More on Eye Wash Stations

imagesCASBGE8PEye wash stations are required wherever there is a possibility that caustic or corrosive chemicals could splash into the eye of an individual. It is important to note that blood and body fluids are not considered to be caustic or corrosive. It is also important to note that the use of Personal Protective Equipment (face shields, glasses, goggles) does not exempt the need for an eye wash station.  Material Safety Data Sheets will specify whether or not an eye wash station is required, by the listed emergency treatment of flushing the eyes with water for 15 minutes.

Accreditation organizations (Joint Commission, HFAP and DNV) as well as CMS does not specify the location for eye wash stations. The organization is expected to conduct a risk assessment (or survey) of their facility’s operation and process areas to determine if and where eye wash station are needed. If the facility has determined that an eye wash station is needed, then it needs to conform with the ANSI standard Z358.1-2009, which has the following specifications:

  • Only eye wash stations that are capable of providing a flow of clean potable water at a rate of 0.4 gallons per minute at 30 psi for 15 minutes are permitted. It is possible that some self-contained eye was stations may provide this flow requirement, but normally only plumbed eye wash stations do.
  • The flow nozzles of the eye wash station must be mounted a minimum of 33 inches and a maximum of 45 inches above the floor, and a minimum of 6 inches from any wall, post or other barrier.
  • Activation of the eye wash station must occur in one (1) second or less of operating the control valve, so this typically eliminates the faucet mounted eye wash stations that requires the operation of three (3) levers to obtain a balanced flow of water. The control valve must remain open on its own until it is intentionally turned off.
  • Approved eye wash stations are required to be located within 10 seconds travel time (or 55 feet) of the hazard and the path to get to an eye wash station must not be hindered or obstructed. The ANSI Z358.1-2009 standard has changed to allow one (1) door in the path to get to an eye wash station, provided the door cannot be locked and the door swings in the direction to the eye wash station.
  • While there is no standard that prohibits the small supplemental personal wash bottles, they cannot meet the flow rate requirements for a 15 minute flush, and therefore are not a substitute for a plumbed eye wash station. They can serve as a supplemental aid but the plumbed eye wash station needs to be located within 10 seconds travel time (or 55 feet) of the hazard. The presence of the small supplemental personal wash bottles indicates a need for a plumbed eye wash station. Check the expiration date on the small bottles.
  • The temperature of the water is required to be tepid. The ANSI standard defines tepid water as being between 60°F and 100°F. In order to achieve this temperature range, the organization may have to install mixing valves. Water temperatures outside of the 60°F and 100°F range may be permitted provide a risk assessment is conducted by qualified individuals which analyzes the hazard and the temperature of the water to flush the hazard. Qualifying individuals must include an individual with clinical or medical training.
  • Weekly activation of the eye wash stations is required to clear any sediment or bacteria. There is no specified time that the water must flow. An annual inspection of the eye wash station is required to determine conformance to installation requirements are maintained.

In response to the question: “How do Accreditation Organizations survey a hospital (or nursing home) in regards to eye wash stations?” Here are my tips and recommendations:

