Current through all regulations passed and filed through September 16, 2024
(A) This rule shall not be construed to
require any maternity unit licensed on or before March 20, 1997, to alter,
upgrade, or otherwise improve the structure or fixtures of the maternity unit
in order to comply with the requirements of this rule, unless one of the
following applies:
(1) The maternity unit
initiates or has, after March 20, 1997, initiated a construction, renovation,
or a reconstruction project that involves a capital expenditure of at least
five
hundred thousand dollars, not including expenditures for equipment or
staffing or operational costs, and that directly involves the area in which the
existing maternity unit is located;
(2) The maternity unit initiates or has,
after March 20, 1997, initiated a service level designation change under rule
3701-7-07 of the Administrative
Code as it existed prior to the effective date of this
rule, or prior Chapter 3701-84 of the Administrative Code;
(3)
On or after the
effective date of this rule, the maternity unit or newborn care nursery
initiates a change of the unit's level classification for which it is licensed;
or
(4) The director determines or has determined, by
clear and convincing evidence, that failure to comply would create an imminent
risk to the health and welfare of any patient.
(B) Each maternity unit, newborn care
nursery, or maternity home shall ensure that the building or structure where
the maternity unit, newborn care nursery, or maternity home is located:
(1) Has a certificate of use from a local,
certified building department or from the Ohio department of commerce as
meeting applicable requirements of Chapters 3781. and 3791. of the Revised Code
and
the
rules adopted thereunder;
(2)
Complies with the state fire code; and
(3) Complies with the applicable provisions
of Chapter 3737. of the Revised Code and the rules adopted under it.
(C) The maternity unit, newborn
care nursery, or maternity home shall develop and follow a disaster
preparedness plan including evacuation in the event of a fire. Evacuation
procedures shall be reviewed at least annually, and practice drills shall be
conducted quarterly on each shift.
(D) The maternity unit, newborn care nursery,
or maternity home shall develop and follow policies for ensuring the safety and
security of all patients, including infant security drills for locating missing
newborns. The policies shall be reviewed at least annually, and practice infant
security drills shall be conducted on each shift at least once every six
months.
(E) Each maternity unit,
newborn care nursery, or maternity home shall label, store and dispose all
poisons, hazardous wastes and flammable materials in a safe manner that does
not jeopardize patient or resident health or safety, and in accordance with
state and federal laws and regulations.
(F) Minimum space or square footage
requirements specified in this chapter are of clear floor space and exclusive
of fixed or wall mounted cabinets, desks, wardrobes, and closets that are floor
based.
(G) Each maternity unit
constructed on or after
January 1, 2012, that utilizes
separate antepartum areas shall provide space for the provision of services and
shall provide:
(1) Single occupancy rooms with
a minimum of one hundred twenty square feet of open floor space. Each room
shall provide space for the mother and a support person;
(2) A private toilet and shower or tub for
each room; and
(3) Two medical gas,
medical air, and vacuum outlets available in each room.
(H) Each maternity unit's
labor-delivery-recovery or labor-delivery-recovery-postpartum area shall
provide space for the provision of services and the following:
(1) Single occupancy rooms with a minimum of
two hundred fifty square feet of open floor space and a minimum room width or
length of thirteen feet. Each room shall provide space for the mother, newborn
and a support person;
(2) A private
toilet and shower or tub for each room;
(3) A distinct area within the room for
newborn resuscitation and stabilization. The distinct area shall be equipped
with one medical gas, medical air, and vacuum outlet available to each mother
and one medical gas, medical air, and vacuum outlet available to each
newborn;
(4) A minimum of six total
air changes per hour with the ability to provide fifteen air changes per hour
during the performance of a cesarean delivery where that room is designated as
such. Maternity units constructed on or after
January 1,
2012, shall provide a minimum of six total air changes per hour with the
ability to provide twenty air changes per hour during the performance of a
cesarean delivery where that room is designated as such; and
(5) Immediately accessible examination
lights.
(I) Each
maternity unit that utilizes separate labor rooms shall provide space for the
provision of services and shall provide:
(1) A
minimum area of one hundred square feet per bed. Each maternity unit
constructed on or after
January 1, 2012, shall have private
occupancy labor rooms. Maternity units constructed on or after
January 1, 2012, shall provide a minimum area of
two hundred square feet per bed;
(2) One medical gas, one medical air and one
vacuum outlet accessible to each mother's bed; and
(3) A minimum of two total air changes per
hour with the ability to provide twenty air changes per hour during the
performance of a cesarean delivery where that room is designated as such.
