National Standard for

Undergraduate Nursing and

Midwifery Programs

March 2021
 Document #2

Acknowledgements

This standard was undertaken for the Ministry of Science and Higher Education
(MoSHE) by selected members from three Universities in Ethiopia: Jimma
University, Addis Ababa Science and Technology, and Bahir Dar University.

During the preparation of this standard document, under the supervision of MoSHE,
the team formed i.e. the Biomedical and Medicine team consists of four (4)
professionals from different background, from the said Universities was working
extensively on preparing the documents within a short time.

The team is grateful to MoSHE for giving this opportunity and their fruitful support
and valuable feedback during the development of this draft standard. We are also
thankful to the officials and technical experts of MoSHE for their kind treatment
during the workshop.

The team consists of the following experts:

Dr. Molla Tadesse

Habtamu Eskezia
Mohammed Mustefa
Mohammed Adem

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Contents

Acronyms ............................................................................................... iv

1 Introduction ......................................................................................... 1

2 Objectives ............................................................................................. 2

3 Scope .................................................................................................... 2

3.1 Description of laboratories ............................................................................................... 2

3.2 Limitations during the preparation of this standard ....................................................... 3

4 Methods (Approaches) ......................................................................... 3

5 Human Resource Requirement ............................................................ 4

5.1 General requirement ......................................................................................................... 4

5.2 Teaching staffs .................................................................................................................. 4

5.3 Support staffs ................................................................................................................... 5

6 Infrastructure Requirement ................................................................. 6

6.1 General requirements ....................................................................................................... 6

6.2 Building Space Layout/ Design ........................................................................................ 7

6.3 Space for Nursing and Midwifery laboratories .............................................................. 10

6.4 Simulation consultation rooms .......................................................................................16

6.5 Space for teaching rooms ................................................................................................16

6.6 Summary of the list of rooms and space required ......................................................... 20

7 Laboratory Facilities ........................................................................... 21

7.1 Laboratory Furniture .......................................................................................................21

7.2 Fridges & freezers ........................................................................................................... 23

7.3 Special Need Equipments ............................................................................................... 23

7.4 ICT and Audio-visual aid ................................................................................................ 23

7.5 Generator ........................................................................................................................ 24

7.6 Basic Nursing lab equipment and apparatuses .............................................................. 24

7.7 Chemicals and reagents .................................................................................................. 25

7.8 Clinical Skill Laboratory (CSL)....................................................................................... 26

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8 Health and Safety ............................................................................... 37

8.1 Ensuring health and safety ............................................................................................. 37

8.2 Design considerations for safety .................................................................................... 37

8.3 General safety guidelines ............................................................................................... 38

8.4 Guides to potential hazards ........................................................................................... 38

8.5 Safety equipment and personal protective equipment .................................................. 39

8.6 Hand washing .................................................................................................................41

8.7 Fire safety ........................................................................................................................41

8.8 Safe Storage in Laboratory ............................................................................................. 42

8.9 Waste collection and disposal ........................................................................................ 42

8.10 Safety signs and signals ................................................................................................ 42

8.11 Labels ............................................................................................................................ 42

8.12 First aid kit.................................................................................................................... 43

8.13 Emergency Exit............................................................................................................. 43

8.14 Training for laboratory personnel ................................................................................ 43

9 Documentation................................................................................... 44

9.1 Laboratory Manuals and Protocols ................................................................................ 44

9.2 Safety Data Sheet............................................................................................................ 44

9.3 Log Sheets ...................................................................................................................... 45

9.4 Brochures ....................................................................................................................... 45

9.5 Learning and Information-Oriented Books ................................................................... 45

9.6 Summary of Documentation .......................................................................................... 45

10 Quality Assurance ............................................................................. 46

11 References......................................................................................... 47

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Acronyms
AV Audio/Visual
CLSI Clinical and Laboratory Standards Institute
HE Higher Education
ICT Information and Communications Technology
ICU Intensive care Unit
IUSS Infrastructure Unit Support Systems
JICA Japan International Cooperation Agency
MoSHE Ministry of Science and Higher Education
SSL Simulation skills laboratory
UNC The University of North Carolina
WHO World Health Organization

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1 Introduction
Over the last couple of decades, the Ethiopian government has been aggressively
investing a large sum of budget to expand the higher education (HE) Institutions.
Moreover, private higher education institutions also increased largely. Despite the
government’s efforts in the expansion of HEs, there are still problems and challenges
related to access, quality, cost, relevance, infrastructure, and human resources to
meet the demands of the nation. The qualities of the HEs vary widely; from
standardised research schools to substandard institutions whose eligibility for a
university title is questionable, because they lack the corresponding infrastructure,
staff and resources. The major cause for this is that the construction of classrooms,
laboratories, office, libraries, excellence centres, basic laboratory facilities, computer
labs, and the development of electronic networks lag way behind enrolment
expansion and the expected education quality.

To solve these issues, the Ministry of Science and Higher Education (MoSHE) is
planning to establish and maintain minimum standards for laboratories and
workshops of undergraduate Science, Medicine, Engineering education, Social
Sciences, and other programs across all HEs in Ethiopia.

Quality education is the foundation for developing qualified and competent health
professionals who are equipped with the required knowledge, skill, and attitude to
deliver quality health care. Nursing and Midwifery educations are the foundation of
qualified and competent nursing and midwifery workforce. Improving the quality of
nursing and midwifery education and training is an important way of strengthening
the health status of a country. This is mainly solved by establishing standards for
professional education, assuring quality educational processes, and accreditation.
Thus, MoSHE places great emphasis on standardizing the laboratories operating
under all HE institutions in Ethiopia. This can be achieved through well-developed
standards including necessary infrastructure, protocols, practice guideline, and
relevant human resource. To this end, herewith, the first national standards for
Nursing and Midwifery education programmes which will be used for teaching
undergraduate students is developed by selected staffs from various Universities.
Hence, as per the direction given by MoSHE, the minimum standards for Nursing
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and Midwifery laboratories of undergraduate programs in the Nursing and Midwifery

laboratory have been prepared.

2 Objectives
It is anticipated that this standard will be used in the nursing and midwifery
profession within the HE Institutions as well as in other health-related professions,
policy and decision-makers, the public, regulatory bodies and stakeholders. This
national standard will have the following objectives:
• To enhance quality nursing and midwifery education and training.
• To promote safe practise for nurses and midwives according to standards
• To harmonize the quality of Nursing and Midwifery education across the
country for competent and high-quality nursing and midwife workforce.
• To established for the preparation of nurses and midwives based on global
norms and recognized internationally.

3 Scope
The Ministry of Science and Higher Education has taken a commendable initiative to
develop standards for laboratories in the undergraduate nursing and Midwifery
programs.
• This standard shall be applicable for all new and existing HE Institutions
teaching Nursing and Midwifery programs, both governmental and non-
governmental.
• The standard covers the minimum requirements concerning human resource,
premises, Facilities, Safety, and products or materials put into use for Nursing
and Midwifery laboratories

3.1 Description of laboratories

This standard is specific to the Nursing and Midwifery study programme applicable
to all laboratories both government and private higher educations used for teaching
and learning, and research purposes. The standard consists of the following specific
laboratories under the Nursing and Midwifery undergraduate programme.
1. Fundamentals of Nursing Laboratory
2. Physical Assessment of Nursing Laboratory

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3. Paediatric and Neonatal Nursing Laboratory

4. Obstetrics & Gynaecological Laboratory
5. Critical care Nursing Laboratory

3.2 Limitations during the preparation of this standard

One limitation that worth to be mentioned is that, there were limited time and
expertise during the preparation of the standard. Consequently, it may need further
improvement by expertise in the area of Nursing and Midwifery education before
approval and application.

