Texas Register, Volume 23, Number 49, Part III, Pages 12311-12450, December 4, 1998 Page: 12,331
12311-12450 p. ; 28 cm.View a full description of this periodical.
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21. RESPONSE: The department has reconsidered and
agrees that 6 feet between preoperative patient holding beds
is excessive and has revised the language to require 4 feet
- 6 inches in 135.52(d)(7)(B)(ii) and (d)(9)(B)(i)-(ii). The
department has also changed the requirement for a clear space
of "3 feet" at the foot of the gurney or bed in the patient stations
of the preop and recovery room to "4 feet" to allow adequate
space for the passage of gurneys or beds for easier transport
of patients.
22. COMMENT: Concerning 135.52(d)(9), recovery room
(construction requirements for new ASCs), a commenter stated
that this room should be termed "Post Anesthetic Care Unit
(PACU)."
22. RESPONSE: The department disagrees. The word
"recovery" for an ASC is more applicable than "Post Anesthetic
Care Unit," because not all ASCs use anesthetic agents. No
change was made as a result of the comment.
23. COMMENT: Concerning 135.52(d)(10)(B)(i) and (III),
staff changing area (construction requirements for new ASCs),
a commenter supported the requirement for separate male
and female dressing rooms in larger facilities; however, the
commenter believes that a single operating room ASC probably
does not have the staff to warrant separate dressing rooms. The
commenter further stated "Although privacy is important, this
could be accomplished by an adjacent toilet. It seems strange
to provide separate dressing rooms yet a shower can be shared
by both male and female dressing rooms." The commenter
suggested that a simple solution could be to build a shower
into the toilet room and allow a single dressing area (which is
common in many medical facilities); and to distinguish between
large and small ASCs for these requirements.
23. RESPONSE: The department agrees that toilet facilities
and shower facilities may be unisex when properly designed,
but disagrees that dressing room can be shared. The language
relating to the staff changing area has been clarified to require
the following rooms and accommodations: male dressing room
with lockers; female dressing room with lockers; toilet room(s)
with a water closet and hand washing facilities; and shower
room. The toilet room and the shower room may be shared if
accessible to both male and female dressing rooms.
24. COMMENT: Concerning 135.52(d)(12)(B)(i), receiving/de-
contamination room (construction requirements for new ASCs),
a commenter asked if the sterile suite soiled work room which
is required under 135.52(d)(13)(B)(iii), can function as the re-
ceiving/decontamination room. Another commenter stated that
the soiled work room should be combined with the receiving/
decontamination room. The commenter failed to given a rea-
son.
24. RESPONSE: The department agrees that the facility can be
designed to allow the functions of the soiled work room and the
receiving/decontamination room to be combined. The language
has been revised to reflect this.
25. COMMENT: Concerning 135.52(d)(12)(B)(ii), clean as-
sembly/workroom (construction requirements for new ASCs), a
commenter believes that hand washing facilities should not be
required in this room, because the employee working the two
CSPD (Central Sterile Processing Department, i.e., soiled work/l
sterile work) rooms removes his or her apron and then washes
his or her hands in the receiving/decontamination room prior to
going into the clean assembly/work room.25. RESPONSE: The department disagrees and considers
the rule reasonable. The rule is also in accordance with AlA
guidelines No change was made as a result of the comment.
26. COMMENT: Concerning 135.52(d)(12)(B)(iv), sterile
equipment storage (construction requirements for new ASCs),
a commenter stated that this storage should be divided with the
surgical equipment storage as follows: 1) equipment storage,
for items used in operating rooms, but never sterilized; and 2)
surgical equipment/instrumentation storage, for items that must
be sterilized prior to use in the operating room. The commenter
further stated that these two rooms should not be combined
"unless" the sterilized surgical equipment/instrumentation items
are kept on a covered cart
26. RESPONSE: The department disagrees and considers the
standard reasonable. The intent of the rule was to provide
storage for sterile supplies. The procedures used to store
sterile/clean supplies shall be established by the facilities. No
change was made as a result of the comment
27. COMMENT: Concerning 135.52(d)(12XB)(i)-(v), on-site
sterilizing facilities (construction requirements for new ASCs),
a commenter believes that having individual and separate
rooms for receiving/decontamination, clean assembly/work,
sterile storage, sterile equipment storage, and a cart storage
for larger facilities is ideal; however, for small ASCs, some of
these functions can be combined. The commenter suggested
that small ASCs be exempt or allowed to combine certain
functions. The commenter further believes that it is important
to not restrict all ASCs with the same regulations when spacial
considerations should be adjusted to the volume of services
provided.
27. RESPONSE: The department disagrees and considers
the rule reasonable. The intent of the rule is to protect
the patient regardless of the size of the ASC. All ASCs are
required to provide the same level of protection. All the spaces
are interrelated and the particular design of each function
will depend on the owner's preference and functional design.
However, the department allowed for the soiled work room
and the receiving/decontamination room to be combined as
previously discussed in Response 24.
28. COMMENT: Concerning 135.52(d)(13)(B)(v), scrub facil-
ities (construction requirements for new ASCs), a commenter
stated that no reference was made to the requirement for a view
window at the scrub station permitting observation of surgery
room interior, and asked if this was intentionally omitted or if it
was an oversight.
28. RESPONSE: The department intentionally omitted any
requirement for a view window at the scrub station and the
operating room; however, this does not preclude an ASC from
having one. No change was made as a result of the comment.
29. COMMENT: Concerning 135.52(d)(13)(B)(viii), surgical
suitelanesthesia workroom (construction requirements for new
ASCs), a commenter asked "Can the storage racks for cylinders
be located in the medical gas room?" The commenter further
asked "Why bring soiled items into this room when they should
be taken to receiving/decontamination?"
29. RESPONSE: The department agrees that clarification is
needed and has included requirements for a medical gas stor-
age room in new clause (ix) of 135.52(d)(13)(B). Subsequent
clauses have been renumbered.ADOPTED RULES December 4, 1998 23 TexReg 12331
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Texas. Secretary of State. Texas Register, Volume 23, Number 49, Part III, Pages 12311-12450, December 4, 1998, periodical, December 4, 1998; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth379980/m1/31/: accessed May 7, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.