Maternity units constructed on or after
January 1,
2012,shall provide a minimum of six total air changes per hour with the
ability to provide twenty air changes per hour during the performance of a
cesarean delivery where that room is designated as such.
(J) Each maternity unit that utilizes
separate recovery rooms shall provide space for the provision of services and
shall provide:
(1) A minimum of two recovery
room beds;
(2) Space for the
newborn, mother and support person; and
(3) A minimum of six total air changes per
hour per recovery room.
(K) Each maternity unit that utilizes
separate postpartum areas shall provide space for the provision of services and
shall provide:
(1) A minimum of one hundred
square feet of clear floor space per bed in semiprivate rooms and one hundred
and twenty square feet of clear floor space in private rooms. Postpartum rooms
existing on or before March 20,1997 shall provide at least eighty square feet
of clear space per bed in semiprivate rooms and one hundred square feet in
private rooms; and
(2) Patient
access to a bathroom with toilet and shower or tub, without entering the main
corridor. Bathrooms in postpartum rooms existing before
January 1, 2012, may serve no more than two
postpartum beds. Postpartum rooms constructed on or after
January 1, 2012, shall have one bathroom with
toilet and shower or tub for each patient in that room.
(L) Each maternity unit shall provide at
least one cesarean delivery room in every obstetrical area. Each cesarean
delivery room shall provide space for services and shall
provide:
(1) Cesarean delivery rooms with a
minimum of three hundred and sixty square feet of open floor space and a
minimum room width or length of sixteen feet. Any additional delivery rooms
without cesarean delivery capability shall have a minimum open floor area of
three hundred square feet;
(2)
Space for newborn resuscitation that meets one of the following:
(a) A minimum of an additional forty square
feet of open floor space within the cesarean delivery room. Cesarean delivery
rooms constructed on or after
January 1, 2012, shall provide a minimum an
additional eighty square feet of open floor space within the cesarean delivery
room; or
(b) An area of one hundred
and fifty square feet in a separate room immediately accessible to the cesarean
delivery room; and
(3) A
minimum of
fifteen air changes per hour per cesarean delivery
room.
Cesarean delivery rooms constructed on
or after January 1, 2012, shall provide a minimum of twenty air changes per
hour.
(M)
Each maternity unit shall provide the necessary equipment and supplies for the
complete care of the newborn in the location where the physiologic transition
period occurs. Equipment shall include:
(1)
Heat source equipment;
(2) Oxygen,
suction, and air outlets;
(3)
Oxygen blender available for delivery;
(4) Resuscitation equipment;
(5) Equipment necessary for physiologic
monitoring; and
(6) Transport
conveyance.
(N) Each
maternity unit shall provide at least one airborne infection isolation room in
or near
at
least one nursery. The room shall be enclosed and separated from the
nursery with the ability to observe the infant from adjacent nurseries or
control area and shall be consistent with current infection control guidelines,
issued by the United States centers for disease control and
prevention.
(O) The maternity unit
shall provide separate areas as necessary to support the services provided
including:
(1) The consultation, or
demonstration of breast feeding or breast pumping; and
(2) Family waiting.
(P) Each newborn nursery room shall provide a
floor area of twenty-four square feet for each newborn station with a minimum
of two feet between newborn stations. Maternity units providing care to
newborns requiring close observation shall conform to the requirements for the
level designation of
that
neonatal care service, and shall, at a minimum provide
a floor area of fifty square feet with a distance of four feet between and at
all sides of newborn stations. Maternity units constructed on or after
January 1, 2012, that provide care to newborns
requiring close observation shall conform to the requirements for the level
designation and classification of that newborn service and shall provide a
minimum of one hundred twenty square feet of open floor space for each newborn
station with additional space based on the acuity level of the
newborn.