4 Methods (Approaches)
In the course of preparing this standard, the major method used was a Literature
review of the existing National and International standards, personal
communication, and adaptation of best practices from different parts of the world
through online research. The existing status of the laboratories in Ethiopian HE’s was
not taken into consideration due to limited data availability.
Benchmarks
International Benchmarks have been taken into consideration to develop this draft
standard. The following international standards and guidelines were used as a
reference to develop the standard.
a) The Oxford College of Nursing
b) The University of Damman, College of Nursing, Saud Arabia
c) IUSS Health Faculty Guides, Nursing Education Institutions, Republic of
South Africa
d) Ethiopian Standards ES 3609:2012 and ES 3614:2012
e) Global Standards for Midwifery Education (2010) Amended 2013,
International Confederation of Midwives
f) A guide to nursing and midwifery education standards, WHO Regional
Publications, Eastern Mediterranean Series

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5 Human Resource Requirement

5.1 General requirement

• The Nursing and midwifery programmes shall have adequate human resources
to support both classroom/theoretical and practical learning
• A sufficient number of teaching and support staffs with the necessary
qualifications, training and skills must be considered
• The required number and qualifications depend on the programme taught and
the number of students, and the available facility.
• There must be clear human resource policies on recruitment, deployment and
retention.
• Human resources management systems must have clear job descriptions,
regular staff performance appraisals, continuing professional development,
promotion and/or recognition that support the mission of the institution.
• There shall be a staff development policy to support the capacity building of the
lecturers/tutors concerning their roles.
• The ratio of students to teachers in the classroom and the laboratory is
determined by the specific programme and the requirements of regulatory
authorities.

5.2 Teaching staffs

• The Nursing and Midwifery faculty shall include lecturers, clinical instructors/
mentors who have nursing/midwifery expertise as well as from other disciplines
as needed

• Full-time Nursing or Midwifery teachers shall take the nursing or midwifery

pedagogical training course, and be certified

• Generally, there shall be at least two teachers for each professional subject being
taught, and the number of teachers shall increase according to student
enrolments

5.2.1 Head Nurse (Principal)

• The head Nurse is responsible for the overall teaching, research, and
managerial activities

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• The head of nursing or the midwifery educator is a nurse or midwife holding a

graduate degree and above
• The head Nurse should have the required experience in leadership and
administration and is an experienced educator

5.2.2 Lecturer (s)

• Lecturers must have a formal preparation in education or undertake such

preparation as a condition of continuing to hold the position and should
maintain competence in nursing and midwifery practice and education.
• Nursing and Midwifery lecturers shall have a minimum of two years of clinical
experience before recruited as a lecturer
• The nursing and midwifery lecturers must possess a qualification above the
level of the programme offered
• Nursing and Midwifery lecturers shall provide education, support and
supervision to individuals who teach students in practical learning sites.

5.2.3 Clinical Mentor (s)

• The nursing and midwifery clinical mentor /clinical instructor shall

demonstrate competency in both classroom teaching and clinical practice and
must have a formal preparation for clinical teaching
• The Clinical Mentor shall be a registered Nurse/midwife who has undergone
the required mentorship training and holds a current licence to practice as a
mentor within the field of expertise/speciality.
• A clinical mentor shall have a minimum of one year of clinical experience
before being trained as a mentor.

5.3 Support staffs

• Support staff shall be available, have relevant qualifications and are sufficient to
meet programme requirements.
• The type of support staff required will depend very much on the size of the facility
and the range and number of projected users. To the minimum, the following
staffs are required.

5.3.1 Manager/administrator

• The lab manager is responsible for day to day operational control.

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• Involved in the planning and development of the activities within the skills
learning facility.
• Ensures the smooth running of the facility and monitors the use of and promote
the facility as a learning resource.
• Shall have a BSc degree in Nursing or midwifery and two years of managerial
experience

5.3.2 Patient ⁄simulated patient co-ordinator

• Is responsible for maintaining a database of real patients and simulated patients

(actors or volunteers) who will be used in the learning and assessment of clinical
skills.
• Should hold a BSc degree in Nursing and Midwifery and a minimum of one-year
experience as simulated/patient coordinator.
• This post might also be combined with the role of training and standardisation of
patients to ensure consistency of presentation.

5.3.3 Technician(s)

• Maintains and ensures availability of models, manikins and other clinical

diagnostic and therapeutic equipment required for skills learning activity.
• Maintains and monitors the use of clinical and other consumables.
• Puts up and takes down resources required for specified learning activities.
• Shall complete training of maintenance course nursing medical equipment and a
minimum of one-year experience

5.3.4 Cleaner(s)

• Enough cleaning staffs shall complete the lab training and induction to be
capable of performing the work.
• They shall at least read and write so that can understand the signs and able to fill
forms and keep records

6 Infrastructure Requirement
6.1 General requirements

• A Nursing and Midwifery laboratory shall fulfil minimum standards for the
building which contains the facilities required for teaching and learning purposes

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• The rooms shall have adequate light and ventilation.

• The laboratory premises shall ensure the availability of continuous water and
power supply
• The arrangement of rooms shall consider proximity between related services.
• The potential source of accidents shall be identified and acted upon like slippery
floors, a misfit in doorways and footsteps.
• The Nursing and Midwifery laboratory facilities shall be well marked and easily
accessible for persons with disability.
• The Nursing and Midwife shall have a fire extinguisher placed in a visible area.
• The Internal surfaces of the laboratory (floors, walls, and ceilings) shall be:
a) Smooth, impervious, free from cracks, recesses, projecting ledges and
other features that could harbour dust or spillage,
b) Easy to clean and decontaminate effectively,
c) Constructed of materials that are non-combustible or have high fire-
resistance and low flame-spread characteristics.
• There shall be a waste disposal mechanism for all categories of wastes generated
by the Nursing and Midwifery laboratory
• The infrastructure shall provide a conducive working environment with little or
no disturbance, cleanness, good durability, etc.
• The laboratory building should be constructed in a way such that it has minimal
noise disturbance.
• The wall plastering and roofing should not allow leakage and it should have a
wheelchair ramp to allow access for students and staff with disabilities.
• Due consideration shall be given for safety, ergonomics, free movement of people,
for peoples with special needs, and good ventilation.

6.2 Building Space Layout/ Design

• The laboratory shall have space allocated so that its workload can be performed
without compromising the quality of work, quality control procedures, and safety
of the staff and students.
• The laboratory shall have adequate space and a safe environment to perform
testing. It must provide adequate lighting, ventilation, water, waste and waste
disposal

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• The necessary space for a specific laboratory needs an understanding of all its
functions and this should be taken into consideration
• The space available in Nursing and Midwifery laboratories must be appropriate
to the tasks that are to be carried out within them.
• In all cases, the equipment must be placed so that it has enough access to the
operators, students, and maintenance personals.
• Laboratory features that are required by regulatory and accreditation agencies
need to be addressed when determining square footage.
• The general understanding is that peoples working in the lab areas must able to
work and move freely unimpeded with each other and no fixed equipment affects
the free movement.
• The minimum space requirement per person in research or academic medical
laboratories is 4-5 sq. meter, the recommended number of students is 24 per
room.
• Clearance to walk around the system and analyser is NO less than 112 cm,
preferably 153 cm. The general space clearances and clear widths used in
medical laboratories are listed in Table 1 below and illustrated in Figures 1 and 2.

6.2.1 Flooring

• The floor should be flat, smooth, non-slip surface, durable and resistant to stains.
Sloped and tiered floors are used for medical labs.
• A non-slip surface is required for corridors, rows and side aisles. Sealed concrete
under seated areas is advisable. Use different colours with each floor height
change.

6.2.2 Walls and Ceiling

• The laboratory must be completely separated from outside areas (i.e., must be
bound by four walls) and the minimum clear room height is 3 meters.
• The premises of the medical laboratory shall have ceilings
• The walls and ceiling should be smooth and painted with a hard gloss, acrylic
emulsion or high-quality waterproof vinyl.
• Walls and ceilings of all rooms shall be easily cleanable, and any sort of carpeting
is not allowed.
• An acoustic tile ceiling is acceptable in most medical laboratories.

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• The laboratory is considered hazardous, therefore must be constructed to contain

fire fume and biohazardous.

