1. (a) General.

   1. (1)

      1. (A) All electrical material and equipment including conductors, controls, and signaling devices shall be:

2. (i) Installed in compliance with and maintained per applicable sections of NFPA 70 and NFPA 99; and

   1. (ii) Listed as complying with:
3. (a) (a) Available standards of listing agencies; or

4. (b) (b) Other similar established standards where such standards are required.

   1. (B) Maintenance and testing of receptacles in patient care areas shall be performed at initial installation, replacement, or servicing of devices.

      1. (C) Records shall be maintained of all tests and rooms or areas tested, with itemized pass/fail indicators.

   2. (2)

      1. (A) The electrical installations including alarm, nurse call, and communication systems shall be tested to demonstrate that equipment installation and operation is appropriate and functional.
      2. (B) A written record of performance tests on special electrical systems and equipment shall demonstrate compliance with applicable codes and standards.

   3. (3) Shielded isolation transformers, voltage regulators, filters, surge suppressors, and other safeguards shall be provided as required where power line disturbances are likely to affect:

      1. (A) Data processing; and/or
      2. (B) Automated laboratory or diagnostic equipment.

5. (b)

   1. (1) Main switchboards shall be:

      1. (A) Located in an area separate from plumbing and mechanical equipment; and
      2. (B) Accessible to authorized persons only.

   2. (2) Switchboards shall be:

      1. (A) Convenient for use;
      2. (B) Readily accessible for maintenance;
      3. (C) Away from traffic lanes; and

      4. (D) Located in dry, ventilated spaces free of:

         1. (i) Corrosive or explosive fumes and gases; or
         2. (ii) Any flammable material.

   3. (3) Overload protective devices shall operate properly in ambient room temperatures.

      1. (c) Lighting.

   4. (1)

      1. (A) The Illuminating Engineering Society (IES) has developed recommended lighting levels for healthcare facilities.
      2. (B) The reader should refer to the IES Handbook.
   5. (2) Approaches to buildings and parking lots and all occupied spaces within buildings shall have fixtures that can be illuminated as necessary.

   6. (3)

      1. (A) Patient rooms shall have general lighting and night lighting.
      2. (B) A reading light shall be provided for each patient.
      3. (C) Reading light controls shall be readily accessible to the patient or patients.
      4. (D) Incandescent and halogen light sources that produce heat shall be avoided to prevent burns to the patient and/or bed linen.
      5. (E) The light source should be covered by a diffuser or lens.
      6. (F) Flexible light arms, if used, shall be mechanically controlled to prevent the lamp from contacting the bed linen.
      7. (G) At least one (1) night light fixture in each patient room shall be controlled at the room entrance.
      8. (H) Lighting for coronary and intensive care bed areas shall permit staff observation of the patient while minimizing glare.

   7. (4)

      1. (A) Operating and delivery rooms shall have general lighting in addition to special lighting units provided at surgical and obstetrical tables.
      2. (B) General lighting and special lighting shall be on separate circuits.
   8. (5) Nursing unit corridors shall have general illumination with provisions for reducing light levels at night.

   9. (6)

      1. (A) Light intensity for staff and patient needs should generally comply with healthcare guidelines set forth in the IES publication.
      2. (B) Consideration should be given to controlling intensity and/or wavelength to prevent harm to the patient’s eyes (i.e., retina damage to premature infants and cataracts due to ultraviolet light).
      3. (C) Many procedures are available to satisfy lighting requirements, but the design should consider light quality as well as quantity for effectiveness and efficiency.
   10. (7) An examination light shall be provided for examination, treatment, and trauma rooms.

   11. (8)

       1. (A) Light intensity of required emergency lighting shall follow IES guidelines.

       2. (B) Egress and exit lighting shall comply with NFPA 101.

          1. (d) Receptacles.

