(a)

1. (1) Normal newborn infants shall be housed in nurseries that comply with the standards below.

2. (2) All nurseries other than pediatric nurseries shall be convenient to the:

   1. (A) Postpartum nursing unit; and
   2. (B) Obstetrical facilities.
3. (3) The nurseries shall be located and arranged to preclude the need for nonrelated pedestrian traffic.
4. (4) No nursery shall open directly into another nursery.
5. (5) There should be one (1) breastfeeding/pumping room readily available for mothers of NICU babies to pump breastmilk.

(b) General. Each nursery shall contain the following:

1. (1) At least one (1) lavatory, equipped with hands-free handwashing station, for every eight (8) infant stations;

2. (2) Glazed observation windows to permit the viewing of infants from:

   1. (A) Public areas;
   2. (B) Workrooms; and
   3. (C) Adjacent nurseries;
3. (3) Convenient, accessible storage for linens and infant supplies at each nursery room;

4. (4)

   1. (A) A consultation/demonstration/breastfeeding or pump room shall be provided convenient to the nursery.
   2. (B) Provision shall be made, either within the room or conveniently located nearby, for:

(i) Sink;

1. (ii) Counter;

   1. (iii) Refrigeration and freezing;

      1. (iv) Storage for pump and attachments; and
      2. (v) Educational materials.
   2. (C) The area provided for the unit for these purposes, when conveniently located, may be shared;
2. (5) Enough space shall be provided for parents to stay twenty-four (24) hours;

3. (6)

   1. (A) An airborne infection isolation room is required in or near at least one (1) level of nursery care.
   2. (B) The room shall be enclosed and separated from the nursery unit with provisions for observation of the infant from adjacent nurseries or control area or areas.

   3. (C) All airborne infection isolation rooms shall comply with the requirements of 20 CAR § 43-143(d), physical facilities — patient accommodations — adult medical, surgical — communicable or pulmonary disease except for separate:

      1. (i) Toilet;
      2. (ii) Bathtub; or
      3. (iii) Shower;

4. (7)

   1. (A) Workroom or workrooms.
   2. (B) Each nursery room shall be served by a connecting workroom.

   3. (C) The workroom shall contain:

      1. (i) Scrubbing and gowning facilities at the entrance for staff and housekeeping personnel;
      2. (ii) Work counter;
      3. (iii) Refrigerator;
      4. (iv) Storage for supplies; and
      5. (v) A hands-free handwashing fixture.
   4. (D) One (1) workroom may serve more than one (1) nursery room provided that required services are convenient to each.
   5. (E) The workroom serving the full-term and continuing care nurseries may be omitted if equivalent work and storage areas and facilities, including those for scrubbing and gowning, are provided within that nursery.
   6. (F) Space required for work areas located within the nursery is in addition to the area required for infant care.

   7. (G)

      1. (i) Adequate provision shall be made for:

(b) (b) The sanitary storage and disposal of soiled waste.

1. (ii) When the functional program includes a mother-baby couplet approach to nursing care, the workroom functions described above may be incorporated in the nurses’ station that serves the postpartum patient rooms.

   1. (iii) Neonate examination and treatment areas. Such areas, when required by the functional program, shall contain:

(b) (b) Storage facilities; and

1. (c) (c) A hands-free handwashing station.

   1. (iv) Neonate formula facilities.

(b) (b) The room may be located near the nursery or at other appropriate locations in the hospital, but shall include:

1. (1)

   1. (A) (1)(A) Cleanup facilities for washing and sterilizing supplies.

   2. (B) (B) This area shall include:

      1. (i) (i) A handwashing station;
      2. (ii) (ii) Facilities for bottle washing;
      3. (iii) (iii) A work counter; and
      4. (iv) (iv) Sterilization equipment;

2. (2)

   1. (A) (2)(A) Separate room for preparing infant formula.

   2. (B) (B) This room shall contain:

      1. (i) (i) Warming facilities;
      2. (ii) (ii) Refrigerator;
      3. (iii) (iii) Work counter;
      4. (iv) (iv) Formula sterilizer;
      5. (v) (v) Storage facilities; and
      6. (vi) (vi) A handwashing station; and
3. (3) (3) Refrigerated storage and warming facilities for infant formula accessible for use by nursery personnel at all times;

4. (8)

   1. (A) Commercial neonate formula.
   2. (B) If a commercial infant formula is used, the separate cleanup and preparation rooms may be omitted.

   3. (C) The storage and handling may be done in:

      1. (i) The nursery workroom; or
      2. (ii) Another appropriate room in the hospital that is conveniently accessible at all hours.

   4. (D) The preparation area shall have:

      1. (i) A work counter;
      2. (ii) A handwashing station; and
      3. (iii) Storage facilities;

5. (9)

   1. (A) Housekeeping/environmental services room.
   2. (B) A housekeeping/environmental services room shall be provided for the exclusive use of the nursery unit.

   3. (C) It shall:

      1. (i) Be directly accessible from the unit;
      2. (ii) Contain a service sink or floor receptor; and
      3. (iii) Provide for storage of supplies and housekeeping equipment; and

6. (10)

   1. (A) Charting space.

   2. (B) Charting facilities shall have linear surface space to ensure that staff and physicians may chart and have simultaneous access to information and communication systems.

      1. (c) Newborn nursery.

7. (1)

   1. (A) Each newborn nursery room shall contain no more than sixteen (16) stations.
   2. (B) The minimum floor areas shall be twenty-four square feet (24 sq. ft.) per bassinet, exclusive of auxiliary work areas.
   3. (C) When a rooming-in program is used, the total number of bassinets provided in these units may be appropriately reduced, but the newborn nursery shall not be omitted in its entirety from any facility that includes delivery services.
   4. (D) When facilities use a rooming-in program in which all infants are returned to the nursery at night, a reduction in nursery size may not be practical.

8. (2)

   1. (A) Baby-holding nurseries may replace traditional nurseries with baby-holding nurseries in postpartum and labor-delivery-recovery-postpartum units.
   2. (B) The minimum floor area per bassinet, ventilation, electrical, and medical vacuum and gases shall be the same as that required for a full-term nursery.
   3. (C) These holding nurseries should be next to the nurses’ station on these units.

   4. (D) The holding nursery shall be sized to accommodate the percentage of newborns who do not remain with their mothers during the postpartum stay.

      1. (d) Continuing care nursery. For hospitals that provide continuing care for infants requiring close observation (for example, low birthweight babies who are not ill but require more hours of nursing than do normal neonates), the minimum floor space shall be fifty square feet (50 sq. ft.) per bassinet, exclusive of auxiliary work areas, with provisions for at least four feet (4’) between and at all sides of each bassinet.

(e) Pediatric nursery.

1. (1)

   1. (A) To minimize the possibility of cross-infection, each nursery room serving pediatric patients shall contain no more than eight (8) bassinets.
   2. (B) Each bassinet shall have a minimum clear floor area of forty square feet (40 sq. ft.).

2. (2) Each room shall contain:

   1. (A) A lavatory equipped for hands-free handwashing;
   2. (B) A nurses’ emergency calling system; and
   3. (C) A glazed viewing window for observing infants from public areas and workrooms.
3. (3) Limitation on number of patients in a nursery room does not apply to the pediatric critical care unit.