Proposed Text
12VAC5-410-442. Obstetric service design and equipment criteria.
A. Renovation or construction of a hospital's obstetric unit
shall be consistent with (i) section 2.1‑4 2.2‑2.11
of Part 2 of the 2006 2014 Guidelines for Design and Construction
of Health Care Hospitals and Outpatient Facilities of the American
Facility Guidelines Institute of Architects pursuant to §
32.1-127.001 of the Code of Virginia and (ii) the Virginia Uniform Statewide
Building Code (13VAC5-63).
B. Delivery rooms, LDR/LDRP; labor, delivery, and
recovery (LDR) rooms; labor, delivery, recovery, and postpartum (LDRP)
rooms,; and nurseries shall be equipped to provide emergency
resuscitation for mothers and infants.
C. Equipment and supplies shall be assigned for exclusive use in the obstetric and newborn units.
D. The same equipment and supplies required for the labor room and delivery room shall be available for use in the LDR/LDRP rooms during periods of labor, delivery, and recovery.
E. Sterilizing equipment shall be available in the obstetric unit or in a central sterilizing department. Flash sterilizing equipment or sterile supplies and instruments shall be provided in the obstetric unit.
F. Daily monitoring is required of the stock of necessary
equipment in the labor, delivery, and recovery LDR rooms (LDR)
and labor, delivery, recovery and postpartum (LDRP) LDRP rooms
and nursery.
G. The hospital shall provide the following equipment in the labor, delivery and recovery rooms and, except where noted, in the LDR/LDRP rooms:
1. Labor rooms.
a. A labor or birthing bed with adjustable side rails.
b. Adjustable lighting adequate for the examination of patients.
c. An emergency signal and intercommunication system.
d. A sphygmomanometer, stethoscope and fetoscope or doppler.
e. Fetal monitoring equipment with internal and external attachments.
f. Mechanical infusion equipment.
g. Wall-mounted oxygen and suction outlets.
h. Storage equipment.
i. Sterile equipment for emergency delivery to include at least one clamp and suction bulb.
j. Neonatal resuscitation cart.
2. Delivery rooms.
a. A delivery room table that allows variation in positions for delivery. This equipment is not required for the LDR/LDRP rooms.
b. Adequate lighting for vaginal deliveries or cesarean deliveries.
c. Sterile instruments, equipment, and supplies to include sterile uterine packs for vaginal deliveries or cesarean deliveries, episiotomies or laceration repairs, postpartum sterilizations and cesarean hysterectomies.
d. Continuous in-wall oxygen source and suction outlets for both mother and infant.
e. Equipment for inhalation and regional anesthesia. This equipment is not required for LDR/LDRP rooms.
f. A heated, temperature-controlled infant examination and resuscitation unit.
g. An emergency call system.
h. Plastic pharyngeal airways, adult and newborn sizes.
i. Laryngoscope and endotracheal tubes, adult and newborn sizes.
j. A self-inflating bag with manometer and adult and newborn masks that can deliver 100% oxygen.
k. Separate cardiopulmonary crash carts for mothers and infants.
l. Sphygmomanometer.
m. Cardiac monitor. This equipment is not required for the LDR/LDRP rooms.
n. Gavage tubes.
o. Umbilical vessel catheterization trays. This equipment is not required for LDR/LDRP rooms.
p. Equipment that provides a source of continuous suction for aspiration of the pharynx and stomach.
q. Stethoscope.
r. Fetoscope.
s. Intravenous solutions and equipment.
t. Wall clock with a second hand.
u. Heated bassinets equipped with oxygen and transport incubator.
v. Neonatal resuscitation cart.
3. Recovery rooms.
a. Beds with side rails.
b. Adequate lighting.
c. Bedside stands, overbed tables, or fixed shelving.
d. An emergency call signal.
e. Equipment necessary for a complete physical examination.
f. Accessible oxygen and suction equipment.
12VAC5-410-445. Newborn service design and equipment criteria.
A. Construction and or renovation of a
hospital's nursery shall be consistent with sections 2.22.12.1 through
2.22.12.6.6 (i) section 2.2‑2.12 of Part 2 of the 2010
2014 Guidelines for Design and Construction of Health Care Hospitals
and Outpatient Facilities of the Facilities Facility
Guidelines Institute (formerly of the American Institute of Architects) pursuant
to § 32.1-127.001 of the Code of Virginia and (ii) the Virginia Uniform
Statewide Building Code (13VAC5-63). Hospitals with higher-level nurseries
shall comply with sections 2.22.10.1 through 2.210.9.3 section 2.2‑2.10
of Part 2 of the 2010 guideline 2014 edition of the guidelines as
applicable.
