which is located at the nourishment station or the clean work room;
(xxii) adequate number of drinking fountain fixtures;
(xxiii) adequate number of telephones available for
patients' private conversations;
(xxiv) a visitor room for patients to meet with friends
or family with a minimum floor space of 100 square feet;
(xxv) a quiet room for a patient who needs to be alone
for a short period of time but does not require a seclusion room.
Each quite room shall be not less than 80 square feet. The visitor
room may serve this purpose;
(xxvi) separate consultation room. The room shall have
a minimum floor space of 100 square feet, and provided at a room-to-bed
ratio of one consultation room for each 12 patient beds. The room(s)
shall be designed for acoustical and visual privacy and constructed
to achieve a level of voice privacy of 50 STC (which in terms of vocal
privacy means that some loud or raised speech is heard only by straining,
but is not intelligible); and
(xxvii) a conference and treatment planning room for
use for patient care planning. This room may be combined with the
charting room or use of the multipurpose room.
(3) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title and this paragraph.
(A) Details.
(i) Egress. Means of egress from each patient suite
shall comply with the requirements of NFPA 101, §18-2.
(ii) Patient bathroom and toilet room doors. Door leaves
to all patient bathrooms and toilet rooms shall be at least 36 inches
wide and shall swing outward or be double acting so that nursing staff
may gain access to a patient. Doors lockable from the inside shall
have hardware that allows staff to open the door from the outside.
(iii) Vision panels. Vision panels shall be provided
in the door between an anteroom and an airborne infection isolation
room.
(iv) Windows. Each patient sleeping room shall have
an outside window. The windows shall be restricted. Where the operation
of windows requires the use of tools or keys, the tools or keys shall
be located at each nurses station, on the same floor, and easily accessible
to staff. The bottom of the window opening shall not exceed 36 inches
above the floor.
(v) Location of patient room windows. Windows shall
be located on an outside wall. Windows may face an atrium, an inner
court, or an outer court provided the following requirements are
met.
(I) Atria windows. Atria onto which the required windows
face shall comply with the requirements of NFPA 101, §8-2.5.6.
(II) Outer courts. Outer court (not enclosed by building
on one side) onto which the required windows face shall have a minimum
width, at all levels, of not less than three inches for each foot,
or fraction thereof, of the height (average height of enclosing walls)
of such court, but in no case shall the width be less than five feet.
An outer court shall have a horizontal cross sectional area not greater
than four times the square of its width.
(III) Inner courts. Inner court (enclosed by building
on all sides) onto which the required windows open shall have minimum
width, at all levels, of not less than one foot for each foot, or
fraction thereof, of the height (average height of enclosing walls)
of such courts, but in no case shall the width be less than 10 feet.
If operable windows are provided, a horizontal, unobstructed, and
permanently open air intake or passage having a cross-sectional area
of not less than 21 square feet shall be provided at or near the bottom
of the court. Metal decorative grilles not effectively reducing the
open area by more than 5.0% shall be permitted at the ends. Walls,
partitions, floor, and floor-ceiling assemblies forming intakes or
passages shall be noncombustible and shall be constructed in accordance
with NFPA 101, §18-3.1(b) and (c). An inner court shall have
a horizontal cross sectional area of not less than one and one-half
times the square of its width.
(vi) Visibility. All areas of the nursing suite, including
entrances to patient rooms, shall be visible from the nurse station(s).
Observation by video cameras of seclusion rooms, entrances, hallways,
and activity areas shall be acceptable.
(vii) Special fixtures, hardware, and tamper-proof
screws. Special fixtures, hardware, and tamper-proof screws shall
be used throughout the patient nursing suites.
(I) All exposed and accessible fasteners shall be tamper-resistant.
(II) Suitable hardware shall be provided on doors to
toilet rooms so that access to these rooms can be controlled by staff.
Hardware shall be utilized which is appropriate to prevent patient
injury.
(III) Only break-away or collapsible clothes bars in
wardrobes, lockers, towel bars, and closets and shower curtain rods
shall be permitted. Wire coat hangers shall not be permitted in nursing
suites.
(IV) When grab bars are provided, the space between
the grab bar and the wall should be filled to prevent a cord being
tied around it for hanging. Bars, including those which are part of
such fixtures as soap dishes, shall be sufficiently anchored to sustain
a concentrated load of 250 pounds.
(viii) Detention screens.
(I) When operable windows are provided in patient sleeping
rooms, it may be necessary to provide detention screens on windows
or limit the amount of window operation in order to inhibit possible
tendency for suicide or elopement. The type and the degree of security
required shall be determined by the facility administration.
(II) When detention screens are provided, windows shall
be capable of opening with the screens in place. Where glass fragments
may create a hazard, safety glazing or other appropriate security
features shall be incorporated.
(III) In building housing for certain types of patients,
detention rooms, or a security section, the facility shall provide
detention screens to confine or protect building inhabitants, when
necessary.
(ix) Hand washing amenities. Hand washing amenities
shall be conveniently located near the nurses station and in the medication
area. One lavatory in an open medication area can meet this requirement.
(x) Elevator lobbies. Elevator lobbies shall be physically
separated from the required means of egress with one hour fire rated
construction which resist the passage of smoke on all floors containing
patient rooms.
(B) Finishes.
(i) Seamless floors with coved wall bases described
in §134.122(d)(2)(B)(iii)(III) of this title shall be provided
in soiled workrooms.
(ii) Wall bases in the soiled workroom shall be made
integral and coved with the floor, tightly sealed to the wall, constructed
without voids that can harbor insects, retain dirt particles, and
impervious to water.
(iii) Monolithic ceilings described in §134.122(d)(2)(B)(vi)(III)
of this title shall be provided in airborne infection isolation rooms,
seclusion rooms, and security rooms.
(iv) Ceilings of patient rooms may be acoustically
treated; however, they shall be monolithic as described in §134.122(d)(2)(B)(vi)(III)
of this title.
Cont'd... |
