8.8.1 Physical
Facility
A. All construction shall be subject
to the laws, rules, regulations and codes of R.I. Gen. Laws Chapters 23-17 and
23-28.1, and "Guidelines for Design and Construction of Hospital and Outpatient
Facilities" incorporated above at §
8.2(A) of
this Part, and all other appropriate state and local laws, codes, regulations
and ordinances. Where there is a difference between codes, the code having the
more stringent standard shall apply.
B. All plans for new construction or the
renovation, alteration, extension, modification or conversion of an existing
Birth Center that may affect compliance with "Guidelines for Design and
Construction of Hospital and Outpatient Facilities" incorporated above at
§
8.2(A) of
this Part shall be reviewed by a licensed architect, acceptable to the
Director. Said architect shall certify that the plans conform to the
construction requirements of "Guidelines for Design and Construction of
Hospital and Outpatient Facilities" incorporated above at §
8.2(A) of
this Part, prior to construction. The Birth Center shall maintain a copy of the
plans reviewed and the architect's signed certification, for review by the
Department upon request.
1. In the event of
non-conformance for which the Birth Center seeks a variance, the general
procedures outlined in §8.9.1 of this Part shall be followed. Variance
requests shall include a written description of the entire project, details of
the non-conformance for which the variance is sought and alternate provisions
made, as well as detailing the basis upon which the request is made. The
Department may request additional information while evaluating variance
requests.
2. If variances are
granted, a licensed architect shall certify that the plans conform to all
construction requirements of "Guidelines for Design and Construction of
Hospital and Outpatient Facilities" incorporated above at §
8.2(A) of
this Part, except those for which variances were granted, prior to
construction. The Birth Center shall maintain a copy of the plans reviewed, the
variance(s) granted and the architect's signed certification, for review by the
Department upon request.
C. Upon completion of construction, the Birth
Center shall provide written notification to the Department, describing the
project, and a copy of the architect's certification. The Birth Center shall
obtain authorization from the Department prior to occupying/re-occupying the
area. At the discretion of the Department, an on-site visit may be
required.
8.8.2 General
Provisions for Physical Facility (Including Existing Facilities)
A. Each Center shall be constructed,
designed, planned, equipped and maintained to protect the health and safety of
mothers, newborns, personnel and the public, and to facilitate emergency exit
of mothers and/or newborns in the event of emergency.
B. Reception areas, examination rooms, birth
rooms, family rooms and other supportive areas shall be designed and equipped
to provide good and safe care as well as to provide privacy and comfort to
mothers and their families.
C. The
birth room(s) shall be located to provide unimpeded, rapid access to an exit of
the building where emergency transportation vehicles may be accommodated.
1. Hallways and doors providing access and
entry into the birth room shall be of adequate width to accommodate ambulance
stretchers and wheelchairs.
2. The
birth room shall be spacious enough to accommodate staff to move freely and to
include at least:
a. A large bed or double
bed;
b. Chairs - lounge and
straight-back;
c. Bedside/procedure
tables;
d. A bassinet;
e. Space for birth room supplies and
equipment and for family belongings; and f. Access to a sink with hot and cold
running water with elbow-wrist controls.
D. Acceptable toilet facilities shall be
available to each laboring mother and adequate shower facilities shall also be
available to accommodate mothers.
E. Utility, storage and laundry areas shall
be designed and equipped for washing, sterilizing and storage of equipment,
linens and medical supplies in a manner which insures segregation of clean
linen and sterile supplies and equipment from those that are soiled and/or
contaminated.
F. Medication and
storage areas shall be provided and equipped with locks to ensure the
safekeeping of drugs and biologicals.
G. Heating and ventilation systems shall be
capable of maintaining comfortable temperatures.
H. Lighting and electrical services: Each
Center shall be adequately lighted with appropriate lighting for examination in
the birth room(s).
1. An emergency source of
electrical light shall be available for the protection of mothers and families
in the event the normal electrical power is interrupted.
2. All electrical and other equipment used in
the Center shall be maintained free of defects which could be a potential
hazard to mother/newborns, their families and staff.
I. An elevator shall be provided where care
is provided at different floor levels. The cab size of the elevator shall be
large enough to accommodate a stretcher, an attendant and such equipment as may
be needed.
8.8.3
Equipment
A. Each Center shall be equipped
with those items needed to provide low-risk maternity care and shall include
equipment to initiate emergency procedures in life threatening events to mother
and newborn. Such equipment shall include no less than:
1. Oxygen and positive pressure
masks;
2. DeLee trap suction and
infant laryngoscope and airways;
3.
IV equipment;
4. Blood
expanders;
5. Medications
identified in protocols for emergency needs;
6. Infant transport equipment and infant
warmers.
B. In addition,
the Center shall be equipped with standard equipment which includes no less
than:
1. Equipment for standard
screening;
2. Laboratory tests;
and
3. Sterilization of
instruments.
8.8.4 Plumbing
All plumbing material and plumbing systems or parts thereof
installed shall meet the minimum requirements of R.I. Gen. Laws Chapter
23-27.3.
8.8.5 Water Supply
Water shall be obtained from an approved water system and
shall be distributed to conveniently located taps and fixtures throughout the
facility and shall be adequate in volume and pressure for all Center purposes,
including fire safety in accordance with R.I. Gen. Laws Chapter 23-27.3.
8.8.6 Waste Disposal
Waste disposal methods shall be provided that are
acceptable to the Department.