B. The hospital shall provide the following equipment in the general level nursery and all higher level nurseries, unless additional equipment requirements are imposed for the higher level nurseries:
1. Resuscitation equipment as specified for the delivery room in 12VAC5-410-442 G 2 shall be available in the nursery at all times;
2. Equipment for the delivery of 100% oxygen concentration, properly heated, blended, and humidified, with the ability to measure oxygen delivery in fractional inspired concentration (FI02). The oxygen analyzer shall be calibrated every eight hours and serviced according to the manufacturer's recommendations by a member of the hospital's respiratory therapy department or other responsible personnel trained to perform the task;
3. Saturation monitor (pulse oximeter or equivalent);
4. Equipment for monitoring blood glucose;
5. Infant scales;
6. Intravenous therapy equipment;
7. Equipment and supplies for the insertion of umbilical arterial and venous catheters;
8. Open bassinets, self-contained incubators, open radiant heat infant care system or any combination thereof appropriate to the service level;
9. Equipment for stabilization of a sick infant prior to transfer that includes a radiant heat source capable of maintaining an infant's body temperature at 99°F;
10. Equipment for insertion of a thoracotomy tube; and
11. Equipment for proper administration and maintenance of phototherapy.
C. The additional equipment required for the intermediate level newborn service and for any higher service level is:
1. Pediatric infusion pumps accurate to plus or minus 1 milliliter (ml) per hour;
2. On-site supply of PgE1;
3. Equipment for 24-hour cardiorespiratory monitoring for neonatal use available for every incubator or radiant warmer;
4. Saturation monitor (pulse oximeter or equivalent) available for every infant given supplemental oxygen;
5. Portable x-ray machine; and
6. If a mechanical ventilator is selected to provide assisted ventilation prior to transport, it shall be approved for the use of neonates.
D. The additional equipment required for the specialty level newborn service and a higher newborn service is as follows:
1. Equipment for 24-hour cardiorespiratory monitoring with central blood pressure capability for each neonate with an arterial line;
2. Equipment necessary for ongoing assisted ventilation
approved for neonatal use with on-line online capabilities for
monitoring airway pressure and ventilation performance;
3. Equipment and supplies necessary for insertion and maintenance of chest tube for drainage;
4. On-site supply of surfactant;
5. Computed axial tomography equipment (CAT) or magnetic resonance imaging equipment (MRI);
6. Equipment necessary for initiation and maintenance of continuous positive airway pressure (CPAP) with ability to constantly measure delineated pressures and including alarm for abnormal pressure (i.e., vent with PAP mode); and
7. Cardioversion unit with appropriate neonatal paddles and ability to deliver appropriate small watt discharges.
E. The hospital shall document that it has the appropriate equipment necessary for any of the neonatal surgical and special procedures it provides that are specified in its medical protocol and that are required for the specialty level newborn service.
F. The additional equipment requirements for the subspecialty level newborn service are:
1. Equipment for emergency gastrointestinal, genitourinary, central nervous system, and sonographic studies available 24 hours a day;
2. Pediatric cardiac catheterization equipment;
3. Portable echocardiography equipment; and
4. Computed axial tomography equipment (CAT) and magnetic resonance imaging equipment (MRI).
G. The hospital shall document that it has the appropriate equipment necessary for any of the neonatal surgical and special procedures it provides that are specified in the medical protocol and are required for the subspecialty level newborn service.
Part III
Standards and Design Criteria for New Buildings and Additions, Alterations and
Conversion of Existing Buildings
12VAC5-410-650. General building and physical plant information.
A. All construction of new buildings and additions,
renovations, alterations or repairs of existing buildings for occupancy as a
hospital shall conform to state and local codes, zoning and building
ordinances, and the Virginia Uniform Statewide Building Code (13VAC5-63).
In addition, hospitals shall be designed and constructed according
to consistent with Part 1 and sections 2.11 through 2.28 of
Part 2 of the 2010 2014 Guidelines for Design and Construction of
Health Care Hospitals and Outpatient Facilities of the Facilities
Facility Guidelines Institute (formerly of the American Institute of
Architects). However, the requirements of the Uniform Statewide Building Code
and local zoning and building ordinances shall take precedence pursuant
to § 32.1-127.001 of the Code of Virginia.
