Heads up: There are no amended sections in this chapter.
Appendix material, shown in shaded boxes at the bottom of the page, is advisory only.
This chapter shall apply to a psychiatric hospital intended for the care and treatment of inpatients who do not require acute medical services.
A2.5-1.1.1 See Section 2.2-2.12 (Psychiatric Patient Care Unit) for psychiatric units in general hospitals.
The psychiatric hospital shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines as amended in this section.
Parking for psychiatric hospitals shall comply with the requirements in Section 1.3-3.4.1 (Parking-General) and the specific requirements in this section.
In the absence of local requirements governing parking, the following shall be provided:
- At least one space for each employee normally present during one weekday shift plus one space for every five beds, or a total of 1.5 spaces per patient. Reduction of this ratio shall be permitted in compliance with Section 1.3-3.4.3.
- Additional parking to accommodate outpatient or other services provided on site
Where the psychiatric facility is part of another facility, or where different psychiatric patient populations share the same facility, shared ancillary and clinical services shall be permitted when these shared services are located and configured to accommodate programmatic requirements for safety, security, and other clinical considerations.
A2.5-1.5 Environment of care. The majority of persons who attempt suicide suffer from a treatable mental disorder or a substance abuse disorder or both. Patients of inpatient psychiatric treatment facilities are considered at high risk for suicide; therefore, the environment should avoid physical hazards while maintaining a therapeutic environment. However, although a safe environment is critical, no environment can be entirely free of risk. The built environment, no matter how well designed and constructed, cannot be relied upon as an absolute preventive measure. Staff awareness of the environment, the latent risks of that environment, and the behavior risks and needs of the patients served in that environment is absolutely essential. Different organizations and different patient populations will require greater or lesser tolerance for risk.
Hidden alcoves and blind corners or areas shall be avoided.
A2.5-126.96.36.199 Therapeutic environment. The facility should provide a therapeutic environment appropriate for the planned treatment programs.
- The environment of a psychiatric hospital should be characterized by a feeling of openness with emphasis on natural light. In every aspect of building design and maintenance, it is essential to base determinations on the potential risk to the specific patient population served.
- The openness of the nurse station will depend on the planned treatment program. Consideration should be given to acoustic and visual privacy requirements and also to staff safety. See appendix section A2.5-188.8.131.52 (Open nurse stations) for factors to consider when using open nurse stations.
Means for visual observation (e.g., electronic surveillance) of patient care unit corridors, dining areas, and social areas such as dayrooms and activity areas shall be provided.
The design shall provide the level of security needed for the specific type of service or program provided as well as for the age level, acuity, and risk of the patients served (e.g., geriatric, acute psychiatric, or forensic for adult, child, and adolescent care). See Section 1.2-4.6 (Behavioral and Mental Health Risk Assessment) for requirements.
A2.5-184.108.40.206 See Section 2.5-2.2.3 (Outdoor Areas) for security requirements for these areas.
Where provided, perimeter security shall meet the following requirements:
(1) A perimeter security system shall be designed to:
(a) Contain patients within the patient care unit or treatment areas outside the unit until clinical staff and/or hospital security can escort them to an adjacent compartment or an exit stair.
(b) Prevent elopement and contraband smuggling
(c) Include provisions for monitoring and controlling visitor access and egress.
*(2) Openings in the perimeter security system (e.g., windows, doors, gates) shall be controlled by locks (manual, electric, or magnetic) when required by the safety risk assessment.
(3) Use of security cameras and other security measures consistent with the safety risk assessment shall be permitted in addition to the security perimeter requirements above.
A2.5-220.127.116.11 The owner or designer should consult with the authorities having jurisdiction regarding the acceptability of the intended perimeter security system.
A2.5-18.104.22.168 (2) Perimeter locks
- Manual locks. Manual locks should have a normal lock function on the inpatient unit side.
- Electric locks. Electric locks should have a fail secure function with a key override on emergency power with battery backup to prevent loss of security during power failure. These locks may also be equipped with card or proximity readers to ease staff access.
