SECTION .6200 - CONSTRUCTION REQUIREMENTS
10A NCAC 13B .6201 MEDICAL, SURGICAL AND POST-PARTUM CARE UNIT
The following requirements shall apply to licensed beds:
(1) Each patient room shall meet the following requirements:
(a) Maximum room capacity shall be four patients;
(b) Minimum room areas exclusive of toilet rooms, closets, lockers, wardrobes, bathing room, or vestibules less than six feet wide shall be 100 square feet in single bed rooms and 80 square feet per bed in multi-bed rooms;
(c) A minimum of three feet of clear working space on three sides of each bed shall be provided;
(d) A window which can be opened from the inside shall be provided. The window sill shall not be higher than three feet above the floor and shall be above grade;
(e) A nurses' calling station at each patient bed and toilet room shall be provided;
(f) At least one lavatory shall be provided in each patient room. In a single bedroom other than post-partum rooms, the lavatory may be omitted from the patient room when a lavatory is located in an adjoining toilet room which serves that room only;
(g) A toilet room containing a water closet and a lavatory shall be provided to serve no more than four beds or two patient rooms;
(h) A wardrobe, locker or closet shall be provided for each patient suitable for hanging garments as well as for storage of personal effects; and
(i) Provision shall be made for the visual privacy of each patient in multi-bed rooms.
(2) The following service areas shall be located no further than 120 feet travel distance from each patient bedroom door:
(a) Nurses' station with work counter and storage facilities;
(b) Hand washing facilities located at the nurses' station;
(c) Charting facilities;
(d) A clean workroom or a clean holding room for storage and distribution of clean supply materials. The clean workroom shall contain a work counter and hand washing and storage facilities. A clean holding room shall be similar to a clean workroom except it shall be a part of a clean supply system and the work counter and hand washing facilities may be omitted;
(e) A soiled workroom or a soiled holding room as a part of a system for the collection and disposal of soiled materials. The soiled workroom shall contain a clinical sink or other suitable flushing device, sink equipped for hand washing, a work counter, a waste receptacle, and a linen receptacle. A soiled holding room shall be similar to the soiled workroom except that it shall be a part of the soiled disposal system. The waste receptacle clinical sink and work counter may be omitted;
(f) A drug distribution station that meets the current minimum requirements of governing state and federal agencies regulating controlled substances including a lavatory;
(g) A clean linen storage closet. This may be a designated area within the clean workroom. If a closed cart system is used, storage may be in a controlled alcove out of corridor traffic;
(h) A separate nourishment station that contains a lavatory, equipment for serving nourishment between meals, refrigerator and storage facilities. Ice dispensing facilities for patient service and treatment shall be of a type that will not require use of scoops;
(i) Storage of equipment including emergency equipment shall be provided to insure corridors are kept clear; and
(j) Parking for stretchers and wheelchairs located out of corridor widths.
(3) The following service areas shall be provided for each nursing unit:
(a) Nurses office;
(b) Closets or compartments for the safekeeping of coats and personal effects of staff;
(c) Conference room;
(d) Room for examination and treatment of patients. This room may be omitted if all patient rooms are single-bed rooms. This room shall have a minimum floor area of 100 square feet, excluding space for vestibule less than six feet wide, toilet, closets and work counters (whether fixed or movable). The minimum room dimension shall be 10 feet. The room shall contain a lavatory, a work counter, storage facilities and a desk, counter or shelf space for writing;
(e) Lounge and toilet room for staff;
(f) Janitors' closet. This room shall contain a floor receptor or service sink and storage space for housekeeping supplies and equipment; and
(g) Individually enclosed bathtubs or individually enclosed showers at the rate of one for each 12 beds or fraction thereof which are not otherwise served by bathing facilities within the patient rooms.
(4) Each facility shall make provisions for at least one room for patients needing close supervision including provisions to minimize the chance of a patients' hiding, escape, injury or suicide.
(5) Isolation Rooms. Rooms for patients requiring protective or infectious isolation for infection control purposes shall be provided at the ratio of one isolation room for each 30 acute care licensed beds or major fraction thereof. These may be located within each nursing unit or placed together in a separate unit. Each isolation room shall be a single-bed room and shall conform to the requirements of Item (1) of this Rule except as follows:
(a) A private toilet room containing a water closet and a bath or shower for the exclusive use of the patient which can be entered directly from the patient bed area without passing through the vestibule or anteroom shall be provided;
(b) A lavatory for the exclusive use of the patient shall be provided. It may be located in the patient room or in the private toilet room;
(c) Entrance from the corridor shall be through a closed anteroom which contains facilities to assist staff personnel in maintaining aseptic conditions. The anteroom shall contain a lavatory equipped for hand washing, storage for clean and soiled materials, and gowning facilities; and
(d) A view window in the door for nursing observation of the patient from the anteroom shall be provided.
(6) Provision shall be made for delivery of medications to patients. All medications and related items shall be stored in compliance with current Federal and State laws and rules and made accessible only to authorized personnel. A medication preparation area, alcove, room or other designated area shall be under the direct supervision of the nursing staff when not in use. It shall contain at least a work counter, lavatory, medication-only refrigerator and designated locked area for controlled substances; if mobile systems are used, storage in corridors is prohibited except when in use by the nursing staff.
History Note: Authority G.S. 131E-79;
Eff. January 1, 1996.