6.2.3 Doors and windows

• The doors must have vision panels in them in the appropriate height except when
activities specify otherwise such as in dark rooms.
• Laboratories that use hoods or other larger equipment should be equipped with
doorways that have 122 cm openings. Any laboratory door’s clear opening should
not be less than 82 cm.
• The doors must open with a single operation outwards using appropriate
push/pull plates installed on the door. Doorstops must be considered to ensure
equipment and fittings are not damaged during opening and closing.
• The doors also must be lockable to ensure a good level of security but must open
without a key on the scape side. High-level security must be provided especially
for labs located on the ground floor or accessible windows to prevent
unauthorized entry.
• Laboratory doors should be self-closing to keep the laboratory area contained
from the surrounding areas.
• Sliding doors are not considered self-closing; therefore, they are not appropriate
exit doors, they are also difficult to clean.
• The location of the doors should not be more than 23 meters to exit from any
point in a laboratory. Doors that would be used to exit the laboratory in case of a
fire are not blocked by the automation system.
• Doors should be located around places where entry and exit are easy and does not
interfere with the laboratory benches or equipment.
• Additional fire exit doors may be required depending on the fire hazard level.
• Windows shall be a minimum of 50 cm wide x 100cm high. However, dimension
shall be adjusted for the climate and bed capacity of the room.
• Windows for medical laboratory shall be fitted to swing/ open to outside. In areas
where security/ safety grids applied or wire mesh fitted, opening to the room can
be allowed.
• Windows for medical laboratory shall have open, fitted with wire mesh, at to
portion for cross ventilation & uninterrupted circulation of air.

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6.2.4 Sink and Basins

• Each laboratory must contain a sink for handwashing. Elbow or electronic

sensing faucet controls are recommended particularly for biological agents
and/or highly toxic chemicals.
• Sink faucets and hose bibs that are intended for use with attached hoses must be
equipped with back siphon prevention devices.
• Laboratory sinks shall have lips that protect sink drains from spills.
• Sink lips or berms should be >= 0.6 cm and designed to completely separate the
lab bench or fume hood work area from the sink drain.
• There is a wide range of sinks in different materials, the appropriate type shall be
selected based on the laboratory requirement.

6.2.5 Washroom

• There should be at least one washroom that provides distilled water, deionized
water, cleaning, sterilization, and recycling services to all labs.

• The washroom comprises a glassware washing machine (dishwasher),

Autoclaves, Distiller, Deionizer, and other related equipment.

6.3 Space for Nursing and Midwifery laboratories

▪ There should be a demonstration room with at least two to four beds and an
adequate number of cupboards with necessary articles for demonstration.
▪ Provision should be made for community, midwifery and first aid
demonstration and practice.

6.3.1 Simulation Skills Labs

▪ The Simulation skills laboratory (SSL) is a specialised learning facility
designed to simulate real-life clinical scenarios for students to learn,
experience and practice procedures in a safe and controlled environment as a
method of educating without putting students or patients at risk.
▪ The SSL provides a bridging gap between education and practice and may be
utilized for both teaching and evaluation of students.
▪ Simulation areas are set up for actual clinical teaching/demonstrations before
students are allocated to the wards, for supervised practice sessions and
assessment of competence.

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▪ Adult, child and infant models for resuscitation and inserting intravenous
therapy should be available.
▪ Models of pelvises with dolls to demonstrate the mechanisms of birth,
skeletons and models of systems and organs are also necessary for anatomy
classes.
▪ To simulate the real-life scenarios that nurses are required to deal with,
various simulation areas can be planned for:
• General ward areas and associated support service areas
• Maternity delivery rooms
• Intensive care unit
• Primary health care consulting rooms
• Paediatrics wards
• Trauma
• Simulated Bathroom

6.3.2 Sample configuration of Simulation Labs

▪ There are various sizes of simulation areas containing different rooms
dependent on the programme offered.
▪ The simulation area may consist of just a ward simulation room with only one
bed, a sluice configuration against the wall within the ward area and a small
seminar room of the single bed ward unit or
▪ The simulation area may be a suite of rooms
▪ The simulation suite consists of skills laboratories, each with a focus on a
specific set of nursing skills: medical/surgical, health assessment,
maternal/child and critical care, dependent on the programmes to be taught.
▪ This allows students to acquire the full range of skills needed for nursing,
ranging from drawing blood, giving injections, taking temperatures, hanging
an IV bag to delivering babies and preparing toddlers for surgery.

The sample layout of the simulation suite may include:

• Four or Six bed simulated inpatient hospital rooms
• A multipurpose room that can function as a simulated Operating Room,
Emergency Room, or Intensive Care Unit

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• A professional skills/task training lab with body-part models for learning how to
perform such procedures as drawing blood, lumbar puncture, and insertion of
central and IV lines
• A sluice rooms
• A treatment rooms
• Counselling room with viewing room attached
• Assisted toilet\Assisted shower

Figure 6.1 Components of a sample simulation suite

6.3.3 Simulated bed unit

• A simulation bed unit consists of a room laid out to closely resemble the bed unit
on the inpatient unit with working hospital beds each with bed head services at
each bed - simulated oxygen, suction and medical air.
• There should be a locker next to the bed and bedside tables at each simulated
hospital bed area.
• Also included are IV poles, IV infusion pumps, medication administration
supplies, physiologic monitors, sinks, hand washing solution, gloves, IV supplies,

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thermometers, and other medical equipment as needed to simulate a hospital

environment.
• The exact set up depends on the programmes taught, facility, and student
number. High-tech video equipment (ceiling cameras, special monitors and AV
boxes) should be available in each simulation room to record simulations for
viewing by other students in all the classrooms in the Skinner Building.
• Simulations can also be recorded individually and replayed by the student or
student group privately so they can critically reflect on their performance in the
simulation. This is critical for the reflective discussions with faculty and students
after the simulations
• In each room, there should be a well-stocked cart of Heath Assessment supplies
that includes alcohol wipes, cotton balls, cotton-tipped applicators, tongue
blades, tape measures, penlights, reflex hammers, tuning forks, ear
thermometers, Welch-Allyn Suretemp thermometers, non-mercury
Thermometers with sheaths, eye charts, blood pressure cuffs (different sizes),
stethoscopes, and dual teaching stethoscopes.

Photograph 1: Bed Unit: General Ward Simulation Area

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Photograph 2: Standard Bed Unit Examples

The complexity of the bed unit simulation increases according to the programme:
▪ The registered auxiliary nurse programme: The simulation areas will
be simple with a standard bed unit and low-level mannequins
▪ The registered staff nurse: The simulation bed unit will be as per a normal
bed unit with beds, bed head services (oxygen, medical air and suction outlets
as well as an equipment rail) and a medium level mannequin. Areas must be
supplied for practice on simulated arms
▪ Registered Professional Nurse and Midwife: same as for the registered
nurse but with an additional maternity delivery set up which is usually in a
separate room
▪ Midwife: a maternity delivery room set up adjacent to the simulated bed unit

Photograph 3: Paediatric Bed Unit

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Photograph 4: Intensive Care Bed Unit

6.3.4 Control booth

• Each simulation room has a control booth room with 1 to 3 operators.
• The operator running the simulation has a laptop with the Sim Man/Sim Baby
program, confidence monitor, microphone, directions for the equipment, copy of
the simulation and a one-way mirror to view the simulation.
• Special lighting and shades should be available for adequate viewing of the student
performing the simulation procedure

Photograph 5: Simulation Skills Laboratory

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6.4 Simulation consultation rooms

• For the primary health care programme, rooms should be set up to simulate
consulting rooms.
• Depending on the number of students, there may be a number of these rooms.
• Each consultation room shall have an examination couch, rolling stools, desk,
exam lamps, wall otoscopes and ophthalmoscopes and other equipment needed
to perform health examinations.

6.5 Space for teaching rooms

• The nursing and midwifery institution must have physical facilities, clinical
training resources, information technology, research facilities, and educational
exchange programmes for the staff and the students to ascertain that the
curriculum can be delivered adequately in line with relevant policies.