  1. In a healthcare setting, eye wash stations are typically found where cleaning chemicals are mixed (such as housekeeping areas), plant operations, dialysis mixing rooms and laboratories. The surveyor will determine if the organization has conducted a risk assessment to determine the need for eye wash stations.
  2. All required eye wash stations must be the plumbed type, that can operate in one (1) second or less. This means the faucet mounted type that requires turning the hot water lever and the cold water lever and then pulling a center lever is not permitted.
  3. Access to the eye wash station must be within 10 seconds (or 55 feet) of the hazard. The individual seeking an eye wash station may travel through one (1) door to get to an eye wash station, provided the door does not have a lock on it, and swings in the direction to the eye wash station.
  4. If an eye wash station is observed outside of an area where they are typically needed, the surveyor may ask the organization why it is there. They will want to determine if you have a risk assessment that requires it to be there. If there is no valid reason for the eye wash station to be there, it can be removed and may save you time and resources in maintaining it.
  5. Eye wash stations may need to have a mixing valve to maintain a flow of water in the 60°F and 100°F range. The surveyor may ask to see the risk assessment to determine if a mixing valve is required.
  6. Every eye wash station needs to be tested weekly by flowing water to clear any sediment and bacteria. There is no requirement how long the water must flow. Every eye wash station must be inspected annually to determine the eye wash station still conforms to the installation parameters. The surveyor will likely ask to see the weekly and annual inspection reports.
  7. The presence of eye wash bottles indicates someone in the organization decided it was needed. The surveyor will likely investigate and ask why the bottles are located there. If the surveyor determines a need for a plumbed eye wash station within 10 seconds travel time (or 55 feet) of the perceived hazard, then you are ripe for a finding. Conduct a risk assessment to determine if a plumbed eye wash station is required. If so, have one installed or relocate the hazard. If not, then remove the portable eye wash bottles.  Also, if you retain the bottles, check the expiration date to ensure it has not expired.

While there may not be a direct standard in the Accreditation Organization’s manual that addresses eye wash station, any deficiency that a surveyor finds will likely be entered under a standard that addresses general safety in the physical environment, such as EC.02.01.01, EP 1 for Joint commission; 11.02.02 for HFAP; and PE.1, SR.1 for DNV.

Portable Eye Wash Stations

I was out all last week and when I returned to my office I was inundated with comments (complaints, really) as to why the portable squeeze bottles are not a good idea for a first-aid eye care for staff to use as they walk to the ANSI approved Z358.1 eye wash stations which are plumbed. Forgive me if this is not a Life Safety Code issue, but it certainly is an issue that facility managers in healthcare organizations must deal with.

The placement and eventual use of the portable hand-held squeeze bottles for first-aid eye care are certainly not a violation of any Life Safety Code, Joint Commission, or OSHA compliance standard. However, they present a serious problem for various reasons.

They are a ‘red flag’ for any surveyor or inspector as 90% of these portable first-aid eye care squeeze bottles are placed in locations (and in lieu of) where an ANSI approved Z358.1 eye wash plumbed station would be required. Therefore, a surveyor is used to writing findings for non-compliant eye wash stations when they see the squeeze bottles. What often happens, the organization wants to provide as much emergency care equipment as they can in the event a staff member splashes something caustic or corrosive into their eye, but they don’t want to spend the $500 – $1,000 required to installed the proper ANSI Z358.1 approved station. If the organization decides that a squeeze bottle should be mounted at any specific location, then that is a pretty sure bet that an ANSI Z358.1 approved eye wash station (plumbed) should be installed in the first place. It usually is a decision made from ignorance, where a manager or supervisor wants the best for their employee, but may not have the authority or wherewithal to have a $1,000 eye was station installed.

When the portable squeeze bottles are installed, they often times are ‘out-of-sight, out-of-mind’. Even though they are mounted on the wall, in plain view, staff eventually loses track of them and forgets they are there. The expiration date of the water solution in the bottles are about 2-years, if memory serves me correctly. When staff forgets those bottles are there, then they don’t replace the bottles when they expire. A surveyor will see them very easily as they are mounted out in the open and in plain view, and an expired bottle of water solution will create another round of findings. Also, the worst case scenario is a staff member grabbing an expired eye wash bottle and causing more damage to their eyes with water that may have bacteria growing in it.

Can an organization overcome these scenarios that I have stated? Sure, but it is not likely, and my recommendation is to not start down this slippery slope and do not install portable eye was squeeze bottles. The organization should bite the bullet and pay the $500 – $1,000 each to have an approved eye wash station installed where they are required.

Take a look at the ANSI approved Z358.1 eye wash station to the left. It does not have to be plumbed to a sink or drain. It can be mounted by itself, and an alternate plan to catch the water when it washes onto the floor can be used, such as sand-bags and a mop and bucket.  These types of eye was stations are not that expensive to purchase. Take a look at the Lab Safety or Grainger catalogues to find them.