Or. Admin. R. 333-535-0080

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

Section 333-535-0080 - Emergency Department

(1) Hospitals offering emergency patient care services shall include facilities required under section (2) of this rule. If outpatient clinical services are to be included as a part of the Emergency Department, elements under OAR 333-535-0085 shall also be provided.

(a) Except as permitted under OAR 333-500-0065, every hospital classified as mental or psychiatric and any other hospital, regardless of classification, that provides psychiatric services shall have at least one psychiatric seclusion room that meets the requirements of section (7) of OAR 333-535-0061 and 309-033-0727.

(2) Hospitals providing emergency services shall include the following:

(a) Entrance located on the same level and proximate to the emergency department, sheltered from the weather, and with provision for ambulance and disabled pedestrian access. Emergency entrance location shall be marked by a lighted sign. The emergency access shall be paved to permit discharge of patients from automobiles and ambulances. Temporary parking convenient to the entrance shall be provided;

(b) A reception, triage and control area conveniently located near the entrance, waiting area(s), and treatment room(s). The control station(s) shall be located to permit staff observation and control of access to treatment areas, pedestrian and ambulance entrances and public waiting area;

(c) Public waiting space with toilet facilities, public telephone, and drinking fountain;

(d) Examination and Treatment room(s):

(A) Space requirements. Each examination room shall have a minimum clear floor area of 120 square feet exclusive of toilets, waiting area and casework.

(B) Each examination room shall contain an examination light, medication storage, work counter, a hand-washing station, medical gas outlets per Table 5 (OAR 333-535-0300), electrical outlets above floor level to accommodate required equipment, suction, and space for storage of emergency equipment such as emergency treatment trays, defibrillator, cardiac monitor, and resuscitator.

(C) Treatment cubicles:

(i) Where treatment cubicles are in open multiple-bed areas, each cubicle shall have a minimum of 80 square feet of clear floor space with a minimum of 5 feet between beds and shall be separated from adjoining cubicles by curtains.

(ii) Hand-washing stations shall be provided at a rate of one per four treatment cubicles.

(e) Trauma/cardiac rooms for emergency procedures, including emergency surgery shall have:

(A) At least 250 square feet of clear floor space.

(B) Additional square footage and cubicle curtains for privacy shall be provided to accommodate more than one patient at a time in the trauma room.

(C) Cabinets and emergency supply shelves, image readers, examination lights, and counter space for writing in each room.

(D) Provisions in each room for monitoring equipment.

(E) Storage provided for immediate access to protective attire for infection control.

(F) Doorways leading from the ambulance entrance to the cardiac trauma room shall be a minimum of 5 feet wide to simultaneously accommodate stretchers, equipment, and personnel.

(G) Medical gas outlets shall equal that required of an operating room in Table 5, OAR 333-535-0300;

(f) Provisions for orthopedic and cast work. There shall be storage for orthopedic supplies including but not limited to: splints, traction hooks, portable image readers or exam lights. These provisions may be in a separate room(s) or in a treatment room. If a sink is used for the disposal of plaster of paris, a plaster trap shall be provided. The amount of clear floor space for this area shall be dependent on the Functional Program, procedures planned and the equipment needed;

(g) Scrub stations or hand-washing stations located in or adjacent to each trauma or orthopedic room;

(h) Provisions for infection control and for the handling of a patient requiring isolation in accordance with the hospital's ICRA. If so determined by the hospital's ICRA, the emergency department waiting area and triage areas shall require special measures to reduce the risk of airborne infection transmission. These measures may include enhanced general ventilation and air disinfection similar to inpatient requirements for airborne infection isolation rooms;

(i) Communication center with related equipment shall be convenient to the control station(s), nursing station and have radio, telephone, and intercommunication systems;

(j) Access to radiology and laboratory services;

(k) Storage area out of line of traffic for stretchers and wheelchairs with access from emergency entrances;

(l) Staff work and charting area(s). This may be combined with reception and control area or located within the treatment room;

(m) Storage out of traffic and under staff control for general medical/surgical emergency supplies, medications and equipment such as a ventilator, defibrillator, pumps, patient monitoring, portable image readers and splints;

(n) Soiled utility room or area per OAR 333-535-0260(5) containing clinical sink, work counter, a hand-washing station, waste receptacle, and linen receptacle;

(o) Patients' toilet room convenient to treatment room(s) that shall include a nurse call device or other approved alternative to summon staff; and

(p) Security station. Where dictated by the Functional Program, a security station system shall be located near the emergency entrances and triage/reception area.

(A) Accommodation for hospital security staff, police officers and monitoring equipment, for example, silent alarms, panic buttons, intercom systems or visual monitoring devices.

(B) Located near emergency entrance and triage/reception area.

Or. Admin. R. 333-535-0080

HB 183, f. & ef. 5-26-66; HB 209, f. 12-18-68; HB 213, f. 3-25-69; HD 7-1979, f. & ef. 7-17-79; HD 11-1980, f. & ef. 9-10-80; Renumbered from 333-023-0200(8); HD 29-1988, f. 12-29-88, cert. ef. 1-1-89, Renumbered from 333-074-0240; HD 21-1993, f. & cert. ef. 10-28-93; HD 2-2000, f. & cert. ef. 2-15-00; OHD 1-2002, f. & cert. ef. 2-28-02; PH 14-2005, f. 8-10-05, cert. ef. 8-15-05; PH 10-2009, f. & cert. ef. 10-1-09; PH 7-2016, f. & cert. ef. 2/24/2016; PH 18-2019, repeal filed 10/01/2019, effective 1/1/2020

Tables referenced are available from the agency.

Statutory/Other Authority: ORS 441.060

Statutes/Other Implemented: ORS 441.060