Distinct facilities shall be provided for clean and soiled utilities, medical equipment storage, and unit management services.

Clean Utility/Holding Area(s): For storage of supplies frequently used in the care of newborns.

Soiled Utility/Holding Room: Essential for storing used and contaminated material before its removal from the care area. Unless used only as a holding room, this room shall contain a counter and a hands-free handwashing station separate from any utility sinks. The handwashing station shall have hot and cold running water that is turned on and off by hands-free controls, soap and paper towel dispensers, and a covered waste receptacle with foot control.

The ventilation system in the soiled utility/holding room shall be engineered to have negative air pressure with air 100% exhausted to the outside. The soiled utility/holding room shall be situated to allow removal of soiled materials without passing through the infant care area.

A designated area for collection of recyclable materials used in the NICU shall be established. This area shall measure at least one square foot per patient bed and be located outside the patient care area.

Charting/Staff Work Areas: Provision for charting space at each bedside shall be provided. An additional separate area or desk for tasks such as compiling more detailed records, completing requisitions, and telephone communication shall be provided in an area acoustically separated from the infant and family areas. Dedicated space shall be allocated as necessary for electronic medical record keeping within infant care areas.

Interpretation: Storage Areas: A three-zone storage system is desirable. The first storage area should be the central supply department of the hospital.

The second storage zone is the clean utility area described in the standard; it should be adjacent to and acoustically separated from the infant care area. Routinely used supplies such as diapers, formula, linen, cover gowns, charts, and information booklets may be stored in this space. There should be at least 8 cubic feet (0.22 cubic meters) for each infant for secondary storage of syringes, needles, intravenous infusion sets, and sterile trays.

There should also be at least 18 square feet (1.7 square meters) of floor space allocated for equipment storage per infant in intermediate care, and 30 square feet (2.8 square meters) for each infant bed in intensive care. Total storage space may vary by unit size and storage system.

Easily accessible electrical outlets are desirable in this area for recharging equipment.

The third storage zone is for items frequently used at the infant's bedside. Bedside cabinet storage should be at least 16 cubic feet (0.45 cubic meters) for each infant in the intermediate care area and 24 cubic feet (0.67 cubic meters) for each infant in the intensive care area. Bedside storage should be designed for quiet operation.

Hospitals contribute significant waste each year to incinerators and landfills. This creates not only an environmental hazard, but also conditions that are harmful to human health. Providing a designated collection area enables staff to separate and store for collection waste such as paper, newsprint, corrugated cardboard, plastics, metals, batteries, fluorescent lamps, and glass to either facilitate existing hospital procedures for recycling or initiate a recycling system. Space within the designated collection area also may be used for collection of medical supplies for distribution to hospitals or clinics in need of such materials.

Charting/Staff Work Areas: A clerical area should be located near the entrance to the NICU so personnel can supervise traffic into the unit. In addition, there should be one or more staff work areas, each serving 8 to 16 beds. These areas will allow groups of 3-6 caregivers to congregate immediately adjacent to the infant care area for report, collaboration, and socialization without impinging on infant or family privacy. Infants' charts, computer terminals, and hospital forms may be located in this space.

Design of the NICU must anticipate use of electronic medical record devices so that their introduction does not require major disruption of the function of the unit or impinge on space designed for other purposes. Design considerations include ease of access for staff, patient confidentiality, infection control and noise control, both with respect to that generated by the devices and by the traffic around them.

Laundry Room: If laundry facilities for infant materials are provided, a separate laundry room can serve the functions of laundry and toy cleaning within the NICU. Infant clothing and the cloth covers of positioning aids should be laundered on a regular schedule and as needed. In addition, toys utilized by infants or siblings are required to be cleaned on a regular schedule for each infant and between infants. Space for a commercial-grade washer and dryer should be accommodated. The dryer should be vented through an outside wall. The placement of a commercial-grade dishwasher could promote the efficiency and effectiveness of the aseptic cleaning process for toys.