- Magnetic locks. Use of magnetic locks on double egress doors and other doors is permitted. Magnetic locks should be on emergency power with battery backup and must have a key override to ensure security during power failure. These locks may also be equipped with card or proximity readers to ease staff access.
Patient safety and suicide prevention
- For information on psychiatric patient injury and suicide prevention risk assessments, see Section 1.2-4.6 (Behavioral and Mental Health Risk Assessment).
- Special consideration for injury and suicide prevention shall be given in designing architectural details and selecting surface materials and building system equipment as specified in sections 2.5-7.2 (Architectural Details, Surfaces, and Furnishings) and 2.5-8 (Building Systems).
Patient care units in psychiatric hospitals shall meet the minimum design requirements described herein.
For renovation of patient care units in existing facilities, see Section 1.1-3 (Renovation) for further guidance when compliance with the Guidelines is impractical.
Where accommodations for care of patients of size are provided, they shall meet the requirements in Section 2.1-2.3 (Accommodations for Care of Patients of Size).
Access control shall be provided for all entrances to a general psychiatric unit.
The primary access point to a locked unit shall be through a sally port when the need for elopement prevention is indicated by the behavioral and mental health section of the safety risk assessment (see Section 1.2-4.6).
A2.5-22.214.171.124 A sally port is the space between two locked doors that must be traversed to enter the unit. When an individual enters the unit, the first door is unlocked to gain access to the sally port and the second door remains closed and locked. Only when the first door has closed and is locked does the second door open. This arrangement prevents patients from bolting out of the unit when the door closest to the unit is opened; it also eliminates tailgating. The sally port should be long enough and the door wide enough to accommodate passage of a bed or laundry cart.
Each bedroom shall meet the following standards:
Maximum room capacity shall be two patients.
Patient bedrooms shall have a minimum clear floor area of:
- 100 square feet (9.29 square meters) for single-patient rooms
- 80 square feet (7.43 square meters) per bed for multiple-patient rooms
Section 2.1-2.1.2 (Patient Privacy) shall not apply to psychiatric patient bedrooms.
- Each patient shall have access to a toilet room without having to enter a corridor. Omission of this direct access requirement shall be permitted in specific patient bedrooms where the use of corridor access is part of the hospital's written clinical risk assessment and management program.
- One toilet room shall serve no more than two patient bedrooms and no more than four patients.
- The toilet room shall contain a toilet and a hand-washing station.
- Toilet room doors
- Where indicated by the safety risk assessment, toilet room doors shall be equipped with keyed locks that allow staff to control access to the toilet room.
- Where a swinging door is used, the door to the toilet room shall swing outward or be double-acting.
- Where a toilet room is required to be ADA- or ANSI-compliant:
- Thresholds shall be designed to facilitate use and to prevent tipping of wheelchairs and other portable wheeled equipment by patients and staff.
- Grab bars shall be designed to facilitate use (i.e., be graspable) and to be ligature-resistant.
- Each entry door into a patient toilet room required to be ADA- or ANSI-compliant shall provide space for health care providers to transfer patients to the toilet using portable mechanical lifting equipment.
A bathtub or shower shall be provided in the patient care unit for each six beds not otherwise served by bathing facilities at patient bedrooms.
A2.5-126.96.36.199 Patient bathing facilities. Bathing facilities should be designed and located to limit travel distance to no more than 150 feet from any patient room.
Each patient shall have in his or her room a separate wardrobe, locker, or closet for storing personal effects.
- Shelves for folded garments shall be used instead of arrangements for hanging garments.
- Storage shall be available for a daily change of clothes for seven days.
Where outdoor areas are provided, they shall meet the following requirements:
A2.5-2.2.3 Outdoor areas are not required; however, if patient care programs require them to be provided, they should be arranged to prevent confused patients from wandering outside of designated patient areas. Plants selected for use should be types that will not grow large enough to facilitate elopement or concealment.
Fences and walls serving a locked patient care unit shall be designed to:
- Hinder climbing
- Be installed with tamper-resistant hardware
- Have a minimum height of 10 feet (3.04 meters) above the outdoor area elevation
- Be anchored to withstand the body force of a 350-pound (158.9-kg) person
Where provided, gates or doors in the fence or wall shall:
- Swing out of the outdoor area
- Have the hinge installed on the outside of the outdoor area
- Be provided with a locking mechanism that has been coordinated with life safety exiting requirements
Trees and bushes shall not be placed adjacent to the fence or wall.
