D.C. Mun. Regs. tit. 22, r. 22-B2033

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-B2033 - CARE AND TREATMENT AREAS

2033.1

The hospital shall not share the following care and treatment areas among detached structures or with other facilities operated by another licensee:

(a) Staff Areas: Facilities that provide nursing services shall provide the following support areas for each distinct group of care and treatment patient rooms.

(1) Control Point: The hospital shall have an area or areas for charting, and patient records, and call and alarm annunciation systems.

(2) Medication Station: The hospital shall have a medication station for storage and distribution of drugs and routine medications. Distribution may be done from a medicine preparation room or unit, from a self-contained medicine- dispensing unit, or by another system. If used, a medicine preparation room or unit shall be under visual control of nursing staff and shall contain a work counter, sink, refrigerator, and double-locked storage for controlled substances.

(3) Utility Areas: The hospital shall have a work area where clean materials are assembled. The work area shall contain a work counter, a hand-washing fixture, and storage facilities for clean and sterile supplies. If the area is used only for storage and holding as part of a system for distribution of clean and sterile supply materials, the work counter and hand-washing fixtures may be omitted. A hospital shall have separate work rooms or holding rooms for soiled materials. A work room for soiled materials shall contain a fixture for disposing wastes and a hand-washing sink.

(b) Equipment and Supplies: The hospital shall have services and space to distribute, maintain, clean and sanitize durable medical instruments, equipment, and supplies required for the care and treatment performed in the hospital.

(1) Durable Medical: The hospital shall ensure that the durable medical equipment is tested and calibrated in accordance with the manufacturer's recommendations.

(2) Sterile Processing: The hospital shall have areas for decontamination and sterilizing of durable medical instruments and equipment.

(A) The hospital shall provide separate central sterile processing and waste processing areas.

(B) In new construction and where provided, central processing areas shall have separate soiled (sorting and decontamination) and clean (sterilizing and processing) rooms. The hospital shall have hand-washing sinks in both clean and soiled rooms.

(C) Equipment Storage: The hospital shall have space to store equipment, stretchers, wheelchairs, supplies, and linen out of the path of normal traffic.

(c) Surgery: A hospital providing surgical services shall have at least one operating or procedure room and the following support areas. In new construction and hospitals with more than two operating rooms, the following support areas and central processing areas shall be located in restricted access areas:

(1) Preoperative Patient Area: Preoperative patient area(s) shall have sufficient space and equipment to accommodate both ambulatory and non-ambulatory patients. These areas shall be under the direct visual control of the nursing staff.

(2) Recovery Area: Recovery area(s) shall contain a medication station, hand-washing sink, charting area, provisions for bedpan cleaning; and equipment and supply storage space.

(3) Dressing Area: A hospital providing outpatient surgery shall have patient dressing and toilet rooms separate from staff gowning areas.

(4) Housekeeping Room: The hospital shall have soiled utility and housekeeping areas exclusively for the surgical suite.

(d) Emergency Care: A hospital providing emergency services shall have at least one procedure or treatment room for emergency services. To support the provision of emergency care, the hospital shall have the following:

(1) Entrance: A well marked, illuminated covered entrance at grade level for emergency vehicle and pedestrian access;

(2) Waiting Area: Patient and visitor waiting area(s) that are in direct observation of the reception, triage, or control station, with access to a public phone and drinking fountain;

(3) Storage: Storage areas for general medical/surgical emergency supplies, medications and equipment under staff control and out of the path of normal traffic; and

(4) Toilet Room: A patient toilet room with hand-washing sink convenient to the procedure or treatment room(s).

(e) Rehabilitation: A hospital providing rehabilitation services in a distinct unit shall have at least one treatment room or cubicle, an area for specialized treatment and care, hand-washing sink(s), storage for equipment and supplies, call system, medication storage and distribution, and areas to allow for patient toileting, dressing, and consultation.

(f) Obstetrics: A hospital providing obstetric services in a distinct unit shall have at least one patient room, nursery with work area, space and equipment to allow for care and treatment of both mother and infant, hand-washing sink, storage for equipment and supplies, call and alarm annunciation systems, medication storage and distribution, and convenient accommodations for patient toileting, dressing, and consultation.

(g) Psychiatric or Mental Health: A hospital providing psychiatric or mental health services in a distinct unit shall provide space and equipment that allows for patient and staff safety. The hospital shall provide at least one observation room, separate quiet and noisy activity areas, dining areas, private and group areas for specialized treatment and care, a hand-washing sink, storage for equipment and supplies, security systems, and an area for medication storage and distribution. Patient toileting, dressing, holding, and consultation rooms shall have durable finishes. In rooms where care and treatment is provided to patients exhibiting violent, aggressive or suicidal behavior, the rooms shall have:

(1) Tamper-resistant air distribution devices, lighting fixtures, sprinkler heads, and safety devices;

(2) Ventilation, exhaust, heating and cooling components that are inaccessible to patients;

(3) Bedroom, toilet, and bathing room doors that are not lockable or capable of being obstructed from within; and

(4) Electrical outlets protected by ground fault interrupting devices.

(h) In-patient Hospice Care: A hospital providing in-patient hospice services in a distinct unit shall have private patient bedrooms, over-night and dining accommodations for family members, private family visiting areas, areas that allow for toileting, bathing, dressing and hand-washing, storage for equipment and supplies, call system, medication storage and distribution.

(1) Alzheimer's, Dementia, and Related Conditions: A hospital providing in-patient services for Alzheimer's, dementia, and related conditions in a distinct unit shall have personalized patient bedrooms, activity areas, separate dining areas, features that support patient orientation to their surroundings, areas for specialized treatment and care, hand-washing sinks, secured storage for equipment and supplies, call and security systems, and an area for medication storage and distribution.

(i) Outpatient Areas: Areas for the care and treatment of patients not residing in the hospital shall comply with the following:

(1) Areas shall not interfere with inpatients being served;

(2) Furniture and equipment shall meet care and treatment needs of outpatients;

(3) Toilets, which are easily accessible from all program areas shall be provided; and

(4) Sufficient inside and outside space to accommodate the full range of program activities and services shall be provided.

D.C. Mun. Regs. tit. 22, r. 22-B2033

Notice of Final Rulemaking published at 55 DCR 8813 (August 15, 2008)