TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER b: HOSPITALS AND AMBULATORY CARE FACILITIES
PART 265 BIRTH CENTER DEMONSTRATION PROGRAM CODE
SECTION 265.2750 BIRTH UNIT REQUIREMENTS
Section 265.2750 Birth Unit Requirements
A minimum of one centrally located nurse station shall be provided for the birth unit. The number of birth rooms shall be provided as determined by the program narrative, but shall not exceed 10 beds.
b) Client Rooms
1) Antepartum testing rooms for prospective mothers presenting with false or suspected false labor and requiring monitoring shall be provided based on the program narrative and located as close to the nurse station as possible.
A) Antepartum testing rooms shall be a single client room and shall have a minimum area of 120 square feet (11.15 square meters).
B) Each antepartum testing room shall be equipped with a hand- washing station.
2) Birth rooms. Delivery procedures in accordance with birth concepts not requiring surgical incisions may be performed in the birth rooms. The maximum number of beds per room is one, exclusive of bassinet. Rooming-in care of newborn infants is permissible under this Part.
The birth rooms shall be clustered in groups, shall be located out of the path of unrelated traffic, and shall be under direct supervision of the nurse station. The birth room will serve as labor, delivery and recovery room. The birth rooms should also be located in an area adjacent to the respite nursery (if provided).
B) Space Requirements
Birth rooms shall be adequate and appropriate to provide for equipment, staff, supplies and emergency procedures required for the physical and emotional care of a maternal client, her support person and the newborn during labor, birth and the recovery period.
Birth rooms shall have an outside window. The window is not required to be operable.
D) Hand-washing Sinks
Each birth room shall be equipped with a hand-washing sink with hands-free operation acceptable for scrubbing. Hand-washing sinks shall be large enough and with an integral drain board and deep sink for infant bathing when not in use for hand washing.
i) Each bathroom shall have direct access or be adjacent to a toilet room containing a toilet and lavatory.
ii) A bathtub or shower shall be available for client use and may include a large tub used for hydrotherapy for labor.
F) Floor, Wall, and Ceiling Finishes
All finishes shall be kept clean and shall be of the type that is appropriate for the cleaning methods and solutions required to maintain a clean and safe environment.
Lighting shall be provided to accommodate the needs of the client and delivery team, during labor, during a delivery, and postpartum, and to permit the examination and treatment of the infant in the infant resuscitation area.
3) Respite Nurseries (if provided)
A respite nursery may be provided to allow for the rest of the mother when requested. The nursery shall be located and accessible from the nurse station and shall meet the criteria established for newborn nurseries contained in Section 184.108.40.206.6 of the AIA Guidelines for Design and Construction of Health Care Facilities.
c) Support Areas – General
The size and location of each support area shall depend on the numbers and types of modalities served. The following support areas shall be readily available in each birth center when required by the program narrative. Identifiable spaces are required for each of the indicated functions.
d) Support Areas for Birth Rooms
1) Nurse Station
A) The area shall have direct visual access to the entrance to the birth unit, the antepartum testing rooms, and the nursery (if provided).
B) Nurse Station Requirements. Nurse stations:
i) Shall have space for counters and storage;
ii) Shall have convenient access to the hand-washing station; and
iii) May be combined with or include centers for reception and communications.
2) Documentation Area
Charting facilities shall have a linear surface space to ensure that staff and physicians can chart and have simultaneous access to information and communication systems.
3) Hand-washing Stations
A) Hand-washing stations shall be conveniently accessible to the nurse station, medication station, and nourishment area.
B) One hand-washing station shall be permitted to serve several areas.
4) Medication Station
Appropriate provisions shall be made for the distribution of medications.
5) Nourishment Area
A) A nourishment area shall have a sink, work counter, refrigerator, microwave, storage cabinets, and equipment for hot and cold nourishment. This area shall include space for trays and dishes used for nonscheduled meal service.
B) Hand-washing stations shall be in or immediately accessible to the nourishment area.
6) Ice Machines
Each nurse station shall have equipment to provide ice for treatments and nourishment.
A) Ice-making equipment may be in the clean workroom or the nourishment room.
B) Ice intended for human consumption shall be provided in the nourishment station and shall be served from self-dispensing ice makers.
7) Clean Workroom or Clean Supply Room
Such rooms shall be separate from and have no direct connection with soiled workrooms or soiled holding rooms. If the clean workroom is used for preparing client care items, it shall contain a work counter, a hand-washing station, and storage facilities for clean and sterile supplies.
8) Soiled Workroom or Soiled Holding Room
Such rooms shall be separate from and have no direct connection with clean work rooms or clean supply rooms and shall contain the following:
A) A clinical sink (or equivalent flushing rim fixture) and a hand-washing sink. Both fixtures shall have a hot and cold mixing faucet; and
B) A work counter and space for separate covered containers for soiled linen and a variety of waste types.
9) Housekeeping Rooms
A housekeeping room shall be provided at the ratio of one housekeeping closet per 10 birth rooms. The room shall:
A) Contain a service sink or floor receptor;
B) Have space for storage of supplies, housekeeping equipment, and housekeeping carts; and
C) Be well ventilated and have negative air pressure relationship to adjacent areas.
e) Support Areas for Staff
1) Staff Toilet Rooms
Toilet rooms for staff and visitors shall be conveniently located in the birth unit. Client toilet rooms cannot satisfy this requirement.
2) Staff Storage Locations
Securable lockers, closets, and cabinet compartments for the personal articles of staff shall be located in or near the nurse station.
f) Support Areas for Clients
1) Client and Family Research Library and Consultation Room (if provided)
A) This room shall be located in the general public access areas, but shall be capable of providing access to the client areas.
B) The room shall be equipped with tables, computer terminal and access ports, and library stacks for family and client research, and study carrels. Spaces for group seating for family and staff consultation shall also be provided. This room may be equipped with a private consultation room for client and family privacy.
2) Training/Conference Room (if provided)
A) This room is to be used for meetings, conferences, and Lamaze training classes.
B) The room shall be equipped with storage closets for chairs, tables, mats, exercise equipment and supplies as required by the program narrative.
g) Linen Services
Each birth center shall provide for storing and processing of clean and soiled linen for appropriate client care. Processing may be done within the center, in a separate building on or off site, or in a commercial or shared laundry.
h) Waste Management
1) Space and facilities shall be provided for the sanitary storage and collection of waste.
2) Waste disposal shall be separated from the clean supplies and receiving.
i) Engineering Services and Maintenance
Sufficient space shall be included in all mechanical and electrical equipment rooms for proper maintenance of equipment. Provisions shall also be made for removal and replacement of equipment. The following shall be provided:
1) Equipment Locations
Rooms shall be provided for boilers, mechanical, and electrical equipment.
2) Outdoor Equipment and Supply Storage (if necessary)
A) Supply Storage
Storage for solvents and flammable liquids shall comply with NFPA 30.
B) Outdoor Equipment Storage (if required)
Yard equipment and supply storage areas shall be provided. These shall be located so that equipment may be moved directly to the exterior without interference with other work.
j) Administrative and Public Areas
An entrance at grade level, sheltered from inclement weather, and accessible to handicapped persons (in accordance with the Illinois Accessibility Code) shall be provided.
k) Construction Standards
1) Building Codes. Administrative and public areas in this Section shall be permitted to comply with the business occupancy provisions of the Life Safety Code (NFPA 101) if they are separated from the client care portion of the birth center by a one-hour fire rated barrier.
2) Medical Gas. All medical and/or compressed gases shall be stored in accordance with NFPA 99.