Or. Admin. Code § 333-535-0025

Current through Register Vol. 63, No. 11, November 1, 2024

Section 333-535-0025 - Medical/Surgical Patient Care Unit

Except as permitted under OAR 333-535-0010(1) or 333-500-0065, each patient care unit shall include the following:

(1) Patient rooms. Each patient room shall meet the following requirements:

(a) For new construction projects, maximum room capacity shall be two patients. For major alteration projects, the maximum room capacity shall be the present capacity or four patients, whichever is less.

(b) For new construction, patient rooms shall be constructed to meet the needs of the Functional Program and shall have a minimum of 100 square feet of clear floor area per bed in multiple bedrooms and 120 square feet of clear floor area in single patient rooms, exclusive of toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules. The dimensions and arrangements of rooms shall be such that there is a minimum clearance of 3 feet around the perimeter of the bed and any wall or any other fixed obstruction. In multiple bedrooms, a clearance of 4 feet shall be available at the foot of each bed to permit the passage of equipment and beds, and 4 feet shall be provided between beds. Minor encroachments, including columns and hand washing stations, that do not interfere with function may be ignored when calculating required space. For renovation projects, every effort shall be made to meet the requirement set out in this subsection for new construction. However, if full compliance is not practical for a renovation project, the Division may permit deviations from these requirements as long as patient rooms include at least 80 net square feet of clear floor area per bed in a multiple bedroom and 100 net square feet of clear floor area in a single patient room.

(c) Patient room windows:

(A) Operable windows are not required in patient rooms. If operable windows are provided, operable sections shall be designed to inhibit possible escape or suicide attempt.

(B) A minimum window area of 16 square feet shall be provided for each patient room. The maximum sill height shall be 3 feet above the finished floor. A minimum of 8 square feet of window shall be viewable by the patient from the bed. Walls and other non-moveable items shall not block the view of the window.

(C) Windows located in outside walls shall be 20 feet or more from another building or opposite wall and 10 feet or more from the property line except when the window faces on a street or public right of way of greater than 20 feet in width.

(D) For renovation projects where the exterior wall is being retained, windows shall be permitted to vary from the requirements of this subsection if approved by the Division.

(d) Hand-washing stations: A hand-washing station shall be provided serving each patient room. A hand-washing station shall also be located in each patient toilet room. For new construction, the patient room hand-washing station shall be located within the room and shall be situated for convenient access by staff and to prevent splash on patients. For renovation projects involving single patient rooms that have a private toilet room, a hand-washing station shall be located in either the toilet room or the patient room. Hand-washing stations shall comply with the requirements of OAR 333-535-0260.

(e) Patient toilet rooms: Each patient shall have access to a toilet room without having to enter the corridor. One toilet room shall serve no more than four beds and no more than two patient rooms. The toilet room shall contain a toilet, hand-washing station, and bathing facilities. Patient toilet rooms and central bathing facilities shall comply with the requirements of OAR 333-535-0260.

(f) Each patient shall have a separate wardrobe, locker, or closet suitable for hanging full-length garments and for storing personal effects within the room.

(g) Visual privacy from casual observation by other patients and visitors shall be provided for each patient. The design for privacy shall not restrict patient access to the entrance, hand-washing station, toilet, or nurse call system.

(2) Service areas. Provision for the services listed below shall be in or readily available to each patient care unit. The size and location of each service area will depend upon the numbers and types of beds served. Identifiable spaces are required for each of the indicated functions. Each service area may be arranged and located to serve more than one patient care unit but, unless noted otherwise, at least one such service area shall be provided on each nursing floor. Where the words "room" or "office" are used, a separate, enclosed space for the one named function is intended; otherwise, the described area may be a specific space in another room or common area.

