Feb 26 2012

New Corridor Width Requirements

Category: Life Safety Code UpdateBKeyes @ 6:00 am

Here is a change in the Life Safety Code that I believe will do more harm than good: Changing what can be left unattended in hospital corridors. Currently, the 2000 edition of the LSC only permits attended items in the corridor, such as housekeeping carts, linen carts, foodservice carts, provided they are being attended by an individual. The exceptions to this rule have allowed crash carts and patient isolation supply carts (provided the cart is serving a patient on contact precaution isolation) to be left unattended.

The constant struggle that facility managers had with nurses and technicians was staff leaving items in the corridor, as the picture to the left indicates. The items left in the corridor were done so for various reasons: 1). Staff felt certain medical equipment such as blood pressure cuff machines and IV pumps were necessary to be placed in the corridor for quick and effective patient care; 2). Staff believed there simply was no other place to store the equipment; 3). Some room items such as chairs, tables and even beds were ‘temporarily’ stored in the corridor that ended up being hours and days, and 4). It simply was not convenient for staff to return equipment to their designated storage room. Whatever the reason, leaving unattended equipment in the corridor was not permitted by the 2000 edition of the LSC, and hospitals would be cited by surveyors if they discovered it.

Well, some of that could be changing when the new 2012 edition of the LSC is finally adopted. If CMS adopts the 2012 edition in its entirety, meaning they will not exclude any sections, then I believe facility managers will have new problems concerning items stored in corridors. Here is the reason why I believe that: Section of the 2012 edition will now permit certain wheeled equipment to project into the required width of the corridor, provided the clear width of the corridor is not reduced to less than 5 feet, and there is a written fire safety plan and training program that addresses the relocation of the wheeled equipment during a fire. The permissible wheeled equipment is limited to 1). Equipment and carts in use; 2). Medical equipment not in use; and 3). Patient lift and transport equipment.

Number 1 above is the same as what the 2000 edition currently allows. But number 2 (Medical equipment not in use) sounds to me to be medical equipment that is in storage. The Annex section makes note that equipment ‘not in use’ is not the same as equipment ‘in storage’, but does not offer an explanation on how to tell the difference. And number 3… Patient lift and transport equipment can now be stored in corridors? How can that be safe for the swift and immediate evacuation of patients during a fire emergency?

Here are the potential problems as I see it:

  1. Give the staff an inch and they will take a mile. If you educate and train the staff that they can now store some equipment in the corridor as long as you have 5 feet clear width, they will certainly take more than that. They don’t carry tape measures with them and the possibility of something projecting into the 5 foot clear width requirement is likely.
  2. Where is staff going to relocate the wheeled equipment to, during a fire alarm? If the equipment does not have a designated storage room, then it will have to be stuffed into any empty room that staff can find. What happens when there are no empty rooms available?
  3. The new 2012 edition requires only wheeled equipment to be left in the corridor. Staff will soon either forget this stipulation or try to sneak in chairs, tables, and other non-medical equipment that does not qualify.
  4. How are you going to differentiate between medical equipment not in use, and medical equipment in storage? Unless there is a layer of dust on the stored equipment, it will all look the same. A surveyor may not believe the equipment is not stored.
  5. The ever-present Computers on Wheels (COWs) were not addressed in this new section. Are they considered medical equipment? That is yet to be decided.
  6. The new section says ‘transport’ equipment is allowed to be left unattended in corridors. That means you can expect a bunch of wheelchairs and gurneys lined up in the corridor. But not beds, or at least that seems to be what the code implies. You can guess that once staff sees gurneys and wheelchairs allowed to be stored in the corridor, they will try to add beds as well.
  7. During a fire emergency where patients are being evacuated from their rooms, most of them will be evacuated in their beds. Those beds never roll in a straight line, but take up more corridor room than the width of the bed. And there usually is a monitor, IV pump, or other medical equipment that trails along. All told, evacuating a patient in their bed requires at least 5 feet of corridor to do so quickly and safely. If medical equipment is still in the corridor, how do other staff individuals and fire-fighters get access into the unit when patients are being evacuated out of the unit?

At the minimum, this will require education, training, and then frequent surveillance to make sure this new section is followed correctly. More visits on the floors to make sure everything is within code. And then there is the section that allows fixed furniture that is screwed to the floor or wall, to project into an 8 foot wide corridor as long as the clear width remains 6 feet. There are other restrictions on the fixed furniture issue, but I don’t see fixed furniture in hospitals very often, if ever. I have been told that this section was created with nursing homes in mind, where patients are a bit more mobile and the fixed furniture allows for rest stations in strategic areas in the corridors.

That’s what I think about this new requirement. I would appreciate hearing from you what you think…


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