ANNEXURE V
Building Engineering Environmental Standards

All nursing homes should follow building engineering and environmental standards as prescribed by low bodies. The following standards will be applicable for new Nursing Homes, built after the rules to the act are in force.
1. Location
Hospital sites with high degree of sensitivity to outside noise should be avoided. The site should be compatible with other considerations such as accessibility and availability of services. The buildings should be so planned that sensitive areas like wards, consulting and treatment rooms and operation theatres are placed away from the outdoor sources of noise.

2. Ceilings
The finishes of all exposed ceilings and ceiling structures in areas normally occupied by patients or staff, and those in food preparation or food storage areas shall be readily cleanable with routine housekeeping equipment. Ceilings and walls in operating and delivery rooms shall be free of fissures, open joints, or crevices that may retain on permit passage of dirt particles.

3. Floor Height
The height of all the rooms in the hospital should not be less than 3.00 m and measured at any point from the surface of the floor to the lowest point of the ceiling. Minimum head room, such as under the bottom of beams, fans and lights shall be 2.5 m measured vertical under such beam, fan, light. The design of building shall ensure control of noise due to walking, movement of trolleys, etc.

4. Floors and Walls
The architectural finishes in hospitals shall be of high quality in view of maintenance of good hygienic conditions. The walls should be impervious with appropriate paint. Floors should be covered with good quality tiles in the minimum. The aim being that floor materials shall be readily cleanable and appropriately wear-resistant. In all areas subject to weekly cleaning, floor materials shall not be physically affected by liquid germicidal and cleaning solutions. Floor subject to traffic while wet, including showers and bath areas, shall have a non-slip surface. Floors should be smooth so as to allow smooth passage of wheelchairs and trolleys.

Floor and wall areas penetrated by pipes, ducts, and conduits shall be tightly sealed to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed.

Operating room/Labour room/Delivery room should be made washable. Corners and junctions of walls, floors and ceiling should be rounded to prevent accumulation of dust and to facilitate cleaning. Walls of operation theatre, delivery room, recovery room, scrub room should be fully covered with dado tiles or otherwise made washable with oil paint.
In other areas of critical zone, tiling should be provided until a height of 1.2m.

5. Doors:
PRIVATE The minimum door width for patient use shall be (2feet 10inches) or 86cms.
In the operation Area and Delivery Area, all doors should be two leaf type with a minimum width of 5ft. and shall have self closing devices.

6. Windows:
Wards and rooms for the admission of light and air shall have one or more apertures such as windows (also sufficient numbers of fans and lights) opening directly to the external air or into an open verandah. They should be sufficient to for well ventilation and lighting of the rooms.

7. Corridor:
Minimum public corridor width shall be 4 feet

8. Water Supply, Plumbing And Other Piping Systems (Adequate potable and washing water supply) :
Arrangement shall be made to supply adequate potable water as well as to meet all requirements (including laundry), except fire fighting.
Within the operation theatre there should not be any drains.
Ensure adequate supply of Oxygen (one for each of - OT, Casualty and for immediate use in ward), along with suction apparatus. Drainage piping shall not be exposed in operating and delivery rooms, nurseries, food preparation centers, food serving facilities and other sensitive areas. Where exposed, overhead drain piping is unavoidable, special provisions shall be made to protect the space below from leakage, condensation or dust particles.