• The nursing and midwifery programme shall have standard teaching and
learning resources to meet programme needs including:

• Classrooms to accommodate 40-50 students per sitting time

• Skills laboratories to accommodate 25 students per sitting
• Library to accommodate 100 students per sitting time
• ICT room to accommodate 20 students per sitting time.
• Adequate office space for staff members with standard furniture
• The layout of the laboratory is very important for aspects such as productivity,
safety, workflow, ergonomics etc. The space design considerations in a Nursing
laboratory:
• Should be allocated according to the functional requirements
• Should be flexible that can be utilised for several varied tasks
• Large classrooms should be able to be divided into several smaller spaces.

6.5.1 Classroom

• A classroom is a room or space used primarily for instruction classes and that is
not tied to a specific subject or discipline by equipment in the room or the
configuration of the space.
• The size of classrooms shall be suitable for the courses and the educational
institution shall consider the student admission capacity (1.5m2 student).

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• There should be adequate classrooms, accommodating the required number of

students (e.g. for 20-40 students’ size of the room should be 67 sq. mt.).
• Rooms should be well ventilated and properly lighted.
• There should be chairs with arms or desks according to the number required.
• Suitably placed black/green or whiteboard should be available in the classrooms.
• Chairs and desks to be free-standing to allow for flexible arrangement within the
room.
• The floor should be flat
• Make provision for a wheelchair space of 4 m²

6.5.2 Seminar room

These rooms accommodate small groups of students seated in several different
configurations
• Large central table or multiple small tables that can be grouped into one
• Mostly designed for up to 19-25 seats
• A face to face seating arrangement is preferred
• Allow 2.3 to 2.8m² per seat (includes secondary circulation space within the
room)

6.5.3 Demonstration rooms

The demonstration room is an open area used to:
• Display anatomical items in cabinets or laid out on tables for students to
examine or tutors to use as examples
• Display informative posters on the walls
• Teach students anatomy and physiology through demonstration.

• The demonstration room shall be appropriately equipped and have enough

equipment and materials for each professional subject
• There should be sinks for washing hands, soap, protection materials, etc.
• There shall be a storage room for keeping demonstration equipment and
materials.
• Space needs to be open with freestanding desks that can be moved around the
room in different configurations.
• An alternative is to display the equipment in exhibition areas within the library.
New displays can be regularly (weekly) and the bulk of the display items can be

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stored in an adjacent store that is lockable as the equipment is costly. Lockable

display cabinets are recommended.

6.5.4 Computer Training Classroom/Laboratory

This space is designed for and furnished with computer equipment to serve the needs
for group instruction in formally or regularly scheduled classes. Computer rooms
used primarily to instruct students in the use of computers.
• This area should be adjacent to the computer training laboratory for the storage
of equipment
• There should be internet access
• An equipment storeroom is required next to the computer training room
• Design for future and current cabling and electrical requirements
2.2m² to 3m² per student accommodates the larger station sizes required for
equipment and writing space and generous aisle widths to allow unobstructed
instructor movement behind seated students

6.5.5 Offices
Offices are needed for support and teaching staff, with hot-desking arrangements for
teachers brought in for specific sessions.

6.5.6 Staffroom
There should be the necessary equipment for preparing lessons, such as computers,
printers, copy machines, etc

6.5.7 Storage rooms

Storage for the SSLs
▪ Storage space needs to accommodate mannequins, packs, equipment etc and
needs to be of a considerable size
▪ Space that directly serves an SSL as an extension of the activities in that facility
and includes storage of the equipment to be utilised in the facility.
▪ It can include a variety of mannequins, consumables, equipment etc. These
rooms will need to be lockable and well ventilated.
Refrigerated storage
▪ Movable refrigerators and freezers can be used for Nursing and Midwifery
laboratories.
▪ A space dedicated to them is also needed during designing the laboratory room.

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▪ If more materials need a temperature-controlled environment, walk-in freezers

and refrigerators (cold room) which provide large, centralized storage could be
considered
▪ Fridges & freezers may be used for the storage of certain hazardous substances.
Bulk storage
• Laboratory staffs and students use large quantities of consumables every day,
including reagents and dry items such as gloves, tubes, and paper products. An
appropriate storage space that is convenient to the laboratory must be provided.
• The bulk storage area should not be far from the laboratory room to avoid more
storage within the laboratory and consequently constrain the working area.
• The store shall be equipped with cabinets and shelves. Materials shall be labelled,
arranged in order, ready for use (charged) and there shall be ventilation and
enough light
Chemical/Waste storage
▪ Enough space or facilities (e.g. storage cabinets with partitions) shall be provided
to separate incompatible chemicals.
▪ It is recommended that solvent storage should NOT be located under the
laboratory fume hood, as this is a location where fires are most likely to occur in
laboratories.
▪ Chemical storage shelves shall not be placed above laboratory sinks.
▪ Chemical storage shelves shall be flush to a back wall and shall have a 1.30 cm lip
along the front edge.
▪ All labs should be designed to conveniently and safely accommodate the
temporary storage of biological, radiological, and chemical wastes based on
laboratory use projections.
▪ Adequate space must be available for the collection of waste material including
radioactive wastes generated by projects within the lab. Wastes are generally
stored in the lab in which they are generated, not in centralized accumulation
areas.

6.5.8 Toilets
▪ There should be adequate toilets facility in the school building for the students
and teachers
▪ There should also be a toilet space designated for disabled people which fulfils
the standard safety requirements.

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Toilet for disabled people

▪ A room containing a toilet and handbasin for use by disabled persons with or
without assistance and shall be a minimum space of 5 m².
▪ The Disabled Toilet should have direct access to a waiting or circulation passage.
Considerations:
▪ Toilets special height for wheelchair users
▪ Wash hand basin accessible whilst still on the toilet for paraplegics
▪ Wall fixed toilet for cleaning under Mirrors –height and size are important
regarding those using the facility
▪ Soap dispensers & hand towel dispensers, hands-free essential
▪ Soap dishes, towel rails (grab rails) in all ablutions
▪ Toilet roll holders in all toilets
▪ The door to be fitted with escape hardware to allow staff access in an emergency.
▪ Nurses call and emergency call buttons and indicators
▪ Elbow taps

6.5.9 Janitor room

A room dedicated for both cleaning staffs and a store for cleaning aids shall be
available in the medical laboratory facility.

6.6 Summary of the list of rooms and space required

Table 1 List of premises required for a Nursing school
Premises required Minimum No Room Size per
of rooms seat
required
Instruction areas
Classrooms 2 Different size
Seminar room 1 2.3 – 2.8m² per
seat
Computer training lab 1 3m²
Simulation rooms
Simulation - General ward (with the store) 28 – 42 m²
Simulation– Maternity (with the store) 28 – 42 m²
Simulation - Control room 10m2
Simulation sluice 28 – 42 m²
Simulation treatment room 28 – 42 m²
Simulation consulting room 28 – 42 m²
Demonstration room (with the store) 28 – 42 m²

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Simulation interview room with an 12m2

observation room adjacent
Simulation specialist (ICU, Trauma) 28 – 42 m²
Academic support areas
Office for 2 persons 2 9 m²
Staffroom 1 4-5 m2 per seat
Counselling room 1 9 m²
Meeting room 1 2.4-2.5 m2 per
seat
Toilet rooms and shower (Separate for men 2 each 0.16 m2 per
and female) person
Nurse changing room with cabinet, chairs, 1 12 m²
cupboard
Janitors room 1 10 m²
Storage room 1 NA

7 Laboratory Facilities
7.1 Laboratory Furniture

7.1.1 Lab benches

▪ A lab bench, with a full accessory, is one of the single most important parts of any
laboratory. This is the space where work is prepared, experiments take place,
readings are taken, and laboratory equipment is stored and used.
▪ Work surfaces must be an appropriate height to enable laboratory users to sit or
stand comfortably whilst working.
▪ The surfaces must be smooth, hard, non-absorbent and compatible with any
chemicals likely to be used in the laboratory and must be impervious to water,
resistant to acids, alkalis, solvents and disinfectants and easy to clean and a drip
strip must be cut on the under surface.
▪ There are three countertops for benches: chemically resistant plastic laminate,
epoxy resin, and stainless steel. Epoxy resin is a good solution in areas where
there are corrosive chemicals and in very wet areas, such as sinks.

