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007.05.10-53. Physical Facilities, Nuclear Medicine.

AR ADC 007.05.10-53Arkansas Administrative CodeEffective: February 5, 2021

West's Arkansas Administrative Code
Title 007. Department of Health
Division 05. Health Facility Services
Rule 10. Rules for Critical Access Hospitals in Arkansas (Refs & Annos)
Effective: February 5, 2021
Ark. Admin. Code 007.05.10-53
007.05.10-53. Physical Facilities, Nuclear Medicine.
A. Equipment and space shall be provided to accommodate the functional program.
B. A certified physicist or other qualified expert representing the owner shall specify the type, location, and amount of radiation protection to be installed in accordance with final approved department layout and equipment selection. These specifications shall be incorporated into the plans.
C. Floors and walls shall be constructed of materials that are easily decontaminated in case of radioactive spills.
D. If radiopharmaceutical preparation is performed onsite, an area adequate to house a radiopharmacy shall be provided with appropriate shielding. This area should include adequate space for storage of radionuclides, chemicals for preparation, dose calibrators, and record keeping. Floors and walls should be constructed of easily decontaminated materials. Vents and traps for radioactive gases should be provided if such are used. Hoods for pharmaceutical preparation shall meet applicable standards. If pre-prepared materials are used, storage and calculation area may be considerable smaller than that for on-site preparation. Space shall provide adequately for dose calibration, quality assurance, and record keeping. This area may still require shielding from other portions of the facilities.
E. Nuclear medicine area when operated separately from the imaging department shall include the following as required to accommodate the functional program:
1. Space adequate to permit entry of stretchers, beds, and able to accommodate imaging equipment, electronic consoles, and if present, computer terminals;
2. A darkroom onsite available for film processing. The darkroom should contain protective storage facilities for unexposed film that guard the film against exposure or damage;
3. When the functional program requires a centralized computer area, it should be a separate room with access terminals available within the imaging rooms.
4. Provisions for cleanup located within the suite for convenient access and use. It shall include service sink or floor receptacle as well as storage space for equipment and supplies;
5. Film storage with cabinets or shelves for filing patient film for immediate retrieval;
6. Inactive film storage under the departmental administrative control and properly secured to protect film against loss or damage;
7. A consultation area with view boxes illuminated to provide light of the same color value and intensity for appropriate comparison of several adjacent films;
8. Provisions for physicians, assistants and clerical office space, individual consultation, viewing, and charting of film;
9. Waiting areas out of traffic, under staff control, with seating capacity in accordance with the functional program. If the department is routinely used for outpatients and inpatients at the same time, separate waiting areas with screening or visual privacy between the waiting areas;
10. A private area for dose administration located near the preparation area;
11. A holding area for patients on stretchers or beds which may be provided and may be combined with the dose administration area with visual privacy between the areas;
12. Patient dressing rooms convenient to the waiting area and procedure rooms. Each dressing room shall include a seat or bench, a mirror, and provisions for hanging patient's clothing;
13. Toilet rooms convenient to waiting and procedure rooms;
14. Staff toilet(s) convenient to the nuclear medicine laboratory;
15. Handwashing stations within each procedure room;
16. Control desk and reception area;
17. Storage area for clean linen with a handwashing station;
18. Provisions shall be made for holding soiled material. Such provision shall include a handwashing station.
19. Separate provision shall be made for holding contaminated material (exposed to radiation).
F. Positron Emission Tomography (PET).
1. Space should be provided as necessary to accommodate the functional program.
2. PET scanning is generally used in experimental settings and requires space for a scanner and for a cyclotron. The scanner room should be a minimum of 300 square feet.
3. Where a cyclotron room is required, it should he a minimum of 225 square feet with a 16 square foot space safe for storage of parts, which may need to cool down for a year or more.
4. Both a hot (radioactive) lab and a cold (nonradioactive) lab may be required, each a minimum of 250 square feet.
5. A blood lab of a minimum of 80 square feet should be provided.
6. A patient holding area to accommodate two stretchers should be provided.