   12. (1)

       1. (A) Each operating and delivery room shall have at least six (6) receptacles convenient to the head of the procedure table.
       2. (B) Each operating room shall have at least sixteen (16) simplex or eight (8) duplex receptacles.
       3. (C) Where mobile X-ray, laser, or other equipment requiring special electrical configurations is used, additional receptacles distinctively marked for X-ray or laser use shall be provided.

   13. (2)

       1. (A) Each patient room shall have duplex-grounded receptacles.

       2. (B) There shall be one (1):

          1. (i) At each side of the head of each bed;
          2. (ii) For television, if used; and
          3. (iii) On every other wall.
       3. (C) Receptacles may be omitted from exterior walls where construction or room configuration makes installation impractical.
       4. (D) Nurseries shall have at least two (2) duplex-grounded receptacles for each bassinet.
       5. (E) Outlets for general care areas and critical care areas shall be provided for as defined by NFPA 99 and NFPA 70.

   14. (3)

       1. (A) Duplex-grounded receptacles for general use shall be installed:

          1. (i) Approximately fifty feet (50’) apart in all corridors; and
          2. (ii) Within twenty-five feet (25’) of corridor ends.
       2. (B) Receptacles in pediatric and psychiatric unit corridors shall be of the tamper-resistant type.
       3. (C) Special receptacles marked for X-ray use shall be installed in corridors of patient areas so that mobile equipment may be used anywhere within a patient room using a cord length of fifty feet (50’) or less.
       4. (D) If the same mobile X-ray unit is used in operating rooms and in nursing areas, receptacles for X-ray use shall permit the use of one (1) plug in all locations.
       5. (E) Where capacitive discharge or battery-powered X-ray units are used, special X-ray receptacles are not required.

   15. (4)

       1. (A) Electrical receptacle cover plates or electrical receptacles supplied from the emergency systems shall be:

          1. (i) Distinctively colored; or
          2. (ii) Marked for identification.
       2. (B) If color is used for identification purposes, the same color shall be used throughout the facility.

   16. (5)

       1. (A) For renal dialysis units, two (2) duplex receptacles shall be on each side of a patient bed or lounge chair.
       2. (B) One (1) duplex receptacle on each side of the bed shall be connected to emergency power.

6. (e) Equipment.

   1. (1) At inhalation anesthetizing locations, all electrical equipment and devices, receptacles, and wiring shall comply with applicable sections of NFPA 99 and NFPA 70.
   2. (2) Fixed and mobile X-ray equipment installations shall conform to Article 517 and Article 660 of NFPA 70.

   3. (3)

      1. (A) The X-ray film illuminator unit or units for displaying at least two (2) films simultaneously shall be installed in each operating room, specified emergency treatment rooms, and X-ray viewing room of the radiology department.
      2. (B) All illuminator units within one (1) space or room shall have lighting of uniform intensity and color value.

   4. (4)

      1. (A) Ground-fault circuit interrupters (GFCI) shall comply with NFPA 70.
      2. (B) When ground-fault circuit interrupters are used in critical areas, provisions shall be made to ensure the other essential equipment is not affected by activation of one (1) interrupter.
   5. (5) In areas such as critical care units and special nurseries where a patient may be treated with an internal probe or catheter connected to the heart, the ground system shall comply with applicable sections of NFPA 99 and NFPA 70.

7. (f) Nurse/patient communication station.

   1. (1)

      1. (A) In patient areas, each patient room shall be served by at least one (1) nurse/patient communication station for two-way voice communication.
      2. (B) All primary nurse call systems shall be of the electrical/electronic nature.

      3. (C) The signal shall activate an annunciator panel at:

         1. (i) The nurses’ station;
         2. (ii) A visible signal in the corridor at the patient's door; and
         3. (iii) Other areas defined by the functional program.
      4. (D) Each bed shall be provided with a call device.
      5. (E) Two (2) call devices serving adjacent beds may be served on one (1) calling station.