7.1.2 Lab stools, Chairs, and Tables

▪ For all medical laboratories in each bench, there must be enough modern height
adjustable Vinyl Upholstery stool with a foot ring. They are movable and perfect
for mixed jobs. The stools should be chemical resistant.

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▪ Chairs used in the laboratory should be covered with a non-fabric material that
can be easily decontaminated. Enough ergonomic chairs shall be used hence
improper seating can hurt a person's health and productivity.
▪ A High-Back chair should be considered especially for work with computer
▪ The waterproof table should be integrated with an epoxy resin and stainless-steel
sink and explosion-proof standard electric socket, acid resistance preferably
made from marble or granite material.
▪ The Table arrangement can be a central areal shelf table or wall table attached to
the wall

7.1.3 Lab Cabinets and Shelves

Lab Cabinets
▪ The material and finish of the cabinets, drawers, and shelves should be resistant
to most chemicals and heat. It should also be easily cleanable.
▪ Enough separate substance storage coated steel cabinets with partitions for
alkalis and acids must be well installed in each laboratory.
▪ The cabinet on which the hood is installed shall be adequate to support shielding
for the radioactive materials to be used therein.
▪ The cabinets must NOT be in an area likely to flood, such as directly below mains
water pipes.
▪ The cabinet must NOT be located near any ventilation inlets or outlets.
▪ The cabinet must be fire rated for 30 minutes, if located under a fume hood or in
a basement area it must be fire rated for 90 minutes.
Shelves
▪ An adequate number of shelves shall be necessary for each laboratory according
to the size of the laboratory and requirements
▪ Generally, shelves must not be more than 1.8 m from floor level.
▪ Any shelving on the workbench spine must-have shelf backs installed.
▪ Vertical storage carousels should be considered instead within consumable
stores.
Lockers
▪ Lockers are necessary for staff coats, boots and personal items and a double lock
locker is recommended.
▪ If the staff changes clothes, separate male and female locker rooms (or changing
rooms) should be provided.

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▪ If toilet rooms connect with the locker room, they can double as changing rooms.
Hooks
Laboratory staff needs places for clean and dirty laboratory coats; this includes
laboratory coat hooks inside the laboratory adjacent to exit doors so that
contaminated laboratory coats can be taken off before exiting

7.1.4 Patient/Simulator Beds

There are different bed types broadly classifies as simple and special beds based on
the application and patient or procedure type. For teaching purpose, all types of beds
shall be available to simulate the hospital setup.

7.2 Fridges & freezers

▪ Fridges & freezers may be used for the storage of certain hazardous substances.
▪ However, where the substances are flammable the unit must not contain any
internal light source or thermostat that could provide a source of ignition for any
flammable vapour.
▪ Proprietary laboratory fridges and freezers that meet these requirements are
available from major lab supply companies are recommended over domestic
appliances.

7.3 Special Need Equipments

Nursing and Midwifery laboratories shall have enough special need equipment such
as wheelchairs, crunches, etc.

7.4 ICT and Audio-visual aid

A Nursing school should have
▪ An overhead projector, DVD TV, player, laptop, and software’s
▪ Educational DVD’s, Posters, and other visual aids
▪ A smartboard to facilitate the teaching and learning process
▪ Shall be equipped with Whiteboards and movable flip chart boards with enough
papers, markers and dusters at each room
▪ Different models, charts, skeleton, dolls etc. for demonstration and skill
development
▪ CCTV Cameras installed at all labs for monitoring and control
▪ Telephone and/or radio communication

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7.5 Generator
• An alternate power source (generator) shall be ready for immediate power
backup during a power interruption.
• The generator should have an auto transfer switch and soundproof canopy
• These ratings are applicable for supplying continuous electrical power (at
variable load) in the event of a utility power failure. No overload is permitted
on these ratings

7.6 Basic Nursing lab equipment and apparatuses

The following minimum equipment and products shall be available in

Nursing and Midwifery laboratories:
a. Specimen collection set
b. Rubber Sheets
c. Restraining equipment (e.g., cushion, belt, vest, long sleeve pullover, etc.)
d. Patient Chart Folders, Midwifery chart and kits
e. Emergency resuscitation sets: airway, Ambu bag of different size
f. Vital Sign Equipment
• Bedside weighing scale • Thermometer, BP apparatus,
• Pulse oximetry stethoscope, measuring tape
• Sphygmomanometer with • Trolley for vital sign monitoring,
stethoscope • Wristwatch/ wall clock,
g. Nursing procedure equipment:
• Bedpan • Dressing set
• Bed screens • Dressing trolley
• Canuala of different gauge • Electrical/pedal
• Catheter (different type, poly, • Enema set
plain, etc) • IV stand
• Catheters • Kidney basin
• Chest tubes and bottles • Minor set
• Connectors • Mobile Examination light
• Cushion bags • NG tube
• Drapes • Oxygen cylinder

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• Oxygen face mask/ nasal • Safety boxes

• Oxygen regulator/gauge • Suction machine:
• Oxygen trolley • Urinal
• Plastic apron • Wastebasket
• Rubber sheets • Wheelchair
h. Soiled utility room:
• Basket, wastepaper, metal • General-purpose trolley
• Bedside cabinet • IV stands
• Bin with lid • Patient chart holder
• Cabinets • Refrigerator
• Chair, stool, stackable, without • Soiled linen trolley
armrests • Table
• Feeding table • Washtub (65L)
• Furniture and fixtures • Worktable with laminated top

7.7 Chemicals and reagents

The following standard chemicals and drugs are required in Nursing and Midwifery
labs

7.7.1 Chemicals and reagents

• Ethyl alcohol • Iodine and iodophor solution
• Bleach • Hydrogen peroxide
• Amicrobial soap • Isopropanol
• Detergents • Chlorohexidine
• Antiseptics and anti-
disinfectants
Oral care agents
• Toothpaste • Fluconazole
• Nystatin • Sucralfate
• Chlorohexidine gluconate • Fluoride
• Sodium bicarbonate • glycerine thymol
7.7.2 Drugs and Medicines
• Antibiotics • Ophthalmic agents
• Contracepts • Gastrointestinal

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• Antihypertensive • Ear, nose, and throat

• Antidepressant preparations
• Antidotes • Antifungal agents
• Vaccines • Respiratory medicines

7.8 Clinical Skill Laboratory (CSL)

Clinical skill labs are designed to recreate a virtual hospital environment complete
with high fidelity simulators and state of the art equipment. This is intended to
provide a safe, risk-free environment where students can practice nursing skills and
patient care without the risk of harming an actual patient. The labs offer facilities to
practice and learn a wide range of nursing skills in a safe non-threatening
environment that benefits both the student and the patient.

Clinical nursing skill laboratories for undergraduate Nursing programme comprise

the following labs but not limited to namely:
6. Fundamentals of nursing laboratory
7. Physical Assessment of Nursing Laboratory
8. Paediatric and Neonatal nursing laboratory
9. Obstetric & gynaecological laboratory
10. Critical care nursing laboratory
The clinical skill labs shall be on the same floor and connected for sharing items and
easy management. The infrastructure, facilities, and safety standards required for
each laboratory is presented as follows.