Plants selected for use shall not be toxic.
- Luminaires shall have tamper-proof lenses.
- Luminaires shall not be accessible to patients.
- Poles supporting luminaires shall not be capable of being climbed.
Where provided, security cameras shall view the entire outdoor area and shall not be accessible to patients.
Where provided, furniture shall be secured to the ground. Furniture shall not be placed in locations where it can be used to climb the fence or wall.
Elevated courtyards or outdoor areas located above the ground floor level shall not contain skylights or unprotected walkways or ledges.
- The need for and number of required AII rooms in the psychiatric hospital shall be determined by an infection control risk assessment (ICRA).
- Where required, the airborne infection isolation room(s) shall comply with the requirements of Section 2.1-2.4.2 (AII Room).
A quiet room shall be provided for a patient who needs to be alone for a short period of time but does not require a seclusion room.
- Provision for the support areas listed shall be located in or readily accessible to each patient care unit unless otherwise noted.
- Arrangement and location of these support areas to serve more than one patient care unit shall be permitted. However, unless otherwise noted, at least one such support area shall be provided on each patient care floor.
See Section 2.1-2.8.2 (Administrative Center or Nurse Station) for requirements.
A2.5-188.8.131.52 Open nurse stations. Where open nurse stations are used, means to communicate with security personnel and other staff members in the event of an emergency should be provided. As well, an area should be provided adjacent to the nurse station that a staff member can access quickly for safety.
A separate charting area with provisions for acoustic and patient file privacy shall be provided.
Location of these space(s) either in the psychiatric patient care unit or immediately accessible to it shall be permitted.
See Section 2.1-2.8.8 (Medication Safety Zones) for requirements.
Use of one or a combination of the following shall be permitted to support food service in the unit:
- A nourishment station
- A kitchenette designed for patient use with staff control of heating and cooking devices
- A kitchen area in the unit with the following:
- Hand-washing station
- Secured storage
- Facilities for meal preparation and/or service
See Section 2.1-2.8.11 (Clean Workroom or Clean Supply Room) for requirements.
See Section 2.1-2.8.12 (Soiled Workroom or Soiled Holding Room) for requirements.
Location of the storage areas listed below in psychiatric patient care units shall be permitted where they will not present a risk to the patient population as indicated in the safety risk assessment.
(1) Clean linen storage. See Section 2.1-184.108.40.206 (Clean linen storage) for requirements.
*(3) Wheelchair storage space
(4) Emergency equipment storage. Emergency equipment storage shall be provided in accordance with Section 2.1-220.127.116.11 (Emergency equipment storage).
(5) Administrative supplies storage
A2.5-18.104.22.168 (3) Where storage space for wheelchairs must be located outside the psychiatric patient care unit, provisions should be made for access as needed for disabled patients and patients of size.
- See Section 2.1-2.8.14 (Environmental Services Room) for requirements.
- Location of this room in the patient care unit shall be permitted when it will not present a risk to the patient population.
- Separate consultation room(s), with a minimum clear floor area of 100 square feet (9.29 square meters) each, shall be provided at a room-to-bed ratio of one consultation room for each 12 psychiatric beds or fewer.
- The room(s) shall be designed for acoustic and visual privacy. See Table 1.2-6 (Design Criteria for Minimum Sound Isolation Performance Between Enclosed Rooms) for acoustic requirements.
- Use of the visitor room in Section 2.5-22.214.171.124 (Visitor room) for this purpose shall be permitted.
A conference and treatment planning room shall be provided for use by the psychiatric patient care unit.
Combination of the space for group therapy with the quiet activity space noted in Section 2.5-126.96.36.199 (Social spaces) shall be permitted where the unit accommodates no more than 12 patients and at least 225 square feet (20.90 square meters) of enclosed private space is available for group therapy activities.
Securable closets or cabinet compartments for the personal effects of nursing personnel shall be immediately accessible to the administrative center or nurse station. At a minimum, these shall be large enough for purses and billfolds.
