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1226.4.13.1 Nurse Station(s)
If required, this area shall have space for counters and storage and shall have direct access to a handwashing stations (refer to Section 1224.3 for definition of handwashing station). It may be combined with or include centers for reception, charting and communication.
1226.4.13.2 Medication Station
Provision shall be made for distribution of medications. This shall be done from a medicine preparation room or a self-contained medicine dispensing unit.
1226.4.13.2.1 Medicine Preparation Room or Area
When provided, the entry of the medicine preparation room or area shall be under the visual control of the staff. This may be a part of the administrative center or nurse station and shall include all of the following:
  1. Work counter
  2. Sink
  3. Lockable refrigerator
  4. Immediate access to handwashing station
  5. Locked storage for biologicals and drugs
When a medicine preparation room or area is to be used to store self-contained medicine dispensing units, the room shall be designed with adequate space to prepare medicines with the self-contained medicine-dispensing units present.
1226.4.13.2.2 Self-Contained Medicine-Dispensing Unit
When provided, the location of a self-contained medicine-dispensing unit shall be permitted in the clean workroom or at the administrative center or nurse station, provided there is adequate security for medications and adequate lighting to easily identify drugs. Immediate access to a handwashing station shall be provided.
1226.4.13.3 Clean Utility Room
A clean utility room shall be provided. If the room is used for preparing patient care items, it shall contain:
  1. Work counter
  2. Handwashing station
  3. Storage facilities for clean and sterile supplies
If the room is used only for storage and holding as part of a system for distribution of clean and sterile materials from a central sterile supply, the work counter and handwashing station may be omitted. Soiled and clean utility rooms or holding rooms shall be separated and have no direct connection.
1226.4.13.4 Soiled Workroom or Soiled Holding Room
Soiled workroom or soiled holding room shall be provided and contain:
  1. Clinic sink
    Exception: For primary care clinics, a utility sink or patient toilet room equipped with a bedpan flushing device may be provided in lieu of a clinic sink. A utility sink may be used for soaking or rinsing and shall be provided as appropriate to the method of decontamination used.
  2. Handwashing station
  3. Work counter
  4. Storage cabinets
  5. A designated area for waste receptacle(s)
  6. A designated area for soiled linen receptacle(s)
If the clinic includes a central sterile supply that complies with Section 1224.22 and the soiled holding room is used only for temporary holding of soiled materials, the clinic sink and work counter may be omitted. Where rooms are used for temporary holding of materials, provisions shall be made for separate collection, storage and disposal of soiled materials. Soiled and clean utility rooms or holding rooms shall be separated and have no direct connection.
1226.4.13.5 Sterile and Pharmaceutical Supply Storage
Separate storage for sterile supplies and pharmaceutical supplies shall be provided.
1226.4.13.6 Sterilization Facilities
When provided, a sterilization facility shall meet the following applicable requirements:
1226.4.13.6.1 Storage
Each facility shall provide space for the storage of disposable sterile supplies or provide space for sterilization and disinfection equipment.
Exception: Facilities with contractual arrangements for outside autoclaving and sterilizing services.
1226.4.13.6.2 Central Sterile Supply and Sterilizing Area
When provided, rooms and spaces of the central supply and sterilizing area shall comply with the following:
  1. Soiled work area. A receiving and gross cleaning area which shall contain work space and equipment for cleaning medical and surgical equipment and for disposal of or processing of soiled materials.
  2. Clean work area. A clean work area which shall contain work space and equipment for sterilizing medical and surgical equipment and supplies.
  3. Sterilizing and equipment disinfection space.
  4. Storage. Space for sterile supplies and unsterile supplies.
1226.4.13.6.3 Sterilizers
When provided, all sterilizers and autoclaves which emit system steam exhaust shall be vented to the outside of the building. Such vents shall be independent from the plumbing vent system.
Exception: Small instrument sterilizers.
1226.4.13.7 Nourishment Room
When provided, the nourishment room or area shall have all of the following:
  1. Sink
  2. Work counter
  3. Refrigerator
  4. Storage cabinets
  5. Equipment for serving nourishment
  6. A handwashing station, as defined in Section 1224.3, shall be located in the nourishment room or be immediately accessible without going through a door.

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