10A NCAC 13B .6226. PLUMBING AND OTHER PIPING SYSTEMS REQUIREMENTS

(a)  A toilet room shall be directly accessible from each patient room and from each central bathing area without going through the general corridor. One toilet room may serve two patient rooms but not more than eight beds. The lavatory may be omitted from the toilet room if one is provided in each patient room.

(b)  All plumbing systems shall be installed in such a manner as to completely prevent the possibility of cross connections between safe and unsafe supplies or back siphonage.

(c)  The following standards shall apply to plumbing fixtures:

(1)           Lavatories and sinks installed in patient care areas shall have the water spout mounted so that its discharge point is a minimum distance of 5 inches (12.7 cm.) above the rim of the fixture;

(2)           All fixtures used by medical and nursing staff and all lavatories used by patients and food handlers shall be trimmed with valves that can be operated without hands (single-lever devices may be used).  Blade handles used for this purpose shall not exceed 4.5 inches (11.4 cm.) in length.  Handles on scrub sinks and clinical sinks shall be at least 6 inches (15.2 cm.) long; and

(3)           Showers and tubs shall have non-slip walking surfaces.

(d)  The following standards shall apply to potable water supply systems:

(1)           Vacuum breakers shall be installed on hose bibbs and supply nozzles used for connection of hoses or tubing;

(2)           Bedpan-flushing devices shall be provided in each inpatient toilet room; installation is optional in psychiatric and substance-abuse treatment units where patients are ambulatory;

(3)           Potable water storage vessels (hot and cold) not intended for constant use shall not be installed; and

(4)           All piping, except control-line tubing, shall be identified.  All valves shall be tagged, and a valve schedule shall be provided to the facility owner for permanent record and reference.  Where the functional program includes hemodialysis, continuously circulated filtered cold water shall be provided.

(e)  The following standards shall apply to hot water systems:

(1)           The water-heating system shall have sufficient supply capacity at the temperatures and amounts indicated in Table 3.  Water temperature is measured at the point of use or inlet to the equipment; and

 

Table 3

Minimum Hot Water Capacity Requirements

		Use
	Clinical	Dietary	Laundry
Gallons/Hour/Bed	6.5	4	4.5
Liters/Second/Bed	.007	.004	.005
Temperature EF	116	180	180
Temperature EC	46.7	82.2	82.2

 

(2)           Hot-water distribution systems serving patient care areas shall be under constant recirculation to provide continuous hot water at each hot water outlet with a temperature range of 100EF to 116EF (37.8EC to 46.6EC).

(f)  The following standards shall apply to drainage systems:

(1)           Drain lines serving some types of automatic blood-cell counters shall be of carefully selected material that will eliminate the potential for undesirable chemical reactions or explosions between sodium azide wastes and copper, lead, brass, and solder;

(2)           Drainage piping shall be installed to avoid installations in the ceiling directly over operating and delivery rooms, nurseries, food preparation centers, food serving facilities, food storage areas, central services, electronic data processing areas, electrical closets, and other sensitive areas.  Where overhead drain piping in these areas is unavoidable, special provisions such as auxiliary drain pans shall be installed to protect the space below from leakage;

(3)           Floor drains shall not be installed in operating and delivery rooms, but may be installed in cystoscopic operating rooms;

(4)           Drain systems for autopsy tables shall be designed to avoid splatter or overflow onto floors or back siphonage and for easy cleaning and trap flushing;

(5)           Kitchen grease traps, unless of the self-skimming type, shall be located and arranged to permit access without the need to enter food preparation or storage areas; and

(6)           Where plaster traps are used, provisions shall be made for routine access and cleaning.

(g)  The performance, maintenance, installation, and testing of medical gas systems, laboratory gas systems, and clinical vacuum systems shall comply with the requirements of the latest edition of National Fire Protection Association Standard 99 and Table 4 for medical gas station outlet requirements.  When any piping or supply of medical gases is installed, altered, or augmented, the altered zone shall be tested and certified as required by National Fire Protection Association Standard 99.  Testing shall be conducted by the facility and at least one other independent testing organization to ensure that the system is safe for patient use.

 

Table 4

Minimum Medical Gas Station Outlets and Vacuum Station Inlets

Location	Oxygen	Vacuum	Medical Air
Operating Room	2/room	3/room	1/room
Delivery Rooms	2/room	3/room	1/room
Cystoscopy Room	1/room	3/room	-
Special Procedures Room	1/room	3/room	1/room
Other anesthetizing Locations	1/room	3/room	1/room
Recovery Room	1/bed	3/bed	1/bed
Intensive Care Unit	2/bed	3/bed	1/bed
Cardiac Intensive Care Unit	2/bed	2/bed	1/bed
Emergency Room	1/bed	1/bed	1/bed
Trauma Room	2/bed	3/bed	1/bed
Catheterization Lab	1/bed	2/bed	-
Labor Room	1/bed	1/bed	-
Nurseries	1/bassinet	1/bassinet	1/bassinet
Patient Room	1/bed	1/bed	-
Exam & Treatment Rooms	1/bed	1/bed	-
Anesthesia Workroom	1/room	1/room	1/room
Autopsy Room	-	1/room	-

 

(h)  The line pressure for the medical gases shall be set in the following order:

(1)           Oxygen, highest pressure;

(2)           Medical air, next to lowest pressure; and

(3)           Nitrous oxide, lowest pressure.

 

History Note:        Authority G.S. 131E-79;

Eff. January 1, 1996.