Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 535 - NEW CONSTRUCTION AND ALTERATIONS OF EXISTING HOSPITALS › Section 333-535-0041 - Critical Care Units

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Critical
			 Care Units: Generally, Critical Care Units require special space and equipment
			 considerations for effective staff functions. In addition, space must be
			 arranged to include provisions for immediate access for emergency medical
			 equipment from other departments. Critical Care Units shall comply in size,
			 number and type with the requirements of this rule and with the hospital's
			 Functional Program. This rule is intended for the more common types of critical
			 care services. Where specialized services are required, the Division may allow
			 such additions and modifications as are necessary for efficient, safe and
			 effective patient care. (See also OAR 333-535-0300  for mechanical requirements
			 and 333-535-0310  for electrical requirements.)
(2) Adult Critical Care Units: Each Adult
			 Critical Care Unit shall comply with the following requirements:
(a) The location shall be convenient for
			 access from emergency, respiratory, laboratory, radiology, surgery, and other
			 essential departments and services, and be located so that medical emergency
			 resuscitation teams may respond promptly to emergency calls;
(b) The location shall be arranged to
			 eliminate the need for through traffic;
(c) For new construction, a private room
			 shall be provided for each patient. A minimum of 200 square feet of clear floor
			 area shall be provided exclusive of anterooms, vestibules, toilet rooms,
			 closets, lockers, wardrobes, and alcoves. A combined total of at least 7 feet
			 of clear space shall be available at the head and foot of the bed. Minimum head
			 wall width shall be 13 feet;
(d)
			 Renovation projects shall comply with subsection (2)(c) of this rule except
			 when existing structural conditions make full compliance impractical. In such
			 cases, the Division may allow the following deviations: Private patient room
			 size may be reduced to 160 square feet with a minimum headwall width of 11 feet
			 6 inches. The combined total of clear space available at the head and foot of
			 the bed may be reduced to a minimum of 6 feet. Multiple bed rooms may be
			 provided with cubicle curtains for patient privacy. The minimum patient cubicle
			 size shall be 130 square feet with a minimum headwall width of 11 feet for each
			 bed. Three of the 7 feet of combined total clear space required at the head and
			 foot of the bed may be outside the curtained cubicle area;
(e) In private rooms or curtained cubicles,
			 visual access to the corridor shall be provided. In multiple bed rooms, cubicle
			 curtains or other alternative methods approved by the Division shall be
			 provided for visual privacy from casual observation by other patients and
			 visitors;
(f) Where only one door
			 is provided to a bed space, it shall be at least 3 feet 8 inches in clear width
			 and arranged to minimize interference with the movement of beds and large
			 equipment. Sliding doors shall not have floor tracks and shall have hardware
			 that minimizes jamming. When a secondary door is desired for staff use, it may
			 be of a smaller width;
(g) For the
			 purpose of allowing day from night orientation, newly constructed patient rooms
			 shall include at least one window meeting the requirements of OAR
			 333-535-0025(1)(c), arranged to allow direct visual access by the patient to
			 the outside. Patient rooms and cubicles in renovation projects shall also meet
			 this requirement except when the Division determines that existing structural
			 conditions make it impractical to do so. In these instances, patients must have
			 direct visual access to an outside window, but it may be a clerestory type and
			 the distance from the patient bed to the outside window may be up to 50
			 feet;
(h) A nurse call device shall
			 be provided at each bed for patient use. A staff use emergency call station
			 shall also be provided in each patient room to summon assistance. In multiple
			 bed rooms, at least one such emergency call station shall be provided for each
			 eight patient beds;
(i)
			 Hand-washing stations shall be convenient to nurses' stations and patient bed
			 areas. One hand-washing station shall be provided in each patient room. The
			 hand-washing station shall be located near the entrance of the patient room,
			 designed to minimize splashing water onto the floor, and shall be equipped with
			 hands-free operable controls. In multiple bed rooms allowed under paragraph
			 (2)(b)(D) of this rule, if the Division determines that existing structural
			 conditions make it impractical to comply with this requirement, there shall be
			 at least one hand-washing station provided for every two beds in multiple bed
			 rooms. The hand-washing station shall be located near the entrances to patient
			 cubicles;
(j) A toilet shall be
			 provided within each patient room or in a separate private toilet room entered
			 directly from the patient room. Space shall be provided adjacent to toilets to
			 allow for staff assistance. An exception to this requirement may be granted by
			 the Division when the project is within an Oregon Health Authority designated
			 Level 1 Trauma Center Hospital and patients typically are unable to utilize
			 toilets. In renovation projects if the Division determines that existing
			 structural conditions make it impractical to comply with this paragraph, a
			 minimum of one enclosed toilet room and hand-washing station shall be provided
			 for each eight patient beds. In these instances, portable toilets are permitted
			 in place of fixed toilets within each patient room or cubicle. If portable
			 toilets are used, facilities for cleaning and storing them shall be
			 conveniently located within or adjacent to the Critical Care Unit;
(k) The nurses' station or a substation with
			 space for charting, monitoring and a hand-washing station within 20 feet not
			 through a door, shall be located so that nurses will have direct visual
			 observation of each patient. In larger Critical Care Units, more than one
			 nurses' station may be needed to provide for observation of all
			 patients;
(l) Individual patient
			 closets or lockers shall be provided for the secure storage of clothing and
			 personal effects. This storage may be within patient rooms or in a central
			 location convenient to the Critical Care Unit; and
(m) Each Critical Care Unit shall provide
			 space for equipment used for continuous physiological monitoring, including a
			 bedside and remote visual display for each patient.