A visitor room with a minimum floor area of 100 square feet (9.29 square meters) shall be provided for patients to meet with friends and family.
- At least two separate social spaces, one appropriate for noisy activities and one for quiet activities, shall be provided.
- Space requirements
- The combined area of these spaces shall have a minimum of 25 square feet (2.32 square meters) per patient with at least 120 square feet (11.15 square meters) for each of the two spaces.
- Dining area
- 20 square feet (1.86 square meters) per patient shall be provided for dining.
- Use of the social space for dining activities shall be permitted where an additional 15 square feet (1.39 square meters) per patient is added.
- Location of dining facilities in a central area off the patient care unit shall be permitted.
Patient laundry facilities with a washer and dryer shall be provided.
- A staff-controlled secured storage area shall be provided for patients' effects that are determined to be potentially harmful (e.g., razors, nail files, cigarette lighters).
- Combination of this storage area with the clean workroom or clean supply room in Section 2.5-188.8.131.52 (Clean workroom or clean supply room) shall be permitted.
A2.5-184.108.40.206 Including a distribution window to allow for distribution and collection of hygiene and other items without opening and closing the storage room door may improve security.
A space for locked storage of visitor belongings shall be provided.
A2.5-220.127.116.11 This storage is needed so those visiting a locked unit cannot smuggle contraband items or items patients could use to pose harm to themselves or others in the unit.
Child psychiatric unit patient areas shall be separate and distinct from any adult psychiatric unit patient areas. The requirements of Section 2.5-2.2 (General Psychiatric Patient Care Unit) shall apply to child units with the following exceptions:
Maximum bedroom capacity shall be four children.
- Each patient shall have access to a toilet room, either from the patient room or from the corridor outside the patient room.
- Where access is provided via a corridor, the following requirements shall be met:
- The toilet room shall be located in the patient care unit.
- The toilet room shall be located no more than 150 feet from the bedroom.
- The combined area for social activities shall have 35 square feet (3.25 square meters) per patient.
- Where a separate dining space is provided, it shall have a minimum of 15 square feet (1.39 square meters) per patient.
- The total area for social activities and dining space shall have a minimum of 50 square feet (4.65 square meters) per patient.
Where outdoor areas for play and therapy are provided, see Section 2.5-2.2.3 (General Psychiatric Patient Care Unit-Outdoor Areas) for requirements.
Storage space shall be provided for toys, equipment, extra cribs and beds, and cots or recliners for parents who may stay overnight.
The requirements of Section 2.5-2.2 (General Psychiatric Patient Care Unit) shall apply to Alzheimer's and other dementia units with the following exceptions:
Patient bedrooms shall have a minimum clear floor area of:
- 120 square feet (11.15 square meters) in single-patient rooms
- 200 square feet (18.58 square meters) in multiple-patient rooms
Each patient bedroom shall have storage for extra blankets, pillows, and linen.
Door openings to patient bedrooms shall have a minimum clear width of 44.5 inches (113 centimeters).
Where a call system is provided, it shall meet the requirements in Section 2.5-8.5.1 (Call Systems).
Storage space for wheelchairs shall be provided in the patient care unit.
The requirements of Section 2.5-18.104.22.168 (Social spaces) shall apply, except that the combined area for social activities shall have a minimum of 30 square feet (2.79 square meters) per patient.
At least one accessible bathtub in a locked room shall be provided in each dementia patient care unit.
The requirements of Section 2.5-2.2 (General Psychiatric Patient Care Unit) shall apply to forensic units.
Forensic units shall have security vestibules or sally ports at the unit entrance.
Areas for children, juveniles, and adolescents shall be separate from adult areas.
Specialized program requirements may indicate the need for additional treatment areas, police and courtroom space, and security considerations.
Where examination rooms are provided, they shall comply with Section 2.1-3.2.2 (Single-Patient Examination Room), except as noted in this section.
A2.5-3.1.1 Where the presence of two staff members is required in psychiatric examination room(s), space for a chair for a second staff person should be provided.
Examination rooms shall be permitted to serve several patient care units.
