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1224.32 Obstetrical Facilities (Perinatal Unit Space)
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The obstetrical facility, including cesarean operating room(s) and delivery room(s), shall be located and designed to prohibit nonrelated traffic through the unit.
Antepartum and post-partum bedrooms shall comply with Section 1224.14.1.
Shall be provided in accordance with Section 1224.14.2 with the following additions:
- Staff lounge.
- Staff storage. Lockable closets or cabinets for personal articles of staff.
- Consultation/conference room(s).
When cesarean operating rooms are located in the obstetrical
suite, access and service arrangements shall be such
that neither staff nor patients are required to travel through
the cesarean delivery area to access other services.
A minimum of one
cesarean operating room shall be provided in the obstetrical
unit, unless a surgical operating room is designated
specifically for cesarean delivery procedures. The cesarean
delivery suite shall include the following:
Provide
a minimum clear floor area of 360 square feet (33.45
m2) with a minimum dimension of 16 feet (4877 mm).
There shall be a minimum of one such room.
Scrub sinks shall be
located outside of sterile areas and meet the
requirements of Section 1224.32.3.8.2.4.
A control station
shall be provided in accordance with Section
1224.15.3.1 and shall be located to restrict unauthorized
traffic into the suite.
A soiled workroom
shall be provided in accordance with Section
1224.15.3.7.
Preoperative
patient holding and post-anesthesia
recovery shall be provided in accordance with Section
1224.16. Post-anesthesia care shall provide
direct access to the cesarean surgical service space
without crossing unrestricted corridors.
At least one delivery
room shall be provided in the obstetrical unit. Delivery
rooms shall have a minimum clear floor area of 300
square feet (27.87 m2). An emergency communication
system shall be connected with the obstetrical facilities
control station
Delivery
rooms, which are used for no other purpose, shall be
provided at the ratio of one per 12 postpartum beds
and for each major fraction thereof.
Exceptions:
- If LDR or LDRP beds are provided, each LDR or LDRP may be counted as a delivery room in the postpartum bed ratio.
- When approved by the licensing agency, the operating room of small or rural hospitals with a licensed bed capacity of 50 or less may serve as the delivery room.
Provide a surgical light in each cesarean operating or delivery room.
Provide within
cesarean operating rooms and delivery rooms a minimum
clear floor area of 80 square feet (7.43 m2) in
addition to the required area of each room or may be
provided in a separate but immediately accessible
room with a clear floor area of 150 square feet (13.94
m2). Six single or three duplex electrical outlets shall be
provided for the infant in addition to the facilities
required for the mother.
Where LDRs or LDRPs are not provided, a minimum of two labor beds shall be provided for each cesarean operating room. Each room shall be designed for either one or two beds with a minimum clear floor area of 120 square feet (11.15 m2) per bed. Each labor room shall contain a handwashing fixture and have access to a toilet room. One toilet room may serve two labor rooms, Labor rooms shall have controlled access with doors that are arranged for observation from a nursing station. At least one shower (which may be separate from the labor room if under staff control) for use of patients in labor shall be provided. Windows in labor rooms, if provided, shall be located, draped, or otherwise arranged, to preserve patient privacy from casual observation from outside the labor room.
Exception: Where renovation of labor rooms is
undertaken in facilities built under the 2001 or prior
California Building Code, existing labor rooms
shall have a minimum clear floor area of 100 square
feet (9.29 m2) per bed.
Each recovery room shall contain at least two beds and have a nurse station, with charting facilities, located to permit visual observation of all beds. Each room shall include a handwashing station and a medication station. A clinical sink with bedpan flushing device shall be directly accessible, as shall storage for supplies and equipment. Provide visual privacy of the new family.
The following services shall be provided:
- Control/nurse station. This shall be located to restrict unauthorized traffic into the service space.
- Soiled workroom or soiled holding room. See Section 1224.4.4.7.
- Fluid waste disposal.
The following services shall be provided and may be shared with the surgical facilities. Where shared, areas shall be arranged to avoid direct traffic between the delivery and operating rooms
Office or station shall be a minimum of 80 square feet (7.43 m2) and have a desk.
This room shall have toilet rooms, telephone(s) and drinking fountains that are immediately accessible. The toilet rooms shall contain a lavatory.
Shall have a handwashing fixture and provisions for controlled storage, preparation and distribution of medication.
Two positions shall be provided adjacent to entrance to the first cesarean operating room. Provide one additional scrub sink per cesarean or delivery operating room. Scrub facilities shall be arranged to minimize any splatter on nearby personnel or supply carts. In new construction, provide view windows at scrub stations to permit the observation of room interiors.
A clean utility room shall be provided if clean materials are assembled within the obstetrical service space prior to use. If a clean utility room is provided see Section 1224.4.4.6.
- Clean sterile storage area readily accessible to the delivery room.
- Equipment storage room(s) for equipment and supplies used in the obstetrical service space.
The clothing change area shall be designed to encourage one-way traffic and eliminate cross-traffic between clean and contaminated personnel. The area shall contain lockers, showers, toilets, handwashing fixtures, and space for donning and disposing scrub suits and booties.
Lounge and toilet room facilities for obstetrical staff shall be readily accessible to cesarean operating rooms(s), delivery room(s), labor rooms(s) and recovery room(s). Each toilet room shall contain a hand-washing station.
These rooms shall have a minimum of 250 square feet (23.23 m2) of clear floor area with a minimum dimension of 13 feet (3962 mm). There shall be space for crib and sleeping space for support person. An area within the room but distinct from the mother's area shall be provided for infant stabilization and resuscitation. The medical gas outlets shall be located in the room so that they are accessible to the mother's delivery area and infant resuscitation area.
Infants shall be housed in nurseries that comply with the standards below. All nurseries shall be immediately accessible to the postpartum unit and obstetrical facilities. The nurseries shall be located and arranged to preclude the need for unrelated pedestrian traffic. No nursery shall open directly onto another nursery. Each nursery shall contain the following:
At least one handwashing fixture for each six infant bassinets.
A consultation/demonstration/breast feeding or pump room shall be provided in a location that is readily accessible to the nursery. Provisions shall be made, either within the room or immediately accessible to the room, for a sink, counter, refrigeration and freezing, storage for pump and attachments, and educational materials. This area may be shared between units.
Each nursery shall be served by a connecting workroom. The workroom shall contain gowning facilities at the entrance for staff and housekeeping personnel, work counter, refrigerator, storage for supplies, and a handwashing fixture. One workroom may serve more than one nursery room provided that required services are convenient to each. Adequate provision shall be made for storage of emergency cart(s) and equipment out of traffic and for the sanitary storage and disposal of soiled waste.
A housekeeping room shall be provided for the exclusive use of the nursery unit. It shall be directly accessible from the unit.
Charting facilities shall have linear surface space to ensure that staff and physicians may chart and have simultaneous access to information and communication systems.
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