B. All buildings shall be inspected and approved as
required by the appropriate building regulatory entity. Approval shall be a
Certificate of Use and Occupancy indicating the building is classified for its
proposed licensed purpose. Architectural drawings and specifications for
all new construction or for additions, alterations, or renovations to any
existing building shall be dated, stamped with professional seal, and signed by
the architect. The architect shall certify that the drawings and specifications
were prepared to conform to the Virginia Uniform Statewide Building Code
(13VAC5-63) and be consistent with Part 1 and Part 2 of the 2014 Guidelines for
Design and Construction of Hospitals and Outpatient Facilities of the Facility
Guidelines Institute. The certification shall be forwarded to the OLC.
12VAC5-410-760. Long-term care nursing units.
Construction and renovation of long-term care nursing units,
including intermediate and skilled nursing care nursing units, shall conform
to be designed and constructed consistent with section 2.13.9
2.2‑2.15 of Part 2 of the 2006 2014 Guidelines for
Design and Construction of Health Care Hospitals and Outpatient
Facilities of the American Facility Guidelines Institute of
Architects pursuant to § 32.1-127.001 of the Code of Virginia.
Architectural drawings and specifications for all new construction or for additions, alterations, or renovations to any existing building shall be dated, stamped with professional seal, and signed by the architect. The architect shall certify that the drawings and specifications were prepared to conform to the Virginia Uniform Statewide Building Code (13VAC5-63) and be consistent with section 2.2‑2.15 of Part 2 of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facility Guidelines Institute. The certification shall be forwarded to the OLC.
Part V
Design Standards for New Outpatient Surgical Hospitals and Additions and
Alterations to Existing Outpatient Surgical Hospitals
Article 1
General Considerations
12VAC5-410-1350. Codes; fire safety; zoning; construction
Local and state codes and standards.
A. All construction of new buildings and additions alterations
or repairs to existing buildings for occupancy as a "free-standing"
outpatient hospital shall conform to state and local codes, zoning and
building ordinances, and the Statewide Virginia Uniform Statewide
Building Code (13VAC5-63).
In addition, hospitals shall be designed and constructed according
to consistent with Part 1 and sections 3.1-1 through 3.1-8 3.1
and 3.7 of Part 3 of the 2010 2014 Guidelines for Design and
Construction of Health Care Hospitals and Outpatient Facilities
of the Facilities Facility Guidelines Institute (formerly of
the American Institute of Architects). However, the requirements of the Uniform
Statewide Building Code and local zoning and building ordinances shall take precedence
pursuant to § 32.1-127.001 of the Code of Virginia.
Architectural drawings and specifications for all new construction or for additions, alterations, or renovations to any existing building shall be dated, stamped with professional seal, and signed by the architect. The architect shall certify that the drawings and specifications were prepared to conform to the Virginia Uniform Statewide Building Code (13VAC5-63) and be consistent with Part 1 and sections 3.1 and 3.7 of Part 3 of the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities of the Facility Guidelines Institute. The certification shall be forwarded to the OLC.
B. All buildings shall be inspected and approved as
required by the appropriate building regulatory entity. Approval shall be a
Certificate of Use and Occupancy indicating the building is classified for its
proposed licensed purpose.
C. B. The use of an incinerator shall require
permitting from the nearest regional office of the Department of Environmental
Quality.
D. C. Water shall be obtained from an approved
water supply system. Outpatient surgery centers shall be connected to sewage
systems approved by the Department of Health or the Department of Environmental
Quality.
E. D. Each outpatient surgery center shall
establish a monitoring program for the internal enforcement of all applicable
fire and safety laws and regulations.
F E. All radiological machines shall be
registered with the Office of Radiological Health of the Virginia Department of
Health. Installation, calibration and testing of machines and storage
facilities shall comply with 12VAC5-480 12VAC5-481, Virginia
Radiation Protection Regulations.
G. F. Pharmacy services shall comply with
Chapter 33 (§ 54.1-3300 et seq.) of Title 54.1 of the Code of Virginia and
18VAC110-20, Regulations Governing the Practice of Pharmacy.
DOCUMENTS INCORPORATED BY REFERENCE (12VAC5-410)
Guidelines for Design and Construction of Health Care Hospitals
and Outpatient Facilities, 2014 Edition, Facilities Facility
Guidelines Institute (formerly of the American Institute of Architects),
Washington, D.C., 2010 Edition, http://www.fgiguidelines.org