Table 3 List of instrument and items required for Nursing and Midwifery skill
laboratories
SN Name of the Laboratory
1 Fundamentals of
Nursing Laboratory
Items
General Medical Supplies
a) Adhesive Tape 1/2 inch width
b) Adhesive Tape 3/4 inch width 1
c) Adhesive Tape 1-inch width
d) "Ace" Type Bandages (Any width)
e) Surgical wound dressing/gauze packs
f) 2x2 gauze pads

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g) 4x4 gauze pads

Access Equipment for Simulation
a) IV cannulas ‐ 16 to 24 French
b) IV gravity flow vented chamber sets
c) 3 ml, 5ml, 10ml syringes
d) TB skin test and Insulin syringes
e) Filter needles for drawing up medicines
f) Ostomy bags with proper rings
g) adhesives for ostomy kit
Standard items for bedside care
1) Sheets
2) Blankets
3) "Mac sheets" (leak protection for bed)
4) Towels
5) Wash clothes
6) Bedpans / normal and "break pans"
7) urinals
Assessment tools
1) Otoscopes w rechargeable batteries
2) Penlights for eye exam rechargeable
3) Snellen eye chart
4) Neuro exam hammer
5) Electronic BP machines
6) Handheld ultrasound machine
Anatomy instructional tools
• Hanging wired full-size adult skeleton
Organ models
• Heart
• Lungs
• Liver
• Kidneys
• Female Pelvis with organs
• Male Pelvis with organs

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• Brain Model
2 Physical Assessment Simulators: Ear Examination Trainer, Kyoto
Nursing Laboratory Lung Sound Auscultation Trainer, Kyoto
Cardiology Patient Simulator K, Multiple Heart
Breath Sound Tutor
Models: Torso Model, Skull, Reproduction,
Breast Cancer, Shoulder, Hip, Arm, Knee, Ear,
Heart
Machines: Electronic Height and Weight Scale,
Electronic Patient Beds, Television, CD Player,
Projector
3 Paediatric & Simulators
Neonatal Nursing • Maternal Neonatal Birthing
Laboratory Models
• Fetal circulation
• Stages of intrauterine development
• Newborn reflex
• Milestone of infancy
• Preschooler
• Schoole
• Normal heart
• Cyanotic heart diseases
• Hydrocephalus
• Cushing syndrome
• Cleft lip and palate
• Tracheoesophageal fistula
• Protein-energy malnutrition
• Weaning
• Neonatal intensive care unit
Charts
• Feeding protocols at different child group
• Caput succedenum&cephalhematoma
• Spina Bifida
• Anencephalus

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Manikins
• Newborn CPR manikin
• Pediatric injectable arm
• Intramuscular injection simulator
• Arterial puncture arm
• Central venous cannulation simulator
• Chester's chest
• Suturing &stapling practice arm
• Tracheostomy care simulator
• Naso gastric tube model
• Male &Female catheter model
Articles
• IV Cannula
• Scalp set
• Tourniquet
• A small tray with a lid
• Syringe 1cc,2cc,5cc,10cc,20cc
• Foleys catheter
• Infant feeding tube
• Suction catheter
• Infant urobag
• Urometer
• Test tube
• Xylocaine gel
• Gloves (sterile & unsterile)
• IV stand
• Burette set
• Inch tape
• Thermometer (oral &rectal)
• Pediatric Weighting machine
• Breast Pump
• Cradle
• Mucus suker
• Kidney tray small(plastic)

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• Pediatric pillow
• Small dolls and Toys
• Linen (bed sheets)
• Footstool
• Chest drainage tube
• Mackintosh
• Sponge cloth
• Vessel with lid
• Bottle Brush
• Silver glass
• Torch
• Long Scale
• Stethoscope
• Knee hummer
• Measuring cup
• Chettle forceps
• Thump forceps
• Artery forceps (straight, curved)
• Enamel Tray (small, medium, big)
• Pedi BP apparatus
• Plaster
• Splint
• Cotton roll
• Goaz bandage
• Pedi nail cutter
• Pedi tongue depressor
• Pedi rectal tube
• Dropper
• Pedi nasal cannula
• Transport Trolley
• Plastic Pocket
• Basin
• Plastic Jug
• Towel

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• Feeding bottle
• Teaspoon
• Pedi ambubag(different size)
• Tracheostomy tube
• Laryngoscope(small)
• Restraints (Jacket, abdominal, elbow)
• Bulb sucker
4 Obstetrics & Equipment /supplies
Gynaecological • Disposable sterile drape
(OBG) Nursing • Disposable umbilical cord clamp
Laboratory • Stainless graduated pitcher
• Stainless small bowel with cover
• Instrument tray with cover
• Instrument tray without cover
• Kocher
• Instrument tray
• Curved forceps
• Needle holder
• Bandage scissors (arge&3small size)
• Straight scissors
• Tissue forceps with tooth
• Umbilical scissors
• Curved scissors
• Straight forceps
• Ouvard vaginal retractor
• Non-pregnant uterine curette
• Cervical dilator
• Uterine sound
• Delivery forceps
• sim's speculum
• Ovum Forceps
• Tissue forceps without tooth
• blade holder
• towel clip

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• curved forceps
• Kidney basin steel
• curette spoon
• Plastic pitcher
• 24 H urine collection bag
• Cold compress pack
• Bedpan, plastic
• Pen Light
• Stethoscope
• Otoscope
• Tuning fork
• Percussion hammer
• Measuring tape
• suction apparatus
• Sphgmomanometer
• Deliver coach
• Bed mattress
• Burgamode
• Sheets
• Stethoscope
• Thermometer
• Tongue depressor
• Weighing scale
• Towels and bed linens
• Examination gowns
• Waterproof sheet (mackintosh)
• Disposable towels/drapes
• Cord clamps (disposable)
• Safety box for sharps
• Cotton or woollen blankets/sheets – for
mother and baby
• sutures
• Syringes (various sizes)
• Needles (various sizes)

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• Mucus extractor
• Decontaminant
• Personal protection equipment
Models
• Female pelvis w/internal organs
• Female genital organs Male pelvic
• Female Breast Model
• Female pelvis Skeleton
• Family planning (IUD, oral contraceptive),
pills
• New-born model
• Abdominal palpation model
• vaginal examination models
• perineal suture model
• Cervical dilation model
• Fetal monitoring & labor progress model
• Pelvic bone w/2 fetal heads
• Birth model
• Blue Phantom U/S Training model
• Breast Examination Model
• Fetal head for intubation
• Fetal doll female
• Fetal doll male
• Newborn doll
• Fetal model with placenta
• Resuscitation Manikin, Baby
• Mama Natalie pregnant and non-pregnant
models
Simulators
▪ Childbirth Simulator
▪ Obstetrical manikin
▪ Cervical dilation/effacement simulator
▪ Episiotomy suturing simulator

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Charts/Visual Depictions
▪ Female reproductive anatomy
▪ Male reproductive anatomy
▪ Normal changes of pregnancy
▪ Prenatal discomforts
▪ Foetal development
▪ Stages of labour
▪ Cervical dilation and foetal descent
▪ Mechanisms of birth (vertex & breech)
▪ Malpresentations
▪ Episiotomy details
▪ Perineal and cervical tears (a technique for
repair)
▪ Adolescent growth and development
▪ Newborn resuscitation protocol
▪ Adult resuscitation protocol
▪ Contraceptive methods
▪ Family planning flip chart
▪ Lactational Amenorrhoea Method (LAM)
▪ Standard days method beads
▪ Gestational age calculator (pregnancy
wheel)
▪ Digestive system
▪ Reproductive system
▪ Renal system
▪ Musculoskeletal
▪ Nervous
▪ Respiratory
▪ Cardiovascular
▪ Anatomy of the breast
Books/Manuals/Videos examples
• National FP protocol
• Manual removal of placenta
• Management of shoulder dystocia

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• Bimanual compression of the uterus

• Aortic compression
• Breastfeeding/latching on
• woman-centred Abortion Care
• Stages of childbirth
• Labour/birthing positions
• States of pregnancy
• Menstrual Cycle
Documentaries (DVD/video)
• IM injections for vaccinations
• CPR
• Processes of pregnancy
• Delivery process
• Essential newborn care
5 Critical Care Nursing Simulator: HAL S1020 Articulating Adult
Laboratory Simulator, Laerdal ALS Skill Master Simulator,
Code Blue Adult Simulator with Defibrillator,
Interactive ECG simulator, Vascular Access
Devices (VAD'S) Simulator Arterial Puncture
Trainer,

Mannequins: Digital Telecontrol Abdomen

Palpation Manikin, Adult Patient Education
Tracheostomy Care Manikin,

Models: Intra Venous Training Arm,

Tracheostomy Care Trainer, Adult airway
management trainer, Paediatric airway
management trainers, neonatal airway
management trainers
Machines: Suction Machines, Infusion Pumps,
Cardiac Monitor, Syringe Pump, ECG Machine,
Portable ventilation device, cardioversion

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device, AED, Intensive care ventilator, Syringe

pump
Equipment:
• Oxygen Suction
• 10ml syringe
• Laryngoscope
• Magills forceps
• Lubricant
• Airway
• Resuscitation bag and mask
• Suction Catheter
• Drugs as ordered
• Stethoscope
• Leucoplast tape
6 Maternity and New- Simulators: Maternal Neonatal Birthing
Born Health Nursing Mannequins: Obstetrical and Gynaecological
Laboratory Trainers
Models: Fetal Skull with Female Pelvis, Breast
Milk Expression, Female Pelvic Examination,
Female Pelvic Organs, Anal Sphincters,
Abdominal Palpation, Episiotomy Suturing,
Baby Care
Machines: Electronic Neonatal Weight and
Height Measuring Scales, Electronic Paediatric
Sphygmomanometers

7.8.1 The lifetime of instruments, apparatus, chemicals, and reagents

All instruments, equipment, apparatus, chemicals, and reagents shall not be used
beyond the date of the expiration based on the manufacturer's direction.

