Adopts Without Amendments:

FGI Outpatient, 2018

Part 1 General

Part 2 Outpatient Facility Types

ANSI/ASHRAE/ASHE Standard 170-2017 Ventilation of Health Care Facilities

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 outpatient facilities where infusion services, including chemotherapy, are provided.
A2.6-1.1 Other cancer treatment services may be combined with an infusion center in a cancer treatment facility.
The infusion center shall meet the standards in this chapter and the standards in Part 1 of these Guidelines.
Requirements in Chapter 2.1, Common Elements for Outpatient Facilities, shall apply to infusion centers as cross-referenced in this chapter.
See Section 2.1-2 (Accommodations for Care of Patients of Size) for requirements.
An infusion area shall be provided.
A2.6-3.1 Considerations for pediatric patients. Where pediatric patients are treated in the infusion area, a play area should be provided. Areas for infusion of pediatric and adult patients should be segregated.
A2.6-3.1.1 The size of the infusion area, and the ratio of open patient care stations and private bays/cubicles/rooms, should depend on the patient acuity mix and planned use of the facility. Bays and cubicles should be considered private. Provision of at least one private treatment room is recommended.
The infusion area shall be permitted to be an open-plan area.
Individual patient care stations shall be permitted to be any combination of bays, cubicles, and single-patient rooms.
The infusion area shall be separate from administrative and waiting areas.
A2.6-3.1.2 Because flexibility for family/friends to accompany patients to infusions is important, patient care stations-whether bays, cubicles, or rooms-should be sized to allow space for visitors.
  1. Where bays are used for patient care, each patient care station shall have a minimum clear floor area of 70 square feet (6.04 square meters).
  2. Where cubicles are used, each patient care station shall have a minimum clear floor area of 80 square feet (7.43 square meters).
  3. Where single-patient rooms are used, each room shall have a minimum clear floor area of 100 square feet (9.29 square meters).
  1. Where bays are used, the following minimum clearances shall be provided:
    1. 5 feet (1.52 meters) between the sides of patient lounge chairs
    2. 3 feet (1.22 meters) between the sides of patient lounge chairs and adjacent walls or partitions
    3. 2 feet (60.96 centimeters) between the foot of a lounge chair and the cubicle curtain
  2. Where cubicles are used, the following minimum clearances shall be provided:
    1. 3 feet (91.33 centimeters) between the sides of patient lounge chairs and adjacent walls or partitions
    2. 2 feet (60.96 centimeters) between the foot of a lounge chair and the cubicle curtain
  3. Where single-patient rooms are used, 3 feet (91.33 centimeters) shall be provided between the sides and foot of patient lounge chairs and adjacent walls or partitions.
A2.6-3.1.2.2 Clearances. The clearance at the foot of the chair should be measured when the chair is in its fully reclined position.
Each patient care station shall have provisions for visual privacy.
A2.6-3.1.4 Acoustic patient privacy should be considered for patients in open-plan infusion areas. This can be achieved by using the exam room for patient communication.
Hand-washing stations shall be provided in accordance with Section 2.1-3.8.7 (Hand-Washing Station), including the requirements for locating hand-washing stations that serve multiple patient care stations.
A hand-washing station shall be located in, next to, or directly accessible to the nurse station.
A2.6-3.1.6 Number of patient toilet rooms. Due to the fluids being administered in an infusion center, a higher ratio of patient toilet rooms may be needed.
At least one patient toilet room with hand-washing station shall be immediately accessible to the infusion area.
The patient toilet room shall be accessible without leaving the infusion area.
Where an examination room(s) is provided in the infusion center, it shall meet the requirements in Section 2.1-3.2.1.2 (Single-Patient Examination/Observation Room).
The need for and number of required AII rooms shall be determined by an infection control risk assessment (ICRA).
Where required, AII room(s) shall comply with the requirements in Section 2.1-3.3.2 (AII Room).
Where nuclear imaging services are provided, see Section 2.1-3.5.7 (Nuclear Imaging Services) for requirements.
Where radiation therapy services are provided, see Section 2.1-3.6 (Radiation Therapy) for requirements.
A nurse station(s) that meets the requirements in Section 2.1-3.8.2 (Nurse Station) shall be located in the infusion area.
The nurse station(s) shall be designed to provide for monitoring of all patient care stations.
A2.6-3.8.2.1 Monitoring could be through direct visual observation or use of technology.
The nurse station(s) shall be out of the direct line of traffic.
See Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
A nourishment area or room shall be provided in accordance with Section 2.1-3.8.9 (Nourishment Area or Room).
Provisions for drinking water shall be provided.
A clean workroom or clean supply room shall be provided in accordance with Section 2.1-3.8.11 (Clean Workroom or Clean Supply Room).
A soiled workroom or soiled holding room shall be provided in accordance with Section 2.1-3.8.12 (Soiled Workroom or Soiled Holding Room).
  1. Designated separate spaces shall be provided for clean linen storage and soiled linen holding.
  2. Clean linen storage shall be permitted to be an alcove with a cart or space between patient care stations.
Space for storage of wheelchairs shall be provided in accordance with Section 2.1-6.2.7 (Wheelchair Storage and Parking Space).
A staff lounge shall be readily accessible and contain the following:
  1. Lockers
  2. Toilet
  3. Hand-washing stations
The staff lounge shall be permitted to serve more than one clinical service area.
A staff toilet room with hand-washing station shall be readily accessible to the nurse station.
Where storage for patient belongings is provided for infusion patients, it shall be located in the infusion area.
Where laboratory services are provided in the infusion center, see Section 2.1-4.1 (Laboratory Services) for requirements.
Pharmacy facilities that comply with the requirements in Section 2.1-4.2 (Pharmacy Services) shall be provided.
See Section 2.1-5.2 (Waste Management) for requirements.
An environmental services room shall be provided in accordance with Section 2.1-5.3.1 (Environmental Services Room).
Public areas shall be provided in accordance with Section 2.1-6.2 (Public Areas) as amended in this section.
A waiting area or room that meets the requirements of Section 2.1-6.2.3 (Waiting Area or Room) shall be readily accessible to the infusion area.
A2.6-6.2.3 Waiting area. Special consideration should be given to the need to isolate immunosuppressed patients from other patients, visitors, or family members. Provision of a small waiting area or room near a private exit may be needed to prepare patients, following treatment, to leave the care area without being transported through the general waiting area or room.
See Section 2.1-6.3.3 (General or Individual Office Space) for requirements.
See Section 2.1-6.3.5 (Medical Records) for requirements.
The minimum corridor width provided shall be in accordance with Section 2.1-7.2.2.1 (Corridor width).
See Section 2.1-7.2.3 (Surfaces) for requirements.
See Section 2.1-8 (Building Systems) for requirements.
A2.6-8 Heated potable water distribution systems. While immunocompromised patients who may be at risk for Legionella or other opportunistic waterborne pathogens are not typically seen in outpatient facilities, patients in infusion centers may be immunocompromised; therefore, heated potable water distribution systems in these facilities should be designed to minimize the risk of Legionella and other opportunistic waterborne pathogens.
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