216 R.I. Code R. § 216-RICR-40-10-4.7 - Environmental && Maintenance Services

4.7.1 Housekeeping and Maintenance Services

A. Written housekeeping and maintenance procedures shall be established for the cleaning of all areas in the hospital based on the guidelines of Health Care Environmental Services: Housekeeping Departmental Training Manual, incorporated above at § 4.2(A)(6) of this Part. Copies shall be made available to housekeeping personnel.

B. All parts of the hospital and its premises shall be kept clean, neat, free of litter and rubbish, and all furnishings maintained in good repair.

C. Equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition.

D. Hazardous cleaning solutions, compounds, and substances shall be labeled, stored in a safe place, and kept in an enclosed section separate from other cleaning materials.

E. Cleaning shall be performed in a manner which will minimize the spread of pathogenic organisms in the hospital atmosphere.

F. Exhaust ducts from kitchens and other cooking areas shall be equipped with proper filters and cleaned at regular intervals. The ducts shall be cleaned and inspected no less than twice a year.

4.7.2 Infection Control

A. The medical staff in cooperation with other disciplines shall establish a multidisciplinary group which shall report to the governing body and which shall be responsible for no less than the following:

1. establishing and maintaining a hospital-wide infection surveillance program which shall include an infection surveillance officer to conduct all infection surveillance activities;

2. developing and implementing written policies and procedures for the surveillance, prevention, and control of infections in all patient care departments/services;

3. establishing policies governing the admission and isolation of patients with known or suspected infectious diseases;

4. developing, evaluating and revising on a continuing basis infection control policies, procedures and techniques for all appropriate phases of hospital operation and services;

5. developing and implementing a system for evaluating and recording the occurrences of all infections among personnel and patients; such records shall be made available to the licensing agency upon request;

6. implementing a TB infection control program requiring risk assessment and development of a TB infection control plan; early identification, treatment and isolation of strongly suspected or confirmed infectious TB patients; effective engineering controls; an appropriate respiratory protection program; health care worker TB training, education, counseling and screening; and evaluation of the program's effectiveness, per guidelines in "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities," incorporated above at § 4.2(A)(7) of this Part.

7. developing and implementing an institution-specific strategic plan for the prevention and control of vancomycin resistance, with a special focus on vancomycin-resistant enterococci, per guidelines in "Recommendations for Preventing the Spread of Vancomycin Resistance: Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC),"incorporated above at § 4.2(A)(17) of this Part.

8. developing and implementing protocols for discharge planning of patients with infectious diseases which may present the risk of continuing transmission in the community or congregate living environment. Examples of such diseases include, but are not limited to, tuberculosis (TB), Methicillin resistant staphylococcus aureus (MRSA), clostridium difficile, etc.

9. assuring that patient care support departments (i.e., central services, laundry, etc.) are available to assist in the prevention and control of infectious diseases and are provided with adequate direction, training, staffing and facilities to perform all required infection surveillance, prevention and control functions.

B. Infection control provisions shall be established for the mutual protection of patients, employees and the public.

C. A continuing education program on infection control shall be conducted periodically for all staff.

D. Reporting of Communicable Diseases

1. The hospital shall promptly report to the Rhode Island Department of Health cases of communicable diseases designated as "reportable diseases" by the Director of Health, when such cases are admitted to or are diagnosed in the hospital in accordance with the most current rules and regulations pertaining to the reporting of communicable diseases (Reporting and Testing of Infectious, Environmental and Occupational Diseases, Part 30-05-1 of this Title).

2. When infectious diseases present a potential hazard to hospitalized patients or personnel, these shall be reported to the Rhode Island Department of Health, even if not designated as "reportable diseases."

3. Reporting by Hospital Laboratories

Hospital laboratories shall report communicable diseases and submit specimens in accordance with the requirements in the most current version of the Rhode Island Epidemiological and Laboratory Reporting and Surveillance Manual issued by the Division of Disease Prevention and Control at the Department of Health.

4. Hospitals must, in addition, comply with all other laboratory reporting requirements for TB, HIV/AIDS, sexually transmitted diseases, childhood lead poisoning and occupational diseases as outlined in Reporting of Infectious, Environmental and Occupational Diseases (Part 30-05-1 of this Title).

4.7.3 Laundry Service

A. Each hospital shall make provisions for the cleaning of all linens and other washable goods.

B. Hospitals providing laundry service shall have adequate facilities and equipment for the safe and effective operation of a laundry service.

C. There shall be distinct areas for the separate storage and handling of clean and soiled linens. Those areas used for the storage and handling of soiled linens shall be negatively pressurized.

D. Special procedures shall be established for the handling and processing of contaminated linens.

E. All soiled linen shall be placed in closed containers prior to transportation.

F. To safeguard clean linens from cross-contamination they shall be:

1. transported in containers used exclusively for clean linens and shall be kept covered at all times while in transit; and

2. stored in areas designated exclusively for this purpose (e.g., linen closets, enclosed carts, etc.).

4.7.4 Electromagnetic Interference and Medical Devices

A. The facility's governing body, or its designee (e.g., Safety Committee), shall develop and implement policies and procedures that achieve electromagnetic compatibility, including, but not limited to, the designation of areas of the facility where the use of common hand-held radio frequency transmitters (e.g., cellular and PCS telephones, two-way radios) by staff, visitors, and/or patients is to be managed and/or restricted. Said policies and procedures shall require no less than the following:

1. Each facility shall perform an assessment of the radiated electromagnetic environment in the facility and implement the actions needed to minimize radiated electromagnetic interference and promote electromagnetic compatibility.

2. Each facility shall actively manage its equipment to foster electromagnetic compatibility and to mitigate the risks of electromagnetic interference

Notes

216 R.I. Code R. § 216-RICR-40-10-4.7