7.8.2 Calibration and Controls

▪ All Nursing and Midwifery laboratory instruments and equipment that need
calibration shall be calibrated according to the manufacturers and supplier’s
recommendation.

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▪ Daily quality controls shall be carried out for automated instruments

8 Health and Safety

8.1 Ensuring health and safety
Because of the nature of the work, there are many hazardous materials and medical
waste in a Nursing and Midwifery laboratory setting. Health care facilities have
several requirements related to the health and safety of employees. To ensure the
health and safety of the students and staffs:
• The nursing and midwifery programme shall have and implement written
policies that address student and teacher safety and wellbeing in teaching and
learning environments.
• All workers and students should be aware of potential hazards and how to deal
with them.
• There are many different types of hazards within a laboratory; therefore, all
workers must be familiar with common types of accidents and how to deal
with them.
• They should have training in handling hazardous materials, such as laboratory
chemicals and tools.
• Employees and students must receive special training on Occupational Safety
and Health Administration topics such as bloodborne pathogens to prevent the
spread of disease through improper handling of infected materials.
• Whenever any accident occurs in the laboratory, the supervisor or person-in-
charge should be informed, and the incident should be recorded in a logbook.
• Human resources managers are often responsible for conducting or
coordinating required training sessions for laboratory staff.

8.2 Design considerations for safety

• Determine the classification of the laboratory and build accordingly

• Arrange the doors, aisles, equipment, furniture, and corridors to allow direct
and rapid escape in the case of emergency
• Install the correct type of doors with the required arrangement
• Keep hazards away from the doors and paths of egress

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• Ensure proper storage facilities for flammable materials and gas tanks if
available
• Have fire alarm readily available and equipped with visible and audible alarms
• Provide fire extinguishers at all required places
• Provide clean handwash sinks throughout the lab and at the exit in level 3 labs
• Provide emergency eyewash stations and emergency and emergency shower
• Consider the ergonomic issue during design to be as ergonomically correct as
possible

8.3 General safety guidelines

• Safety guidelines, policies, and procedures must be prepared and

communicated for all faculty, staff, and students and shall be always kept at all
laboratories
• Ensure all faculty, staff, and students always know and practice the safety
guidelines while using the labs.
• The Lab Coordinator will ensure that faculty, teaching assistants, students,
and student employees have up to date guidelines, policies, and procedures.
• All lab doors should be locked unless occupied by faculty and/or students
during class or practice.
• Students should always practise safe and appropriate techniques while in the
lab.
• Students should be knowledgeable of the care, handling, and proper use of
equipment before using it in the laboratory.
• Students should inform course coordinators of physical disabilities, recent
injuries, illnesses, surgeries, and latex sensitivities/allergies

8.4 Guides to potential hazards

• All laboratory personnel should be properly trained to identify hazards in the

workplace.
• Many chemical, radiation, and biological substances must be marked with
hazard identification symbols.
• This can alert laboratory personnel to use extra caution when handling these
substances.

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8.5 Safety equipment and personal protective equipment

• Personal protective equipment (PPE) is the clothing or gear used to protect the
user from specific hazards or hazardous materials.
• PPE does not reduce or eliminate the hazard but only protects the user.
• It is the last protection system to be used when administrative and engineering
controls do not reduce risk to an acceptable level.
• Employers are required to train each employee who must use PPE.

8.5.1 Eye and face protection

• Eye and face protection is extremely important when working in a lab and
must be used if hazards are expected that could cause face or eye injury.
• Eye protective Safety glasses and goggles must always be worn when working
in the lab.
• Face shields safeguard the entire face from projectiles and offer some safety
from splashes. Goggles or safety glasses must be worn under face shields. It
should have the following features:
- Should allow unrestricted functioning of any other required PPE.
- Should be reasonably comfortable to wear and fit properly.
- Should provide unrestricted movement and vision.
- Ability to protect against specific workplace hazards.
- Should be cleanable and durable or disposable

8.5.2 Respiratory protection (Masks)

• Inhalation is one of the main routes by which injurious materials can enter the
body.
• If an individual is exposed to any airborne concentration of such a harmful
material, then it may affect the health.
• Masks are recommended as a protection against any aerosol-generating
procedure
• A proper type of mask should be selected as per the hazard and level of
laboratory
• Staff should be well aware of their use and limitations.

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8.5.3 Lab coats and Aprons

• Wear protective clothing that resists chemical, physical and biological hazards
when contact may occur.
• Disposable outer dresses may be used when cleaning and decontamination of
reusable clothing are difficult.
• It is recommended that disposable material sheets must be used instead while
working in the labs dealing with highly infectious materials.

8.5.4 Gloves

• Wear gloves whenever handling hazardous materials, biological samples,

chemicals of unknown toxicity, corrosive materials, rough or sharp-edged
objects, and very hot or very cold materials.
• The use of gloves protects against skin absorption of chemicals, thermal burns,
chemical burns, and cryogenic liquid exposure
• Lab staff and workers should be properly trained regarding the procedure of
wearing and removing gloves.
• Latex gloves are usually utilized; in case of latex allergy, Teflon gloves or other
varieties may be used.

8.5.5 Foot protection

• Always wear closed-toe shoes in buildings where chemicals are stored or used.
• Do not wear perforated or open shoes, cloth sneakers or sandals in
laboratories or where mechanical work is being performed.
• These shoes offer no barrier between the worker and chemical, biological and
physical hazards.
• Leather shoes are likely to absorb chemicals and may have to be discarded if
soiled with the hazardous material.

8.5.6 Protection from sharps

• Scalpels, broken glass, needles, and other sharps are generally associated with
accidental injuries and in turn transmission of microorganisms if
contaminated.
• Staffs and students should be well trained on how to use the sharps and their
disposal correctly.

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• Appropriate usage of sharps containers diminishes the chances of injuries and

transmission of potentially harmful agents.
• All sharps should be considered possibly infectious and should be discarded in
puncture-resistant and leak-proof safety containers.
• The opening of the proper discarder is one-sided so once the used material is
introduced inside, it won't let out. Only one-third of the boxes are to be filled.

8.6 Hand washing

• Hand washing is the simplest but extremely useful procedure to prevent the
transmission of microorganisms and the acquisition of infection in biomedical
laboratories.
• Hands can be contaminated during handling of contaminated equipment,
sample collection, handling of sample containers and touching of sample
storage units.
• Simple handwashing with soap and water should be a habit for all personnel
using the labs to prevent the spread of infectious agents.

8.7 Fire safety

• The wall, ceiling and roof construction shall be of 1-hour fire-resistive

construction for one-story building and 2-hour fire-resistive for multi-story
buildings.
• Floor systems shall be of non-combustible construction.
• Fire Egress should be available, and it should not be blocked by the sample
handling system
• A suitable fire detector should be selected and placed in the laboratory
• Fire alarms must be available in every area of the laboratory that might be
occupied.
• During activation of the alarms, notification to all areas must be visible and
audible.
• There must be a fire extinguisher preferably near the exit doors. In some
situations, locating fire extinguishers near any hazard is considered preferable
to avoid personal trapped without escape and an extinguisher.

