PATIENTS CLOTHES LOCKER ROOM

Since patients of this service will stay longer than patients of the other services, and since
recrational and occupational therapy are a large part of their treatment program, they will
require a large wardrobe. Therefore, a clothes locker will be neccessary for each patients on
each nursing unit for those articles which cannot be kept in the closets of the patient
bedrooms. It is desirable to locate this facility near the entrance to the nursing unit. In
addition to lockers, the room should have luggage compartements and table with equipment
for the careful making of all clothes and personal articles.
RECEIVING AND SPECIAL TREATMENT BEDROOMS
Some new quiet or depressed patients may have difficulty in adjusting to the hospital
atmosphere or may in need of special observation. For this reason, one or two bedrooms or
special treatment room with private baths and with sub-utility are advisable in the treatment
area. These rooms will also be used in administering many treatment requiring isolation such
as : fever treatment, narcosis, electric shock, etc. One of these rooms may be enlarge to four
or more bed capacity for insulin shock treatment area.
This larger room also may be used for recovery area when electric shock is administered in
the one bed room. The amount of insulin treatment given varies in hospitals. It can be
administered in single rooms but requires constant dan careful nursing. Because of the
personnel problem, hospital with arge insuin treatment program may find it advisable to set
up complete nursing units for this purpose, or to provide a special large insulin treatment
room. In any case a small utility room for preparation and a isolation room for difficult
recoveries is necessary.
CONTINUOUS TUB AND PACK ROOMS
While hydrotherapy is not used as extensively as formerly, some sedative and stimulative
hydrotherapy equipment will be required in a complete modern facility.
In the small unit two tubs may be sufficient. Since tub treatment cannot always be scheduled
there must be two separate room for tubs when men and women patients are being treated.
Tubs should be placed at sufficient distance from walls or equipment to provide room for
several personnel to care for exited patients. Linen closets, blanket closets dan blanket drier,
laundry tub and a water closets are requirement of this area. Where stimulative salt rubs may

be given on a moveable table in this suite, a hydrotherapy shower would also be required.
Where special pack rooms are not provided, pack treatment may be given on moveable tables
in this area or in the patients bedroom.
Continuous tub and pack treatment rooms should be adjacent to bedroom areas, particularly
for distrubed patients who will use them frequently.
OTHER FACILITIES
Facilities for treatment rooms, consultation rooms, visitors room, utility room, floor pantry,
flower room, linen and supply closets can be as specified elsewhere for medical and surgical
nursing units, except that the principles of psychiatric safety must be observerd as to locksm
door swings, windows protection, etc.
MATERIAL AND FINISHES
In the open section, material and finishes can be as specified elsewhere for medical nursing
units.
In the locked section maximum security and safety should be provided in an unobtrusive
manner. Care should be taken to avoid projections of structure, sharp corners, exposed piping,
etc. And no design should be accepted which could encourage attempts at hidding, suicide, or
escape. Simplicity of room arangement is desired.
WINDOWS
When detention screen is used at windows openings, any type of sash or glass may be used.
The screen should be mounted flush with the wal surfaces at windoes head, jambs, and sill to
eliminate projections on which a patient may be injured. The best installation will provide
operation of the sash by a removeable crank.
When a detention screen is not used, windows of sturdy design, operated by removable
crank, are recommended. These should be such of design that no opening large enough to
permit exit is possible, while providing sufficient ventilation. Heat tempered glass should be
used to reduce breakage. No window should swing into the room.
Since light may be too stimulating to some patients, it should be possible to darken the room
easily. Shutters or venetian blinds should, therefore, be installed between the detention screen
and sash.