Examination rooms shall be permitted to be located on a different floor than the patient care unit.
Provision of imaging services is not required in a psychiatric hospital. However, where radiology services are provided, the imaging suite shall comply with the requirements in 2.2-3.4 (Imaging Services).
Spaces where rehabilitation therapy services are provided shall comply with the requirements in Section 2.6-3.1 (Rehabilitation Therapy).
- Where electroconvulsive therapy (ECT) is provided in the psychiatric hospital, the requirements in this section shall be met, with the exception noted in (2) below.
- Where a psychiatric unit is part of a general hospital (Section 2.2-2.12-Psychiatric Patient Care Unit), all the requirements in this section shall be permitted to be accommodated in a room that complies with the requirements in one of the following:
A2.5-22.214.171.124 Equipment used in this treatment modality may be portable and can be used in a variety of medical facilities, provided the minimum requirements in this section are met.
The size, location, and configuration of the ECT treatment, recovery, and support areas shall reflect the type of patients to be treated, whether this is an inpatient or outpatient service, and the projected volume of patients.
The ECT treatment area shall be permitted to be a single ECT treatment room or a suite of ECT treatment rooms.
- Space requirements. Each ECT treatment room shall have a minimum clear floor area of 200 square feet (18.6 sq. meters) with a minimum clear dimension of 14 feet (4.27 meters).
- Hand-washing station. A hand-washing station shall be provided in accordance with Section 2.1-2.8.7 (Hand-Washing Station).
- Documentation area. Accommodations for written or electronic documentation shall be provided.
Where ECT services have low-volume throughput, use of the ECT treatment room for pre-treatment patient care and post-treatment recovery shall be permitted.
- Where pre- and post-treatment patient care area(s) are provided, they shall meet the requirements in Section 2.1-3.4 (Pre- and Post-Procedure Patient Care) as amended in this section.
Where a pre-treatment patient care area is provided, the number of patient care stations shall be determined by the following:
- Number of ECT treatments performed
- Anticipated staffing levels
Where a recovery area is provided, the number of patient care stations shall be determined by the following:
- Number of ECT treatments performed
- Types of anesthesia used
- Average recovery periods
- Anticipated staffing levels
See Part 3 (ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities) for ventilation requirements for the ECT treatment room.
Emergency electrical service that meets the requirements in Section 2.5-126.96.36.199 (Essential electrical system) shall be provided in:
- The ECT treatment room
- The recovery area, where provided
- See Table 2.1-3 (Station Outlets for Oxygen, Vacuum, Medical, and Instrument Air Systems in Hospitals) for station outlet requirements.
- All medical gases used shall meet the requirements of NFPA 99: Health Care Facilities Code.
Nurse call devices shall be provided as required in Table 2.1-2 (Locations for Nurse Call Devices in Hospitals).
- Space shall be provided in the treatment area for storage of emergency equipment (e.g., a CPR cart).
- This emergency equipment storage space shall be permitted to serve more than one ECT treatment room.
Where waiting areas and patient toilet rooms are provided, their number and size shall be determined by the following:
Number of ECT treatments performed
Average recovery periods
Anticipated staffing levels
See Section 2.1-4.3 (Food and Nutrition Services) for requirements.
See 2.1-5.1 (Sterile Processing) for requirements.
Psychiatric hospitals shall meet the requirements of Section 2.1-5.3 (Materials Management) as amended in this section.
General storage room(s) with a total area of not less than 4 square feet (0.37 square meter) per inpatient bed shall be provided.
See Section 2.1-5.6 (Engineering and Maintenance Services) for requirements.
See Section 2.1-6 (Public and Administrative Areas) for requirements.
Architectural details, surfaces, and furnishings shall comply with Section 2.1-7.2 (Architectural Details, Surfaces, and Furnishings) as amended in this section.
Special design consideration shall be given to injury and suicide prevention as indicated in the behavioral and mental health portion of the safety risk assessment (Section 1.2-4.6).
A2.5-188.8.131.52 Requirements for planning and detailing spaces in the psychiatric hospital should include reduction or elimination of the potential for injury and suicide, types of finishes, sharp edges, fixtures, heights, door hardware, etc.