7. A gas storage area large enough to accommodate bottles of gas should he provided. Each gas will be piped individually and may go to the cyclotron or to the lab. Ventilation adequate for the occupancy is required. Compressed air may be required to pressurize a water circulation system.
8. Significant radiation protection may be required since the cyclotron may generate high radiation.
9. Special ventilation systems together with monitors, sensors, and alarm systems may be required to vent gases and chemicals.
10. The heating, ventilating, and air conditioning system will require particular attention; highest pressures should be in coldest (radiation) areas and exhaust should be in hottest (radiation) areas. Redundancy may be important.
11. The cyclotron is water cooled with de-ionized water. A heat exchanger and connection to a compressor or connection to chilled water may be required. A redundant plumbing system connected to a holding tank may be required to prevent accidental leakage of contaminated water into the regular plumbing system.
G. Radiotherapy.
1. Rooms and spaces shall be provided as required by the functional program. Equipment manufacturers recommendations should be sought and followed, since space requirements may vary from one machine to another and one manufacturer to another. The radiotherapy suite may contain one or both electron beam therapy and radiation therapy.
2. Cobalt, linear accelerators, and simulation rooms require radiation protection. A certified physicist representing the owner or appropriate state agency shall specify the type, location, and amount of protection to be installed in accordance with final approved department layout and equipment selection. This information shall be Incorporate into the floor plans.
3. Cobalt rooms and linear accelerators shall be sized in accordance with equipment requirements and shall accommodate a stretcher for litter-borne patients. Layouts shall provide for preventing the escape of radioactive particles. Openings into the room, including doors, ductwork, vents, and electrical raceways and conduits, shall be baffled to prevent direct exposure to other areas of the facility.
4. Simulator, accelerator, and cobalt rooms shall be sized to accommodate the equipment with patient access on a stretcher, medical staff access to the equipment and patient, and service access.
5. Flooring shall be adequate to meet load requirements for equipment, patients, and personnel. Provision for wiring raceways, ducts, or conduit should be made in floors and ceilings. Ceiling mounted equipment should have properly designed rigid support structures located above the finished ceiling. The ceiling height is normally higher than 8′-0″ (2.44 meters). A lay-in type of ceiling should be considered for ease of installation, service, and remodeling.
6. Additional Support Areas for Linear Accelerator:
a. Mold room with exhaust hood and handwashing facility.
b. Block room with storage. The block room may be combined with the mold room.
7. Additional Support Areas for Cobalt Room:
H. General Support Areas. The following areas shall be provided unless they are accessible from other areas such as imaging:
1. A stretcher holding area adjacent to the treatment rooms, screened for privacy which may be combined with a seating area for outpatients;
2. Exam rooms as specified by the functional program. Each shall be a minimum of 120square feet and equipped with a handwashing station;
3. Darkroom convenient to the treatment room(s) and the quality control area. Where daylight processing is used, the darkroom may be minimal for emergency use. If automatic film processors are used, a receptacle of adequate size with hot and cold water for cleaning the processor racks shall be provided either in the darkroom or nearby;
4. Patient gowning area with provision for safe storage of valuables and clothing. At least one space should be large enough for staff-assisted dressing;
5. Business office and/or reception/control area;
6. Housekeeping room equipped with service sink or floor receptor and large enough for equipment or supplies storage;
7. Image file area; and
8. A storage area for unprocessed media.
I. Optional Support Area. The following areas may be required by the functional program:
1. Quality control area with view boxes illuminated to provide light of the same color value and intensity;
2. Computer control area normally located just outside the entry to the treatment room(s);
3. Dosimetry equipment area;
4. Hypothermia room (may be combined with an exam room);
5. Consultation room;
6. Oncologist's office (may be combined with consultation room);
7. Physicist's office (may be combined with treatment planning);
8. Treatment planning and record room; and
9. Work station/nutrition station.

Credits

Amended Jan. 1, 2016; Feb. 5, 2021.
<Statutory authority: Promulgated under the Authority of Ark. Code Ann. § 20-7-123, 20-9-201 et seq.>
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.10-53, AR ADC 007.05.10-53
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