Okla. Admin. Code § 310:615-5-3

Current through Vol. 42, No. 4, November 1, 2024

Section 310:615-5-3 - Surgical facilities

The number of operating rooms, recovery beds and the sizes of the service areas shall be based upon the expected surgical workload. The surgical suite shall be located and arranged to preclude unrelated traffic through the suite. The suite shall provide the following elements.

(1)Operating rooms.

(A) All ambulatory surgical center operating rooms shall be constructed and maintained to conform to Standard 70, National Electrical Code, Standard 99, Chapter 3, Use of Anesthetics (Flammable and Nonflammable) and Standard 99, Nonflammable Medical Gas Systems.

(B) Any room or space in which flammable anesthetics or volatile flammable materials are stored or used, shall be considered a hazardous area.

(C) Facilities electing to use only nonflammable anesthetic agents or to provide a mixed facility using both flammable and nonflammable anesthetics, must document the recommendations and approval of such determination by the medical staff of the facility and the adoption of such a regulation by the facility's governing body. Precautionary signs shall be posted at conspicuous points throughout the surgical suite and within the operating rooms. All such signs must be large enough to be read from at least 8' distance.

(D) Each room shall have a minimum clear area of 250 square feet exclusive of fixed and movable cabinets and shelves. An emergency communications system connecting with the surgical-suite control station shall be provided.

(2)Recovery room(s). Room(s) for post-anesthesia recovery of surgical patients shall be provided and shall contain a drug-distribution station, hand washing facilities, charting facilities, clinical sink and storage space for supplies and equipment. At least three feet shall be provided at each side and at the foot of each bed as needed for work and circulation. Should pediatric surgery be a part of the program, separation by partition or curtain from the adult section, and space for the parents shall be provided. A designated, supervised recovery lounge shall be provided for patients who do not require post-anesthesia recovery but need additional time for vital signs to stabilize before leaving the facility. The lounge shall contain a control station, space for family members, and provisions for privacy. It shall have patient access to rest rooms.

(3)Service areas. Individual rooms shall be provided when so noted; otherwise, alcoves or other open spaces which will not interfere with traffic may be used. The following services may be provided:

(A) Control station shall be located to permit visual surveillance of all traffic which enters the operating suite.

(B) Sterilizing facility(ies) with high-speed autoclave(s) shall be conveniently located to serve all operating rooms. When the narrative program indicates that adequate provisions have been made for replacement of sterile instruments during surgery, sterilizing facilities in the surgical suite will not be required.

(C) Drug distribution station shall be provided for preparation of medications to be administered to patients.

(D) Two scrub facilities shall be provided near the entrance to each operating room; however, two scrub stations may serve two operating rooms if the scrub stations are located adjacent to the entrance of each operating room. Scrub facilities shall be arranged to minimize any incidental splatter on nearby personnel or supply carts.

(E) The soiled workroom for the exclusive use of the surgical suite staff (or a soiled holding room that is part of a system for the collection and disposal of soiled materials) shall contain a clinical sink or equivalent flushing-type fixture, work counter, sink equipped for hand washing, waste receptacle, and linen receptacle. A soiled holding room shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

(F) Fluid waste disposal facilities shall be conveniently located with respect to the general operating rooms. A clinical sink or equivalent equipment in a soiled workroom or in a soiled holding room would meet this requirement.

(G) A clean workroom is required when clean materials are assembled within the surgical suite prior to use.

(H) A clean workroom shall contain a work counter, sink equipped for hand washing, and space for clean and sterile supplies.

(I) A clean supply room shall be provided when the narrative program defines a system for the storage and distribution of clean and sterile supplies which would not require the use of a clean workroom.

(J) Anesthesia storage facilities, unless the narrative program and the governing body prohibits the use of flammable anesthetics, in a separate room shall be provided for storage of flammable gases in accordance with the requirements detailed in Sections 310:615-5-9(d) (2) (H) and 310:615-5-10(f) (1) and Chapter 13, NFPA 99.

(K) Space for reserve storage of nitrous oxide and oxygen cylinders shall be provided. Such space shall be free of stored combustible materials.

(L) Appropriate areas shall be provided as staff clothing change areas for male and female personnel (orderlies, technicians, nurses, and doctors) working within the surgical suite. The areas shall contain lockers, showers, toilets, lavatories equipped for hand washing, and space for donning scrub suits and boots. These areas shall be arranged to provide a one-way traffic pattern so that personnel entering from outside the surgical suite can change, shower, gown, and move directly into the surgical suite. Space for removal of scrub suits and boots shall be designed so that it will avoid physical contact with clean personnel.

(M) A separate area shall be provided where ambulatory patients change from street clothing into hospital gowns and are prepared for surgery. This shall include clothing change or gowning area with a traffic pattern similar to that of the staff clothing-change area. Provisions shall be made for securing patient's personal effects.

(N) An area for stretcher and wheelchair storage shall be out of direct line of traffic.

(O) The center shall provide convenient access to and use of emergency crash carts at both the surgical and recovery areas.

(P) Lounge and toilet facilities for surgical staff shall be provided in ambulatory surgical centers having three or more operating rooms and shall be located to permit use without leaving the surgical suite. A nurses' toilet room shall be provided near the recovery room(s).

(Q) A closet containing a floor receptor or service sink and storage space for housekeeping supplies and equipment shall be provided exclusively for the surgical suite.

Okla. Admin. Code § 310:615-5-3

Revoked and reenacted at 9 Ok Reg 2021, eff 6-11-92