(2) Door openings. Door openings for patient use in new construction shall have a minimum clear width of 32 inches (813 millimeters).
(3) Door swings. Doors to private patient toilet rooms or bathing facilities shall swing out, be double-acting with an emergency strike, or have other barricade-resistant provisions to allow for staff emergency access.
(4) Door closers
(a) Use of door closers is to be avoided unless required for the care being provided.
*(b) Door closer devices, if required on the patient bedroom door, shall be a mortised type or surface-mounted on the public side of the door rather than the private patient side of the door.
(5) Door hinges
(a) Door hinges shall be designed to minimize points for hanging (i.e., cut hinge type).
(b) Door hinges used shall be consistent with the level of care for the patient.
(6) Fasteners. All hardware shall have tamper-resistant fasteners.
A2.5-184.108.40.206 (4)(b) Door closers. Ideally, where a door closer is provided, it should be within view of a nurse station or staff workstation.
(1) Windows located in patient care areas or areas used by patients, including the exterior pane of windows accessible by patients from outdoor courtyards, shall be designed to limit the opportunities for patients to seriously harm themselves by breaking the windows and using pieces of the broken glazing material to inflict harm to themselves or others.
(a) All glazing (both interior and exterior), borrowed lights, and glass mirrors shall be fabricated with polycarbonate or laminate on the inside of the glazing or with any glazing that meets or exceeds the requirements for Class 1.4 per ASTM F1233: Standard Test Method for Security Glazing Material and Systems.
*(b) Use of tempered glass for borrowed lights shall be permitted.
(2) To prevent opportunities for suicide, self-harm, and escape, the entire window system and the anchorage for windows and window assemblies, including frames, glazing, and hinges and locking devices for operable windows, shall meet the following requirements:
(a) Designed to resist impact loads of 2,000 foot-pounds applied from the inside
(b) Tested in accordance with AAMA 501.8: Standard Test Method for Determination of Resistance to Human Impact of Window Systems Intended for Use in Psychiatric Applications
(3) A minimum net glazed area of no less than 8 percent of the floor area of each social and dining space shall be provided.
A2.5-220.127.116.11 Windows. Use of operable windows with security locks is recommended to allow for fumigation should rooms require extensive cleaning. Where operable windows are provided, it is important to adhere to the requirement in Section 2.1-18.104.22.168 (2) to limit the size of the opening.
A2.5-22.214.171.124 (1)(b) Tempered glass is often preferred for borrowed lights since it has substantial impact resistance, does not scratch or discolor, and-when broken-shatters into round pellets rather than the jagged shards of laminated glass.
Special design considerations for injury and suicide prevention shall be given to shower, bath, toilet, and sink hardware and accessories, including grab bars and toilet paper holders.
- Grab bars
- Bars shall be anchored to sustain a concentrated load of 250 pounds (113.4 kilograms).
- See Section 2.5-126.96.36.199 (5)(b) (Grab bars) for additional grab bar requirements.
- The following are not permitted:
- Towel bars
- Shower curtain rods
- Lever handles, except where a specifically designed anti-ligature lever handle is used
- In patient areas, fire sprinklers shall be of a design to minimize patient tampering.
- In patient toilet rooms and bathing facilities, light fixtures, fire sprinklers, electrical receptacles, and other appurtenances shall be of a tamper- and ligature-resistant type.
- Monolithic ceilings shall be provided in seclusion rooms, patient bedrooms, patient toilet rooms, and patient bathing facilities.
- In these rooms, the ceiling shall be secured from patient access.
- Mechanical, electrical, and plumbing systems, other than terminal elements serving the room, shall be concealed above the ceiling.
- In seclusion rooms, bedrooms, patient toilet rooms, and patient bathing facilities, ventilation grilles shall be secured using tamper-resistant fasteners and have perforations or openings to eliminate their use as a tie-off point or be designed to prevent them from being used as ligature points.
- Ceiling access doors shall be without gaps and secured with a keyed lock and/or tamper-resistant fasteners.
- Built-in furnishings shall be constructed to minimize potential for injury, suicide, or elopement.
- Built-in furnishings with doors or drawers shall not be provided.