(Q) Each newborn nursery
room or newborn care nursery shall conform to the requirements for the level
designation of that
neonatal
care service and provide space for procedures, equipment, and staff
functions and shall provide:
(1) Medical gas,
medical air, and vacuum outlets accessible to each newborn;
(2)
Every door
in each newborn
nursery room that exits to the main corridor is capable
of being locked;
(3) At least
one sink, capable of hands free operation, for each eight newborn
stations;
(4) Observation windows
to permit the viewing of newborns from public areas, workrooms and adjacent
nursery rooms;
(5) A system for
storage and distribution of emergency drugs and routine medications;
(6) A minimum of six total air changes per
hour in all newborn nursery rooms or newborn care units; and
(7) Lighting capable of varying from indirect
to high intensity.
(R)
Maternity units may replace newborn nursery rooms with baby holding nurseries
in postpartum and labor-delivery-recovery-postpartum areas. The holding nursery
shall meet the requirements of paragraphs (P) and (Q) of this rule.
(S) In addition to the requirements of
paragraphs (N) and (P) of this rule, each maternity unit or newborn care
nursery licensed as a
level II,
level III, or level IV neonatal care service shall provide:
(1) A group patient or open bay area with a
clearly identified entrance large enough to accommodate portable x-ray
equipment, and a reception area for families. The reception area shall permit
visual observation and contact by the staff of all individuals entering the
unit. A hand washing area shall be provided at each family entrance to the
newborn care area;
(2) At least one
door to each nursery room shall be large enough to accommodate portable x-ray
equipment;
(3) A system to provide
efficient and controlled access to the nursery from the labor and delivery
area, the emergency room, and other referral entry points as may be
applicable;
(4) Work areas, in
addition to newborn care space;
(5)
Newborn care nurseries constructed prior to January 1,
2012 shall provide:
(a)
A minimum of one hundred square feet of open floor
space for each newborn station. Additional space shall be provided based on
acuity level of the newborn; and
(b)
An aisle adjacent
to each newborn station with a minimum width of three feet to accommodate
movement through the nursery without disturbing newborn care.
(6)
Newborn care nurseries constructed on or after January 1,
2012 shall provide:
(a)
A minimum of one hundred twenty square feet of open
floor space for each newborn station with additional space based on the acuity
level of the newborn; and
(b)
An aisle adjacent to each newborn station with a
minimum width of four feet to accommodate movement through the nursery without
disturbing newborn care.
(7)
Newborn care nurseries constructed prior to January 1,
2012 shall provide
a minimum of three
medical gas, three medical air, three vacuum outlets, and seven duplex-grounded
electrical receptacles organized in an accessible and safe manner for each
newborn station,
with
fifty per cent of electrical outlets
connected to the emergency system
power and be so labeled.
(8)
Newborn care nurseries constructed on or after January
1, 2012 shall provide a minimum of three medical gas, three medical air, three
vacuum outlets, and sixteen single or duplex-grounded electrical receptacles
organized in an accessible and safe manner for each newborn station, with fifty
per cent of electrical outlets connected to the emergency system power and be
so labeled;
(9) A respiratory therapy work area and storage area
within the newborn care area or in close proximity;
(10) A transition room
that allows parents and infant extended private time together in close
proximity to the nursery. The room shall have a sink and toilet fixtures, a bed
for parents, sufficient space for an infant bed and equipment, communication
linkage with newborn intensive care nursery staff, and electric, air, vacuum,
and medical gas outlets. The transition room may be used for other purposes
when not required for use by parents and infant or infants; and
(11) Newborn care nurseries that utilize single
patient private or semi-private rooms within the nursery shall meet the
requirements of paragraphs
(S)(5) and (S)(6) of this
rule.
(T)
Equipment and technology required under this rule may be replaced by newer
technology and equipment with equivalent or superior capability. In assessing
new equipment and technology, consideration shall be given to the
recommendations of recognized professional societies and accrediting
bodies.
(U) Each maternity unit or
newborn care nursery shall provide hands-free hand washing fixtures in all
areas for staff use where patient care is provided.
(V) Each maternity unit or newborn care
nursery shall provide a system of communication that interconnects all areas in
which patient care is provided and that effectively alerts staff members of
emergencies or patient needs. Each toilet, or shower, or both, used by patients
shall have an emergency communications system capable of alerting staff of
emergencies or patient needs.
(W)
Each maternity unit or newborn care nursery shall provide appropriate safety
features including handrails, emergency power, and electrical outlets for the
services provided.
