Birth Unit Requirements

Section 264.2750  Birth Unit Requirements a)         Size A minimum of one centrally-located nurses’ 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)         Birth rooms.  Delivery procedures shall be performed in the birth rooms. The maximum number of beds per room is one, exclusive of bassinet. This room may also serve as a prenatal/antepartum testing room. Rooming-in care of newborn infants is permissible under this Part. A)        Location 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 clinical staff. 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, their support person and the newborn during labor, birth, and the recovery period. C)        Windows 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 should include accessibility standards (See Section 264.2600(c)(5)) for knee clearance and countertop height. Hand-washing sinks shall be large and deep enough for infant bathing when not in use for hand washing. E)        Bathrooms i)          Each birth room shall have direct access or be adjacent to a toilet room containing a toilet and lavatory. These bathrooms shall meet the accessibility codes per Section 264.2600(c)(5). 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. G)        Lighting Lighting shall be provided to accommodate the needs of the client and delivery team during labor, delivery, and postpartum, and to permit the examination and treatment of the infant in the infant resuscitation area. 2)         If the birth room in subsection (b)(1) is not utilized as an antepartum testing room, the birth center shall provide a separate antepartum testing room for pregnant persons presenting with false or suspected false labor and requiring monitoring.  These shall be provided based on the program narrative and located as close to the nurses’ station as possible. A)        Antepartum testing rooms must be a single client room and must have a minimum area of 120 square feet (11.15 square meters). B)        Each antepartum testing room must be equipped with a hand-washing station. 3)         Respite Nurseries (if provided) A respite nursery may be provided to allow for the rest of the pregnant or postpartum person when requested. The nursery must be located near and accessible from the nurse station and shall meet the criteria established for newborn nurseries contained in Section 2.1.3.6.6 of the AIA Guidelines for Design and Construction of Health Care Facilities. 4)         Family Overnight Stay Rooms (if provided) Family overnight stay rooms must be located in an area outside of the birth unit and clustered around a common living/dining/nourishment preparation room.  They must include the following: A)        An outside window. B)        A toilet room for the exclusive use of the overnight stay room, equipped with a toilet, closet, hand-washing station, and shower. C)        A storage room for clean linens and supplies within the overnight stay room area. D)        A storage room for holding soiled supplies within the overnight stay room area. E)        A janitor closet with slop sink and storage for cleaning supplies and cart within the overnight stay room area. c)         Support Areas – General The size and location of each support area shall depend on its use. The following support areas shall be available in each birth center when included in 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 Stations i)          Nurse stations must have adequate space for counters and storage and be located near the hand-washing station. ii)         Nurse stations may be combined with reception areas. 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 easily 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 must 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 Dispenser Each birth center shall provide ice for treatments and nourishment.  A refrigerator with  self-dispensing ice is acceptable. 7)         Clean Workroom or Clean Supply Room Such rooms must be separate from and have no direct connection with soiled workrooms or soiled holding rooms and contain storage space for clean and sterile supplies. If the clean workroom is used for preparing client care items, it shall also contain a work counter and a hand-washing station. 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 (that is either a deep bowel free-standing wash basin 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 must be provided and meet the following requirements: A)        Contain a service sink; B)        Include storage space for supplies, housekeeping equipment, and housekeeping carts; and C)        Be well-ventilated and have a negative air pressure relationship to adjacent areas. e)         Support Areas for Staff 1)         Staff Toilet Rooms Toilet rooms designated for staff and visitors only must be conveniently located in the birth unit. 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 must be in the public access areas but also accessible to the client areas. B)        The room must 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) This room is to be used for meetings, conferences, and childbirth educational training classes. 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 All mechanical and electrical equipment rooms must include sufficient space for proper maintenance, 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 must be located so that equipment may be moved directly to the exterior without interference with other work. j)          Administrative and Public Areas The birth center must provide an entrance at grade level, sheltered from inclement weather, and accessible to disabled persons (in accordance with the Illinois Accessibility Code). 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.