DOORS
Doors to the bedrooms should be of sturdy design to resist damage and avoid noise
disturbances. They should be at least 3 ft. 10 in. wide and have view panels of heat tempered
glass, approximately eight inches wide by twelve inches long and approximately four feet, six
inches from the floor for ease in observation. Shutters should be provided for the view panels.
These should be installed on the corridor side of the door. The door should have hospital type
hinges and cylinder locks and be capable of being locked from the outside only.
Doors to the bedrooms may swing it is true that a patient may barricade a door which swings
into a room, the majority of opinion seems to prevail that there is better control of the patient
with the in-swinging door. There is danger of injury to patients or personnel or damage to
structure or equipment from an out-swinging doors are more difficult to secure adequately
and, where a number of rooms may occur along a corridor, diminish ease of observation of
the corridor from a nurses station.
Doors to bath rooms, closets and patients laundry room should swing out and be capable of
being locked from the outside only. The patients laundry door should have a vision panel.
Utility room, pantry room, entrance and corridor doors should also have vision panels.
Door to interview, examination, conference rooms, etc., shall be as specified elsewhere for
medical and surgical nursing units, except for locks. It should be possible to lock these doors
from both side
WALLS
Wall construction and finishes can be as specified elsewhere for medical and surgical nursing
unit for the convalescent, quiet, and depressed classification.
For distrubed patients, walls should have sound deadending construction. Wall surface of
painted cement plastic are recommended.
Since room may be locked at times, local fire regulations should be consulted for fire ratings
for locked rooms. A two hour rating is desirable.
Wall in wet sections should be of tile

CEILING
Ceiling should be of acoustical materials except in wet section where they should be of nonabsorbent material.
FLOORS
Floor for patients areas can be of the same material as is used in other patient rooms. Any
type of resilient floor material which is reasonably resistive to indentation is probably the
most satisfactory. In wet sections, floors should be of non-slip tile.
HEATING
Radiant panel heating from ceiling, walls or floors is recommended. If radiators are used,
they should be recessed into the walls and covered with metal grilles placed flush with wall
surfaces. A cove at the interior corners of jambs, head and sill of the recess will facilitate
cleaning.
Air conditioning is recommended, both for patients comfort during treatment and in order
that windows may be closed to prevent noise disturbances to the street areas.
ELECTRICAL
In the distrubed patients area recessed lighting fixtures with heat tempered glass covers are
recommended . outlets for floor or desk lamp should be placed 7 ft. 6 in from the floor. Night
lights should have heat tempered glass covers.
In the area for patients of other classifications, outlets, call systems and fixtures can be as
specified elsewhere for medical and surgical patients.
PLUMBING
For plumbing fixtures see section on toilet and bath room units.
HARDWARE
Cylinder, dead bolt locks are recommended. In general, doors requiring locks should be both
locked and unloked by key only. Patients rooms, bathrooms, and storage closets should not be

locked from the inside. It is recommended to key all locks within the nursing unit, excepting
the drug cabinet, to one key. Entrance doors to the unit should be on separate keys.

TUBERCOLOSIS NURSING UNIT

A twenty bed nursing unit in a general hospital is considered to be the minimum size which
would justify the inclusion of all the elements necessary to comprise completely isolated unit.
A number of central service facilities must be provided for any tubercolosis nursing unit and,
because of the infectiousness of the disease, the tubercolosis beds should be operated as a
separate nursing unit regardless of size. These factors involve a rather high level of cost, both
of construction and operation, which must be pro-rated among the beds in the unit. A
reduction of the tubercolosis unit in a general hospital to less than twenty beds set up such a
high per bed cost that the provision of such a unit is generally considered impractical.
PHYSICAL FACILITIES
The room elements for a tubercolosis unit and their arrangement in the unit are similiar to
those in the basic nursing unit. Additional facilities needed include a nurses looker room,
nurses gown room, visitors gown room, hand washing stations, a physicians office,
examination and treatment room and dishwashing facilities.
PATIENTS ROOMS
For flexibility of operation, a small nursing unit should contain sufficient rooms to
accommodate approximatelt 20 percent of the patients. Facilities should be provided for
isolation of patients who have contracted some other infectious disease and for patient under
observation . these may be designed for the confinement of mentally distrubed patient and
may be used for admissions.
Patients rooms should be oriented for sun, ventilation, view and quiet. They should be
cheerfully decorated and appropriately furnised. Porches or balconies running the full length
of the nursing units should be discouraged in moderate and cold climates where they shut out
too much light.
Space should be provided for beds, bedside table, over bed table, chest of drawers pr dressers,
chairs, a lavatory and generous lockers and closets.