(a) Administrative center(s) or nurses' station(s): This area shall include a desk, storage and work counters and shall have convenient access to a hand-washing station within 20 feet and not through a door, to meet infection control standards. It may be combined with or include facilities for reception and communication systems;

(b) Private consultation/administrative office;

(c) Charting facilities: Charting facilities shall have sufficient surface space to provide for charting by staff and physicians to meet the functional needs of the unit;

(d) Toilet room(s) conveniently located for staff use (may be unisex);

(e) Staff facilities: In addition to lounge facilities, securable closets or cabinet compartments shall be provided for the personal articles of nursing personnel. At a minimum, these shall be large enough for purses and billfolds. Coats may be stored in closets or cabinets on each floor or in a central staff locker area;

(f) Multi-purpose room(s) for staff, patients, patients' families for patient conferences, reports, education, training sessions, and consultation. These rooms shall be accessible to each patient care unit but may be located on other floors if convenient for regular use;

(g) Clean and soiled utility rooms shall be provided in accordance with OAR 333-535-0260(5);

(h) Medication station: Provision shall be made for convenient and prompt 24hour distribution of medicine to patients. This shall be from a medicine preparation room, a self-contained medicine dispensing unit, or by another system approved by the Division. A medicine preparation room or unit shall be under the visual control of the nursing or pharmacy staff. It shall contain a work counter, hand-washing station, and an electrical receptacle for a lockable refrigerator and locked storage for biologicals and drugs. A secured medicine dispensing unit may be located at the nurses' station, in the clean utility room or area, or in an alcove or other space under the direct control of the nursing or pharmacy staff. This area shall have adequate lighting to easily identify drugs;

(i) Clean linen storage: Each patient care unit shall contain a designated area for clean linen storage. This may be within the clean utility room or area, a separate closet, or a distribution system approved by the Division on each floor. If a closed cart system is used, storage may be in an alcove;

(j) Nourishment area: There shall be a nourishment area with sink, work counter, refrigerator, storage cabinets, and equipment for hot and cold nourishments between scheduled meals. The nourishment area shall include space for trays and dishes used for non-scheduled meal service. Provisions and space shall be included for separate temporary storage of unused and soiled dietary trays not picked up at mealtime. A hand-washing station shall be in or immediately accessible from the nourishment area;

(k) Ice machine: Each nursing unit shall have direct access to equipment to provide ice for treatments and nourishment. Ice-making equipment may be in the clean utility room or area or at the nourishment station. Ice intended for human consumption shall be from self-dispensing icemakers;

(l) Equipment storage room(s) or alcove(s): Appropriate room(s) or alcove(s) shall be provided for storage of equipment necessary for patient care as required by the Functional Program, the location of which shall not interfere with the flow of traffic. Each patient care unit shall provide sufficient storage area(s) located on the patient floor to keep the required corridor width free of all equipment and supplies, but at least 10 square feet per patient bed shall be provided. If stretchers and wheelchairs are stored on the patient care unit, additional storage space shall be provided;

(m) In remodel projects that do not include bathing facilities in all existing patient rooms, common use showers and bathtubs shall be provided in accordance with OAR 333-535-0260(6);

(n) Emergency equipment storage: Space for emergency equipment such as cardiopulmonary resuscitation (CPR) carts shall be provided. This space shall be out of traffic, under the direct control of the nursing staff and proximate to the nurses' station;

(o) Housekeeping room: One housekeeping room shall be provided for each patient care unit or nursing floor. It shall be directly accessible from the patient care unit or floor and may serve more than one patient care unit on a floor. At least one housekeeping room per floor shall contain a service sink or floor receptor and space for the storage of supplies and housekeeping equipment and cart. A minimum of 35 square feet shall be provided for each housekeeping room. This housekeeping room shall not be used for other departments and patient care units that are specifically required by rule to have separate housekeeping rooms; and

(p) Low voltage room/closet(s), electrical room/closet(s) and other technical support spaces shall be provided as required to meet the service needs of the patient care unit.

(3) Patient care units shall comply with the requirements of OAR 333-535-0260, 333-535-0270, 333-535-0280, 333-535-0300 and 333-535-0310. Additional rule requirements may apply to specialty patient care units.

Or. Admin. Code § 333-535-0025

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 18-2019, repeal filed 10/01/2019, effective 1/1/2020

Statutory/Other Authority: ORS 441.060

Statutes/Other Implemented: ORS 441.060