DescriptionThe Ensuite - High Assistance includes a shower, toilet and basin for use by a patient, typically with assistance. This Standard Component is typically used in a nested bedroom layout, however, with careful planning it may be used in conjunction with either an inboard or outboard bedroom layout. The ensuite and bedroom should be planned as a unit.Hours of Operation24 hoursOccupancy1 patient; 1-2 staff assisting as requiredAdditional Considerations~ The door is to be fitted with a lock that has an occupancy indicator and emergency release hardware. An outward swinging door is recommended to mitigate risk of accidental barricade in the event of a fall or loss of consciousness. If an inward swing is provided, an emergency release and pivot hinge to allow for the door to open outward is required.
~ The floor finish at the entry to the ensuite is to be flush with the adjacent floor finish in the bedroom. The floor finish in the shower area must also be flush and continuous with the adjacent floor in the ensuite and is not to have a raised hob.
~ A tiled floor finish may be provided instead of floor vinyl, and it is recommended that where floor tiles are used, wall tiles are also used to achieve an appropriate join between floor and wall finishes.
~ The slope of the floor to the drain in the shower must meet the relevant Australian/New Zealand building code compliance requirements. When meeting these requirements, the slope of the floor is then low enough to have minimal impact on patients using walking aids, patients with impaired mobility/balance, and staff assisting patients on commodes, wheelchairs, etc.
~ Provision of reticulated medical gas outlets (e.g. oxygen and suction) may be considered depending on patient cohort requirements. Where provided, the location of the outlets should allow for use within the shower and on the toilet with standard tubing lengths. Mitigating contamination risk of medical gas outlets from toilet plume is to be considered (e.g. cover to outlets and associated attachments).
~ Patient lifting tracks may be provided in adjacent bedrooms and this provision is to be confirmed at project level to suit clinical service requirements and local WHS policies for patient handling. Configuration (fixed track, traverse track, etc.), installation (recessed or ceiling mounted), weight rating/safe working load (SWL), and extent, including whether that track extends to transfer the patient to the ensuite or is for bed to chair/wheelchair/commode transfer only, must also be confirmed by project teams to inform requirements for the ceiling structure, door width and clearances in the ensuite. Where the path of the lifter track includes full transfer to/within the ensuite, the door height must be increased and the frame must be designed to accommodate linking between tracks. Selected track and lifter equipment must meet local infection prevention and control (IPC) policies and cleaning requirements.
~ The connection point of the hand-held shower is to be located, with consideration of the length of the hose, to ensure that the shower head is not in reach of the toilet bowl. Risk mitigation strategies (e.g. reduced pressure zone devices) to be used where this cannot be achieved.
~ Grab rails are to be securely fixed to the wall with the structural support required to meet weight ratings/SWL that must be confirmed at project level (generally accommodating patients up to 150kg for standard patient rooms). Space for staff assistance to both sides of the toilet is provided in this Standard Component and therefore drop-down grabs rails for use by patients with or without staff assistance have been indicated. Additional structural support requirements are to be confirmed at project level to accommodate the downward force on the cantilevered drop-down grab rails.
~ A shower curtain and track are noted as optional, and inclusion of the curtain and track, or track only (to support flexibility for future provision of curtains) is to be confirmed at project level to suit local work, health and safety (WHS), and IPC policies. Where curtains and tracks are provided, operational models for cleaning and maintenance must be considered.
~ The handwashing basin should include a detachable shroud to enclose pipe fittings. The shroud should be a separate element, rather than being integrally moulded with the basin. This separation ensures there is access to the plumbing (i.e. P-trap or S-bend) for maintenance, without requiring the removal of the entire basin. Refer to ‘Part D: infection Prevention and Control' for more information.
~ The use of commodes, mobile patient transfer equipment and sit-to-stand equipment is to be considered when finalising fitting selection. It is recommended that the set out of the toilet suite and grab rails is tested with assistive equipment that is being considered or has been selected to ensure appropriate clearances, including coordination with the height of the toilet seat and the toilet lid. Clearance from the equipment to the grab rails should ensure there is no risk of pinching or finger entrapment.
~ Operational models and IPC policies for use of a patient’s own mobility/transfer equipment, and any associated considerations for the design of the ensuite, are to be confirmed at project level.
~ With provision of drop-down grab rails to both sides of the toilet, inclusion of an integral toilet paper roll holder and nurse call button are recommended due to reach to wall mounted fittings being impractical. This may mean toilet paper stock differs in this ensuite compared to others where dispensers may be selected for jumbo roll, or interleaved tissue stock.
~ Toilet lids and seats are to be robust and suitable for long term, high frequency use. It is recommended that the toilet lid/seat is coloured to achieve a minimum 30% luminance contrast between the lid/seat, and the toilet pan, the floor, and the adjacent walls to support patients with visual impairments.
~ Mobile duress coverage is to be assessed and planned at a department level and coverage of all patient areas is to suit local security and WHS policies and operational service requirements.
~ A power outlet to support grooming, such as shaving and drying hair, is shown as optional. Local policies around provision and maintenance of electrical outlets in wet areas are to be confirmed to inform inclusion of a power outlet within the ensuite. Where provided, the outlet is to be located to comply with Australian and New Zealand Standards regarding the minimum distance from any water sources (i.e. basin spout and shower).
~ Layout of ensuites should consider the positioning of plumbing fixtures in relation to fire and smoke walls in an overall department configuration to minimise the impact of penetrations required for pipework.