Refrigerators

Q: Generally, is it permitted to use a refrigerator in offices in healthcare facilities when considering fire safety? I ask because more and more offices are starting to request refrigerators.

A: The Life Safety Code does not regulate where appliances like refrigerators may be placed, other than they may not obstruct the required width of the means of egress. I would think refrigerators in an office should not be any problem, other than temperature control of the office.

 

But check with your state and local authorities to see if they have other restrictions.

Toaster Ovens

Q: Are toaster ovens with a grounded third prong plug acceptable in a hospital staff lounge? The plug should allow for any short-circuit.

A: Actually, according to section 19.3.2.5.2 of the 2012 Life Safety Code, I believe toaster ovens are permitted in hospital staff lounges, that are separated from the corridor. The Annex section of 19.3.2.5.2 says it is intended to permit small appliances for reheating, such as microwave ovens and toasters to be exempt from the requirements for commercial cooking equipment and hazardous area protection. But the problem with toaster ovens, is it is a perceived risk by many authorities, because one can set the toaster oven to 450 degrees and it will stay on indefinitely creating a heat source, unlike microwave ovens and even toasters that automatically turn off. So, authorities often ask the hospital if they have a risk assessment or a policy on the proper use of toaster ovens since it is a perceived risk. I think requiring the hospital to have a risk assessment or a policy on the proper use of perceived risk such as a toaster oven is a valid concern.

Oxygen in Use Around Hair Dryers

Q: Can you tell me what the rules are for oxygen usage around hair dryers might be?

A: As you can imagine, the codes and standards cannot have rules for every possible scenario. The NFPA codes and standards primarily deal with the storage of oxygen cylinders, and installation of piped oxygen systems. The NFPA codes and standards do not deal much with the use of oxygen… those standards would likely come from Respiratory Care regulations. To give you an idea, NFPA 99-2012, section 5.1.3.3.1.6 says indoor locations for oxygen shall not communicate with locations storing flammables, kitchens, and areas with open flames. Now, I presume there would not be any open flames around a hair dryer, but you get the idea that a heat source (i.e. a hair dryer) around oxygen is not a good idea. But, there is one standard in NFPA 99-2012 that could be of some help for you. Section 11.5.1.1.4 says: “Nonmedical appliances that have hot surfaces or sparking mechanisms shall not be permitted within oxygen delivery equipment or within the site of intentional expulsion.” Hair dryers are definitely ‘nonmedical’ and they do have hot surfaces, so you could use this section of NFPA 99-2012 to prohibit the use of medical oxygen therapy in close proximity to hair dryers.

Patient Owned Equipment

Q: How are we supposed to deal with patient owned equipment that is brought into the hospital, such as laptop computers, hairdryers, and electric razors? Are we required to maintain a record of electrical checks?

 A: CMS and the accreditation organizations do not specify what your process should be on how to inspect patient owned equipment. As previously mentioned, NFPA (1999) section 7-5.2.2.1 does provide guidance on initial electrical inspections. But first, conducting a risk assessment is a proper course of action to determine whether patients should be allowed to bring in their own equipment. The accreditation organizations expect healthcare facilities to develop a process to address patients’ personal equipment that would be included in the medical equipment management plan. This process should use risk criteria based on equipment function, physical risks associated with the use, and incident history. Documentation of some sort would be expected to prove to a surveyor that the initial inspection and subsequent risk assessments were conducted.

Hospital Owned Appliances

Q: How does CMS and the accreditation organizations look at preventive maintenance of household electrical items, such as lamps and coffee makers used by staff in the hospital? Do I need to remove them from the facility?

 A: No, you do not need to remove those items from your facility, but CMS and the accreditation organizations will expect that you follow accepted practices of conducting initial electrical checks on all equipment used in the hospital, but additional follow-up preventive maintenance (PM) activities would be up to you. NFPA 99 Health Care Facilities (1999 edition) has guidance on this issue under section 7-5.2.2.1, which requires the leakage current for facility owned appliances (e.g. housekeeping or maintenance appliances) that are used in a patient care vicinity and are likely to contact the patient must be measured. The leakage current shall be less than 500 microamperes. Household or office appliances not commonly equipped with grounding conductors in their power cords shall be permitted provided they are not located within the patient care vicinity. For example, electric typewriters, pencil sharpeners, and clocks at nurses’ stations, or electric clocks or TVs that are normally outside the patient care vicinity but might be in a patient’s room, are not required to have grounding conductors in their power cords. The patient care vicinity is defined as a space for the examination and treatment of patients which extends 6 feet beyond the normal location of the bed, table, chair, treadmill, or other device that supports the patient during examination and treatment, and extends to 7 feet 6 inches above the floor. After the initial electrical current check, conduct a risk assessment to determine if these household types of equipment are required to have periodic planned maintenance activities or only be addressed on an as-needed basis.