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8.8 Safe Storage in Laboratory

• All flammables should be stored adequately, identified and labelled properly

and their Safety Data Sheet should be available.
• Heat, sunlight, moisture and other storage conditions should be adequate.
• Safety Data Sheet sent by the supplier or manufacturer needs to be consulted

8.9 Waste collection and disposal

- Wastes are generally stored in the lab in which they are generated, not in
centralized accumulation areas.
- Space for appropriate clinical waste bins must be provided near all laboratory work
areas.
- Wastes must be properly segregated, labelled, and temporarily stored in the lab
until proper disposal.
- Generally, waste bins must be lidded (of the appropriate colour and labelled),
Hard-sided, Foot-operated (hands-free), and Fire retardant.
- Hazardous wastes must be labelled as hazardous waste and sent to waste facilities.
- Any toxic waste shall not be discharged through a sink, it should be stored and
discarded properly.

8.10 Safety signs and signals

- Each laboratory must have a signage holder for clearly displaying hazard
communication information at the entrance door
- Relevant signs, indicating hazards that will be present and local mandatory
requirements, must be placed at an appropriate height on entry doors to
laboratories or suites of laboratories and storage cupboard doors.
- Safety precautions on the use and handling of equipment and chemicals should be
posted on the lab walls which can be clearly seen by researchers and students

8.11 Labels
- All chemical containers should be clearly labelled with the full chemical names (no
abbreviations or formulas), date opened, and appropriate hazard warning
information.
- All waste containers should be clearly labelled with the waste type and appropriate
hazard warning information.

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- Manufacturer chemical labels should never be removed or defaced until the

chemical is completely used.
- Small containers that are difficult to labels such as 1-10 ml vials and test tubes can
be labelled as a group and stored together.
- Unattended beakers, flasks, and other laboratory equipment containing chemicals
used during an experiment should be labelled with the full chemical names.
- All hazardous waste containers must be tagged with "hazardous waste."
- All hazardous waste containers must be marked with an accumulation date. The
accumulation date represents the date that hazardous waste is first placed in the
container (waste containers should NOT be filled to more than 90% of their
capacity).
All chemical storage areas such as cabinets, shelves and refrigerators should be
labelled to identify the hazardous nature of the chemicals stored within the
area (e.g., flammables, corrosives

8.12 First aid kit

A first aid box must be provided in a laboratory for immediate use. The technical
staffs are required to train in first aid so that they can assist when a person needs first
aid. The laboratory teaching staff is responsible for restocking items purchased at the
stockroom.

8.13 Emergency Exit

Two or more emergency exits shall be provided for each lab and this is dependent on
the size of the laboratory, the number of people working in the lab, and the level of
hazard. When there is a high hazard risk, it is prudent to provide a second emergency
exit door, even if the lab is small.

8.14 Training for laboratory personnel

• Any person who works in a laboratory must receive correct training to be

aware of the possible hazards in the laboratory.
• It is the responsibility of the leadership and the administration to conduct
training sessions for the workers so that they are conscious of the potential
hazards and accordingly the preventive and safety measures should be
adopted.

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9 Documentation
9.1 Laboratory Manuals and Protocols

9.1.1 Operational Manuals, Standard Operational Procedures (SOP)

and Instructions
The operations manual is the documentation by which an organization guides the
institution to perform its functions correctly and reasonably efficiently. It documents
the approved standard procedures for performing operations safely to conduct works.
A formal and approved operation procedural manual shall be documented in each
laboratory equipment and apparatuses.
Standard operational procedures having checklists/to-do-list documents, step-by-
step and hierarchical lists, and process flow charts are mandatory for each biomedical
laboratory.

9.1.2 Checklists/Catalogues
Checklists or a comprehensive list or registration of each piece of equipment,
instruments and apparatus shall be documented. Checklists shall include the separate
name, purpose, date/date range, tasks included, and it must be repeated for every
task.

9.1.3 Product Information and Specification Sheet

In each Nursing and Midwifery laboratory, there must be a product specification
sheet in which it shows the details of what each product is. A product specification
shall contain key information (e.g., target users, business needs, goals, and other
essential details) to help guide the product team in building a successful product.
There should be a broad overview and numerous sections that detail the individual
components of the product. The specification shall provide a description and
statement of the requirements of a product, components of a product, the capability
or performance of a product, and/or the service or work to be performed to create a
product.

9.2 Safety Data Sheet

For each Nursing and Midwifery laboratory, Safety Data Sheet is mandatory which
includes information such as the properties of each chemical; the physical, health,

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and environmental health hazards; protective measures; and safety precautions for
handling, storing and transporting the chemical.

9.3 Log Sheets

A log sheet is necessary that features the details of events. A daily Log sheet is
mandatory to record informal issues, required actions or significant events not caught
by other registers or logs. It acts as the lab diary for the lab technicians.

9.4 Brochures
Each Nursing and Midwifery laboratory shall have a brochure which is an informative
paper document (often also used for advertising) that can be folded into a template,
pamphlet, or leaflet. Brochures shall also be a set of related unfolded papers put into
a pocket folder or packet. A minimum standard size brochure of 21.6 x 28cm is
necessary. But the size that institutions should pick for their brochure will depend on
their content.

9.5 Learning and Information-Oriented Books

▪ Laboratory rooms shall provide current and up to date reference books, supply
books, pathology record books, reference magazines, etc for reference.
▪ Bookcases shall be provided in a convenient area that is used only by the
laboratory staff.
▪ There shall be bookcases provided in the laboratory testing areas for those
manuals and references used regularly during testing.

9.6 Summary of Documentation

• Safety Data Sheets (SDS) must be available in the laboratory for all chemicals.
• Require students to sign safety agreements indicating that they have been
informed about all the safety requirements and the hazardous nature of the
microbes and materials.
• The laboratory instructor must maintain student signed agreements in the
laboratory.
• Maintain and post caution signs on lab doors (complete with biohazard
symbol).
• Instructors must provide a detailed list of microorganisms that will be handled
in the laboratory to students.
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• This list can be included in the syllabus, laboratory manual, or online at the
course website.
• Emergency phone numbers and information must be posted in the laboratory

10 Quality Assurance
Programme providers must use effective quality assurance processes to enhance
quality nursing/midwifery education.

• The quality assurance processes must be aligned with the programme

specification, program evaluation and enhancement.
• Must ensure that the feedback from students, mentors, and practice teachers is
used to improve the programme and enhance the practice learning
• The management of the institution shall facilitate annual quality assurance
reviews of the institution.

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11 References
1. Laboratory Design; Approved Guideline – second edition (2007), Clinical and
Laboratory Standards Institute, Vol.27, No.7

2. Safety Design Standard SDS 03 V.01 (2012), Kings College London, University
of London.

3. UNC laboratory design guidelines (2013), The University of North Carolina,

Department of Facilities Services

4. Laboratory Safety Manual (Revised 2020), Medical Laboratory Science

Program Department of Pathology, University of Utah

5. Fundamental of nursing procedure manual for PCL course (2008), Nursing

Department, Khwopa Poly-Technic Institute ＆Japan International
Cooperation Agency (JICA)

6. National Standards for Clinical laboratories (2013), Ministry of Health, Quality

Assurance Section, Republic of Maldives.

7. IUSS health facility guides Nursing Education Institutions (2014), Department

of Health, The Republic of South Africa.

8. Basic Medical Laboratory Requirements, Ethiopian Standard ES3610:2012

9. Advanced Medical Laboratory Requirements, Ethiopian Standard ES

3609:2012

10. Higher Education Policy and Strategy (2020), Ministry of Science and Higher
Education

11. Guidelines for Professional Behaviour in the Clinical Skills Laboratory (2016),
Dundalk Institute of Technology, School of Health and Science Department of
Nursing, Midwifery, and Health Studies.

12. Global Standards for Midwifery Education (2010) Amended 2013,

International Confederation of Midwives
13. A guide to nursing and midwifery education standards (2015), WHO Regional
Publications, Eastern Mediterranean Series

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