- Open shelves shall be fixed with tamper-resistant hardware.
Where provided, robe or towel hooks shall be designed for ligature resistance. Clothing rods shall not be permitted.
Where window treatments are provided, they shall be designed without accessible anchor points or cords.
A2.5-188.8.131.52 Window treatments in patient bedrooms and other patient care areas
- The use of drapery is discouraged.
- The use of integral blinds in the window assembly is highly desirable to provide privacy and sun control without suicide risk.
For building system requirements for psychiatric hospitals, see Section 2.1-8 (Building Systems) and additional requirements in this section.
- At minimum, psychiatric hospitals or sections thereof shall have essential electrical systems as required in the following standards:
- NFPA 99: Health Care Facilities Code
- NFPA 101: Life Safety Code®
- NFPA 110: Standard for Emergency and Standby Power Systems
- Where the psychiatric facility is a distinct part of an acute care hospital:
- Use of the hospital generator system for required emergency lighting and power shall be permitted if such sharing does not reduce hospital services.
- Life support systems and their respective areas shall be subject to applicable standards of Section 2.1-8.3 (Electrical Systems).
- An emergency electrical source shall provide lighting and/or power during an interruption of the normal electrical supply.
Luminaires shall be tamper-resistant and engineered for the specific application, as determined by the behavioral and mental health portion of the safety risk assessment (Section 1.2-4.6).
- Patient bedrooms. Patient bedrooms shall have general lighting and night lighting. At least one nightlight fixture in each bedroom shall be controlled at the room entrance.
- Patient care unit corridors. Corridors in patient care units shall have general illumination with provisions for reducing light levels at night.
- Exterior lighting. Approaches to buildings and parking lots and all occupied spaces shall have luminaires that can be illuminated as necessary.
Special design considerations for injury and suicide prevention shall be given to the electrical equipment in the psychiatric hospital, including light fixtures, electrical outlets, electrical appliances, nurse call systems, and staff emergency assistance systems.
Where electrical receptacles are provided in a patient bedroom, the receptacles shall be:
- All controlled by a single switch outside the room and under the control of staff
- Either ground-fault circuit interrupter devices or on a circuit protected by a ground-fault circuit breaker.
In the absence of local and state plumbing codes, all plumbing systems shall be designed and installed in accordance with the chapters in the International Plumbing Code that are applicable for this occupancy.
Special design considerations for injury and suicide prevention shall be given to shower, bath, toilet, and sink plumbing fixtures. Shower heads shall be of flush-mounted design to minimize hanging appendages.
Communications systems shall meet the requirements in Section 2.1-8.5 (Communications Systems) as amended.
See Table 2.1-2 (Locations for Nurse Call Devices in Hospitals) for locations where call systems are required in psychiatric hospitals.
- Staff response call systems shall be low voltage with limited current.
- Controls to limit unauthorized use shall be permitted.
A2.5-184.108.40.206 Where radiofrequency systems are used, consideration should be given to electromagnetic compatibility between internal and external sources.
Where a nurse call system is provided, the following requirements shall be met:
- Provisions shall be made for easy removal or covering of call buttons.
- All hardware shall have tamper-resistant fasteners.
- Signal location
- Calls shall activate a visible signal in the corridor at the patient's door and at an annunciator panel at the nurse station or other appropriate location.
- In multi-corridor patient care units, additional visible signals shall be installed at corridor intersections.
- Call cords or strings in excess of 6 inches (15.24 centimeters) shall not be permitted.
Where an emergency call system is provided, it shall be designed to meet the following requirements:
- A signal activated by staff will initiate a visible and audible signal distinct from the regular nurse call system.
- The signal shall activate an annunciator panel at the nurse station or other appropriate location and a distinct visible signal in the corridor at the door to the room from which the signal was initiated.
Fire extinguisher cabinets and fire alarm pull stations shall be located in staff areas or otherwise secured in patient-accessible locations.
Hospitals with patient facilities (e.g., patient bedrooms, dining rooms, recreation areas) or services (e.g., diagnostic or therapeutic areas) located on floors other than the grade-level entrance floor shall have elevators.