      6. (F) Calls shall activate a visible signal:

         1. (i) In the corridor at the patient's door;
         2. (ii) In the clean workroom;
         3. (iii) In the soiled workroom;
         4. (iv) In medication;
         5. (v) In charting;
         6. (vi) In nourishment;
         7. (vii) In examination/treatment room or rooms; and
         8. (viii) At the nurses' station.
      7. (G) In multicorridor nursing units, additional visible signals shall be installed at corridor intersections.
      8. (H) In rooms containing two (2) or more nurse/patient communication stations, indicating lights shall be provided at each station.
      9. (I) Nurse/patient communication stations at each calling station shall be equipped with an indicating light that remains lighted as long as the voice circuit is operating.

   2. (2)

      1. (A) An emergency call system shall be provided at each inpatient/outpatient:

         1. (i) Toilet;
         2. (ii) Bath; and
         3. (iii) Shower room.
      2. (B) An emergency call shall be accessible to a collapsed patient on the floor.
      3. (C) Inclusion of a pull cord within four to six inches (4” – 6”) from the floor will satisfy this standard.
      4. (D) The emergency call shall be designed so that a signal activated at a patient's calling station will initiate a visible and audible signal distinct from the regular nurse/patient communication station that can be turned off only at the patient calling station.

      5. (E) The signal shall activate:

         1. (i) An annunciator panel at the nurses’ station; and
         2. (ii) A visible signal in the corridor at:
8. (a) (a) The patient's door; and

9. (b) (b) Other areas defined by the narrative program.

   1. (F) Provisions for emergency calls will also be provided in outpatient and treatment areas where patients are subject to incapacitation.
   2. (3) In areas such as critical care, recovery, and pre-op where patients are under constant visual surveillance, the nurse/patient communication call may be limited to a bedside button or station that activates a signal readily seen at the control station.

   3. (4)

      1. (A) A staff emergency assistance system for staff to summon additional assistance shall be provided in:

         1. (i) Each operating, delivery, recovery, emergency examination, and/or treatment area;
         2. (ii) Critical care units;
         3. (iii) Nurseries;
         4. (iv) Special procedure rooms;
         5. (v) Cardiac catheterization rooms;
         6. (vi) Stress-test areas;
         7. (vii) Triage;
         8. (viii) Outpatient surgery admission and discharge areas; and
         9. (ix) Areas for psychiatric patients including:
10. (a) (a) Seclusion and security rooms;

11. (b) (b) Anterooms and toilet rooms serving them;

    1. (c) (c) Communal toilet and bathing facility rooms; and

       1. (d) (d) Dining, activity, therapy, exam, and treatment rooms.

       2. (B) This system shall annunciate audibly or visually:

          1. (i) In the clean workroom, soiled workroom, medication, charting, nourishment, and examination/treatment room or rooms if provided; and
          2. (ii) At the administrative center of the nursing unit with backup to another staffed area from which assistance can be summoned.

    2. (5)

       1. (A) A nurse/patient communication station is not required in psychiatric nursing units, but if it is included, provisions shall be made for:

          1. (i) Easy removal; or
          2. (ii) Covering call button outlets.
       2. (B) In psychiatric nursing units, all hardware shall have tamper-resistant fasteners.
12. (g) Emergency power shall be provided in accordance with NFPA 99, NFPA 101, and NFPA 110.

13. (h) Emergency electrical generators shall have a minimum forty-eight (48) hours of onsite fuel.

    1. (i) All healthcare occupancies shall be provided with a fire alarm system in accordance with NFPA 101 and NFPA 72.

14. (j) Telecommunications and information systems.

    1. (1) Locations for terminating telecommunications and information system devices shall be provided.

    2. (2)

       1. (A) A room shall be provided for telecommunications and information systems.
       2. (B) Special air conditioning and voltage regulations shall be provided when recommended by the manufacturer.

15. (k) Annuciator alarm panels for emergency systems including but not limited to such as the fire alarms, medical gas, and emergency generators shall be located:

    1. (1) According to the functional program; and
    2. (2) In prominent locations easily observed and accessible by staff at all times.

Codification Notes: “NFPA” means National Fire Protection Association.