10A NCAC 13B .6208      OBSTETRICAL DEPARTMENT REQUIREMENTS

(a)  The obstetrical unit shall be located so as to prevent unrelated traffic through the unit and to provide for reasonable protection of mothers from infection and from cross-infection.

(b)  An emergency communication system connected to the operations and control station shall be provided by the facility.

(c)  Resuscitation facilities for neonates shall be provided within the obstetrical unit and convenient to the delivery room.

(d)  A labor room shall be provided and shall meet the following requirements:

(1)           A minimum of 80 sq. ft. of area shall be provided per labor bed;

(2)           The labor rooms shall be located so as to permit visual observation of each room from the nurses' work station;

(3)           Labor rooms shall afford privacy, and shall be conveniently located with reference to the delivery room;

(4)           If labor rooms also serve as birthing rooms, they shall be equipped to handle obstetric and neonatal emergencies;

(5)           A labor room shall contain facilities for medication, hand washing, charting, and storage for supplies and equipment;

(6)           At least one shower with direct access from within the delivery unit shall be provided;

(7)           At least two labor beds with adjacent toilet shall be provided for each delivery room; and

(8)           No more than two labor beds may be located in one labor room.

(e)  A toilet with hand-washing facilities shall be provided for the staff.

(f)  A separate recovery room may be omitted in facilities with less than 1500 births per year.  When provided, the recovery room shall meet the following requirements:

(1)           A recovery room shall contain not less than two beds and shall have charting facilities located so as to permit visual observation of all beds;

(2)           Provisions for medicine dispensing, hand washing, clinical sink with bedpan washer, and storage for supplies and equipment shall be provided; and

(3)           A toilet with hand washing facilities shall be provided for staff.

(g)  When a facility elects to provide labor, delivery and recovery room (LDR) service as a part of its total services, the following requirements shall be met:

(1)           Each LDR room shall have a minimum of 250 square feet of floor space exclusive of toilet room, closet, or vestibule;

(2)           A toilet directly accessible from each LDR room shall be provided for use by that room only and equipped with a clinical sink or other suitable flushing device for emptying bed pans;

(3)           Each LDR room shall be provided with directly accessible shower for use by that room only;

(4)           Each LDR room shall be equipped with oxygen, suction, medical air, and electrical outlets; and

(5)           Each LDR room shall contain facilities for medication storage, hands-free hand washing, charting, and storage for supplies and equipment.

(h)  When a facility elects to provide labor, delivery, recovery and postpartum (LDRP) service as a part of its total services the following requirements shall be met:

(1)           Each LDRP room shall meet the requirements listed in Paragraph (g) of this Rule; and

(2)           Each LDRP room shall be counted as a single patient room for purposes of determining the facility's bed capacity.

(i)  The following shall be provided:

(1)           If analgesia is used, beds shall be equipped with side rails; and

(2)           There shall be facilities for examination and preparation of patients.

(j)  The obstetrical (OB) unit shall be provided with the following services either in individual rooms, alcoves, or other open spaces not subject to traffic:

(1)           Scrub facilities with stations located adjacent to each pair of delivery rooms and arranged to minimize incidental splatter on nearby personnel or supply carts;

(2)           A storage room for equipment and supplies;

(3)           One delivery room with support services meeting the requirements of a surgical operating room and support services referenced in Rule .6206 of this Section if caesarean sections are to be performed in the obstetrical delivery unit; and

(4)           One janitor's closet exclusively for use by the obstetrics unit.

(k)  The obstetrical unit shall be provided with the following services either in individual rooms, alcoves, or other open spaces not subject to traffic, however, they may be located either in the obstetrics unit or may be shared with the surgical unit if arranged so as to avoid cross traffic between the surgical and obstetrics units:

(1)           Delivery unit control station located so as to permit visual surveillance of all traffic which enters the obstetrical unit;

(2)           Supervisor's office or station;

(3)           Medicine dispensing facilities;

(4)           Scrub facilities with stations located adjacent to each pair of delivery rooms and arranged so as to minimize incidental splatter on nearby personnel or supply carts;

(5)           Soiled workroom or a soiled holding room as a part of a system for the collection and disposal of soiled materials:

(A)          A soiled workroom may not be shared with the surgical unit and shall contain a flushing device, a work counter and sink equipped for hand washing, a waste receptacle, and a linen receptacle; and

(B)          A soiled holding room may be shared with the surgical unit and shall be similar to the soiled workroom except that the flushing device and work counter may be omitted.

(6)           Fluid waste disposal facilities convenient to the delivery rooms; the flushing device in a soiled workroom meets this requirement;

(7)           Staff clothing change areas appropriate for male and female personnel working within the obstetrics unit including lockers, shower, toilet, and lavatory, and space for donning scrub suit and boots;

(8)           Lounge and toilet facilities for obstetrical staff;

(9)           Stretcher storage provisions out of direct line of traffic;

(10)         Clean workroom, or clean supply room:

(A)          A clean workroom or supply room is required when clean materials require assembly prior to use and this assembly is performed within the obstetrics unit; and

(B)          Clean workroom shall contain a work counter, a sink equipped for hand washing, and space for clean and sterile supplies;

(11)         Anesthesia workroom for the cleaning, testing, and storage of anesthesia equipment with a work counter and sink;

(12)         Space for storage of nitrous oxide and oxygen cylinders;

(13)         A storage room for equipment and supplies used in a surgical unit;

(14)         Delivery room(s) used for no other purpose than for the completion of labor and delivery and including a minimum clear area of 300 square feet, exclusive of fixed and movable cabinets and shelves.  The minimum room dimension shall be 16 feet; and

(15)         One delivery room meeting the following requirements if caesarean sections are to be performed in the obstetrics unit:

(A)          The delivery room shall meet the requirements for surgical operating rooms; and

(B)          Support services required for surgical operating rooms shall be provided.

 

History Note:        Authority G.S. 131E-79;

Eff. January 1, 1996;

Amended Eff. July 1, 1996.