Toilet facilities and dental basins adjacent to or between patients rooms are desirable. Water
closets should have bedpan lugs and bedpan flushing attachments.

NURSES LOCKER ROOM

The nurses room should be accessible from the nurses gown room and have a separate
entrance to the main corridor. This room can also serve as a nurse retiring room. It should
provide space to accommodate a dressing table with mirror, two or three easy chairs, a
telephone and locker for nurses personal belongings.
NURSES GOWN ROOM
The nurses gown room can be located near the nurses station and the nurses locker room.
This room should provide for cabinet, shelf or table space, scrub sink with gooseneck spout
and foot or knee control, soal dispensers with foot control, laundry hamper and hookstrips for
gown hooks.
VISITOR GOWN ROOM
For practical purposes this room should be located near the entrance to the unit. The
equipment should be similiar to that of the nurses gown room.
NURSES STATION
In plan and equipment, the nurses station is similiar to that in a general hospital nursing unit.
UTILITY ROOMS
Two separate centrally located utility rooms, one clean and one contaminated, are desirable.
The contaminated utility room should be equipped with an incinerator, clinical sink, double
element hot plate, double door autoclave, scrub sink, double compartement sink and a counter
with a shelf and chest below to hold ice for use in treatments. Contaminated material
originating in the nursing unit may be destroyed in the incinerator. The double door
autoclave, accessible from both utility rooms, is intended for sterilizing equpment such as
patients bedside utensils and certain instruments used in the examination and treatments
room.

The clean utility room should afford ample workspace, counter and sink, cabinets and sheves,
including a locked compartement for poisons.
CORRIDOR HANDWASHING STATIONS
Knee or foot controlled lavatories placed intermittently along the nursing corridor are dirable
for the convinience of the staff.
PHYSICIANS OFFICE
A small room in the nursing unit to serve as an office for the intern, resident physician, or for
consultation by visiting physicians is desirable. This room should be large enough to
accomodate equipment such as a desk, chairs, bookcase, desk film illuminator and mobile
film illuminator stand.
EXAMINATION AND TREATMENT
Inclusion of this room in the nursing unit reduces the need for patients having to leave the
unit for treatment elsewhere in the hospital. The equipment needed for this room is similiar to
that used in the treatment rooms of general hospitals exceptfor the addition of a clinical scale,
pnemo-thorax apparatus and stand.
It should be noted that the facilities and equipment for the Examination and Treatment Room
and the Fluoroscopy Room (described below) as shown here are intended only for the
patients in the tuberculosis unit. If these facilities are to be used by other patients also
consideration may have to be given to providing more space for patients waiting, storage of
supplies and dressing booths.
FLUOROSCOPY ROOM
The fluoroscopy room should be located adjacent to the examination and treatment room and
open directly into it. It should be arranged to permit access for patients in wheel chairs or on
stretchers. Inasmuch as the physician may wish to fluoroscope several patients during the
same period a small patients waiting space should be provided adjacent to this room.
If the fluoroscopy room and examination and treatment room are to be used by out-patients,
dressing booths and a larger patients waiting space should be provided.

INTERVIEWING ROOM
This room is intended for purposes of interviews and private consultation with patients
relative to socioeconomic and welfare problems. It should be acoustically treated,
FLOOR PANTRY
Bulk food service is recommended as being best suited to the requirements for safe food
handling in a tuberculosis unit. Under this method, the bulk food cart is brought to the floor
pantry, where the trays are loaded, and is then immediately returned to the main kitchen in an
uncontaminated condition. The equipment will be similiar to that described for a bulk service
floor pantry elsewhere.