Or. Admin. R. 333-535-0035

Current through Register Vol. 63, No. 8, August 1, 2024

Section 333-535-0035 - Infection Control Physical Requirements

(1) An Infection Control Risk Assessment (ICRA) shall be provided for all projects that include Airborne Infection Isolation Rooms, Protective Environment Rooms, surgical facilities, emergency departments, hospital immediate care and minor emergency facilities, and any other identified areas of special risk related to infection. As used in division 535, an Infection Control Risk Assessment is documentation focusing on reduction of risk from infection. The assessment shall have input from the hospital's infection control personnel, and be based on current Centers for Disease Control guidelines or other applicable rules and guidelines. Each subject health care facility shall also comply with the requirements of OAR 333-505-0070. The Infection Control Risk Assessment shall include at least the following elements:

(a) A statement explaining the needs and risks of the patient population to be served that includes:

(A) The number, location, and type of airborne infection isolation and protective environment rooms;

(B) Location(s) of special ventilation and filtration such as emergency department waiting and intake areas; and

(C) Air-handling and ventilation needs in surgical services, airborne infection isolation and protective environment rooms, laboratories, local exhaust systems for hazardous agents, and other special areas.

(b) Statements regarding infection control risk mitigation recommendations including:

(A) Patient placement and relocation;

(B) Standards for barriers and other protective measures required to protect adjacent areas and susceptible patients from air-borne contaminants;

(C) Temporary provisions or phasing for construction or modification of heating, ventilating, air conditioning, and water supply systems; and

(D) Measures to be taken to train hospital staff, visitors, and construction personnel.

(c) Management of potentially infectious patients that includes:

(A) Location of patients by susceptibility to infection and definition of risks to each; and

(B) Infection control risk mitigation recommendations that describe the specific methods by which transmission of air and waterborne biological contaminants will be avoided during the course of the construction project.

(d) Infection control risks during construction and plan for containment that includes:

(A) The impact of disrupting essential services to patients and employees;

(B) Location of known hazards;

(C) Determination of the specific hazards and protection levels for each;

(D) Assessment of external as well as internal construction activities; and

(E) Impact of potential outages or emergencies and protection of patients during planned or unplanned outages, movement of debris, traffic flow, cleanup, and testing and certification.

(2) Airborne Infection Isolation Room(s): Airborne Infection Isolation Rooms are single occupancy patient care rooms where environmental factors are controlled in an effort to minimize the transmission of those infectious agents usually spread from person to person by droplet nuclei associated with coughing and inhalation. Airborne Infection Isolation Room requirements shall be predicated on the Infection Control Risk Assessment (ICRA) and the needs of specific community and patient populations served, and shall include the following:

(a) Each facility shall have at least one Airborne Infection Isolation Room. These rooms may be located within individual patient care units and used for normal acute care when not required for isolation cases, or they may be grouped as a separate isolation unit. The number of airborne infection isolation rooms for individual patient units shall be increased based upon an ICRA or by a multidisciplinary group designated for that purpose. Each room shall contain only one bed and shall comply with the requirements of OAR 333-535-0025, and ventilation requirements of OAR 333-535-0300.

(b) Each Airborne Infection Isolation Room shall have an area for hand-washing, gowning, and storage of clean and soiled materials located directly outside or immediately inside the entry door to the room.

(c) Airborne infection isolation room perimeter walls, ceilings, and floors, including penetrations, shall be sealed tightly so that air does not infiltrate the environment from the outside or from other spaces.

(d) Each Airborne Infection Isolation Room shall have a self-closing device on all room exit doors, or doors shall be signed "Door shall be closed at all times."

(e) A separate toilet, bathtub (or shower), and hand-washing station shall be required for each Airborne Infection Isolation Room and shall be accessible without having to enter the corridor.

(f) Each Airborne Infection Isolation Room shall have a permanently installed visual mechanism to constantly monitor the pressure status of the room when occupied by a patient with airborne infectious disease. The mechanism shall continuously monitor the direction of the airflow.

(3) Protective Environment Room(s): Protective Environment Rooms are patient care rooms where severely immunosuppressed patients are cared for (e.g. bone marrow transplant units). Protective Environment Rooms shall meet all rules for Airborne Infection Isolation Rooms as required by subsection (2)(a) through (f) of this rule but shall provide positive air pressure relative to adjoining spaces, with all supply air passing through filters in compliance with OAR 333-535-0300. When determined necessary by an ICRA, special design considerations and air ventilation to ensure the protection of patients shall be required. The appropriate number and location of Protective Environment Rooms shall be determined by the ICRA. Each Protective Environment Room shall contain only one bed.

(4) Surgical facilities, emergency departments, immediate care and minor emergency facilities and other identified areas of special risk related to infection: Requirements shall be predicated on the ICRA in addition to the rules applicable to each type of area.

(5) Infectious waste:

(a) Soiled utility or soiled holding room(s) shall include segregated infectious waste storage and recycle storage if part of hospital operations unless a separate designated room for waste storage is provided.

(b) The infectious waste storage spaces shall have a floor drain, cleanable floor and wall surfaces, lighting and exhaust ventilation, and safe from weather, animals and unauthorized entry.

(c) Infectious waste management shall be in accordance with the requirements of OAR 333-056-0010 through 333-056-0050.

(d) Refrigeration requirements for such storage facilities shall also comply with OAR 333-535-0300 and the Oregon Mechanical Specialty Code.

Or. Admin. R. 333-535-0035

OHD 1-2002, f. & cert. ef. 2-28-02; PH 10-2009, f. & cert. ef. 10-1-09; PH 18-2019, repeal filed 10/01/2019, effective 1/1/2020

Statutory/Other Authority: ORS 441.060

Statutes/Other Implemented: ORS 441.060