Electrical Appliances Not Located in the Patient Care Vicinity

I was recently asked how Joint Commission and other authorities look at  electrical items used by staff that do not come into contact with patients, such as refrigerators, fans, coffee pots and lamps.  Do hospitals have to remove all of these personal use appliances? The short and quick answer is No, but there are some things you need to be aware of.

When they do not have a direct standard which addresses the issue, Joint Commission will refer to NFPA 99 on the use and testing requirements for electrical equipment. They are permitted in the hospital, but they must be checked before they are placed into service. Take a look at section 7-5.2.2.1 of NFPA 99 (1999 edition) which says:

Patient Care Area: 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 shall be measured. The leakage current shall be less than 500 microamperes. Tests shall be made with Switch A in Figure 7-5.1.3.5 in the open position for two-wire equipment that is not double-insulated. 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, shall not be required to have grounding conductors in their power cords.”

Note: 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.

As you may deduce, there is not a clear and simple standard that directly regulates electric appliances (such as lamps, refrigerators, fans and coffee pots) when they are not used in patient care vicinities. Here is what I believe Joint Commission and other authorities will expect from your organization in regards to electrical appliances that are away from the patient care vicinity:

1. Write into your Safety Management Plan (or it can be a separate policy referenced into your management plan) the organization’s plan of action concerning electrical devices that are not to be used within the patient care vicinity.

2. Upon initial installation (or before initial installation when the equipment is received at the hospital) conduct a current leakage test on the device, and document same. No further testing is required. If the device is removed and relocated, then a visual examination of the electrical cord needs to be conducted. No record of this visual examination is required.

3. Include language prohibiting the use of extension cords, power strips, adapters from 3-prong to 2-prong, and three-way adapters without the consent and permission of the Facilities department.

Having a policy on an issue when there is not a clear standard governing the issue, is an excellent way to demonstrate to the Joint Commission that you recognize the potential risk involved with the use of the device, and you have a plan to address it. If an electrical appliance shows up that doesn’t exactly fit into this policy, then conduct a risk assessment identifying all of the potential risks to patients, visitors and staff, and have it reviewed and approved by your safety committee.