(a) Space requirements.
(1) Cleaning and Storage of Nursing Supplies and Equipment. There shall be adequate space and facilities for the proper cleaning and storage of nursing supplies and equipment. This space shall be removed from patient contacts and kept stocked and in order so that the contents are easily available for use by the nurse or attending staff. Care homes having five (5) beds or less are excepted from this requirement.
(2) Storage and Preparation of Medicines. Suitable provisions shall be made for the storage and preparation of medicines. Care homes having five (5) beds or less are excepted from this requirement.
(b) Equipment and supplies for bedside care. There shall be sufficient equipment for nursing care according to the type of patient. The following is not a complete list of nursing equipment needed for the care of patients, the aim, rather, has been to include certain minimum essentials and point out special precautions which shall be taken in their use.
(1) Linen.
a. The following articles of linen are required for the treatment or care of the patient and to keep the bed in a comfortable and sanitary condition:
Large sheets
Draw sheets*
Pillow slips
Bedspreads
Bath towels
Face towels
Bath blankets*
Wash cloths
Bedpan covers*
Mattress covers
Hot water bottle covers*
Ice cap covers*
Bath mats
*Care homes with five (5) beds or less are excepted.
b. Individual towels and wash cloths shall be provided for each patient.
c. Bedpan covers shall not be used interchangeably.
(2) Utensils and Other Supplies Needed.
a. There shall be individual wash basins, mouth wash cups and drinking glasses for each patient.
b. In addition to the above articles there shall be the following articles for general use*:
Mouth thermometers
Rectal thermometers
Hypodermic syringes and needles
Bath thermometers
Hot water bottles
Ice caps
Enema apparatus
Douche apparatus
Scales
Urinals
Bedpans
Rubber sheeting
Rectal tubes
Catheters
First aid dressings
Tongue depressors
Applicators
Rubber rings
Side boards for beds
Wheelchairs
Curved basins
Clinical medicine glasses
Covered water pitchers
*Care homes having five (5) beds or less are excepted from this requirement.
c. Hot water bags shall be covered before placing in beds or on a patient. The greatest care shall be exercised in their use to see that water is not too hot and bags are not leaking. The water shall not be over one hundred twenty (120) degrees Fahrenheit.
d. A bath thermometer shall be used to test water.
e. Electric heating pads shall not be used.
(c) Restraints.
(1) When Permitted. Restraints shall be applied only as an essential measure to prevent the patient from harming himself or others, after alternative measures have been proven unsuccessful.
(2) Physician's Order-Required. There shall be a written order signed by a physician approving the use of restraints either at the time they are applied to the patient, or in case of emergency, as soon as possible and not more than twenty-four (24) hours after they have been applied by the person in charge of the institution.
(3) Same-Time Limitation; Additional Orders. The physician's order for restraint shall not extend beyond twenty-four (24) hours. If restraint is required beyond this period the physician's order shall be written at twenty-four-hour intervals.
(4) Form. The form of restraint used shall not cause injury to patients.
(5) Locking Doors-Generally. Patients shall not be kept behind locked doors, that is, doors which patients cannot open, unless a patient becomes too difficult to manage, in which case the room shall be located on the first floor and the door shall not be locked with a key.
(6) Same-By Patients. Patients shall not be permitted to lock doors to their rooms.
(d) Handling and storage of medicines.
(1) Generally. All medicines and stimulants shall be plainly labeled and stored in a specially designated, well-illuminated locked medicine cabinet, closet or storeroom and be accessible only to nursing personnel. The medicine cabinet or closet shall be located near running water to facilitate the preparation of doses.
(2) Narcotics, etc. Narcotics, sedatives and other dangerous drugs shall be securely locked and accessible only to the nurse in charge.
(3) Old Medications. Old medications including prescriptions for patients who have left the institution shall be discarded.
(e) Handwashing facilities. There shall be adequate handwashing facilities with soap and a sufficient supply of linen or paper towels so that a fresh towel can be used for every handwashing. The use of a common towel is prohibited. (Mont. Co. Code 1965, § 89-48.)