Know which NFPA code you use for the facility 2000, 2003, etc.

Transcription

1 TAHQ WEBINAR

2 Know which NFPA code you use for the facility 2000, 2003, etc. Have a valve chart for all valves. Looked into ceiling and wanted us to identify the valve he found. Very interested in whether we had any suites. See NFPA for definitions. You can have fewer restrictions than if the area is identified as a corridor.

3 Fire and patient doors must latch. Fire door vertical and horizontal spacing is checked. Corridors are unobstructed. No trash cans, chair without wheels, pull down computer tables that have not been retracted, etc. If you have fire hose connection cabinets where you have removed the hoses, MUST have a letter from the local fire department saying they know and approve.

4 If you have hose connections, make sure you have the proper devices to connect to fire department hoses. (Sizes of connectors) Letter from fire department stating they will have their own tools and connections is best. Run your fire pump on emergency power quarterly or whenever you feel the need to do so. Document the results.

5 Generator testing. Checked the monthly and/or annual testing.( Annual load test as well.) Make sure your testing language is the same: volts, or amps, or watts, etc. Test emergency (battery) light at the generator 1 ½hours annually and 30 seconds monthly. =Replace as needed. Have an emergency outlet at the generator to run any equipment off of it.

6 Exterior fans should have bio hazard symbols on them if they exhaust air from O.R. s, or negative pressure rooms, or any area that could be Infection Control related, etc. Central Sterile Supply Room has to have positive pressure on the clean side doors and negative pressure on the dirty side doors. During construction, must have SMOKE tight barriers, not just plastic sheeting.

7 Exit signs need to be seen from two directions when fire or smoke doors are closed. Make sure all exit signs have the chevrons punched out appropriately. =Don t have one pointing to a closest or wall. Make sure all lights are working. Exit, hallway, etc. Cages over closet and work space areas light bulbs.

8 Any large open treatment areas should have a protective door way nearby. Who checks the negative pressure rooms pressure and where is it documented? Roof is checked for ponding of water, storage of items that could blow off in a wind, and 3 feet of extension for any air intake pipes. (Also the 120 degree bend)

9 Asking students, interns, residents, and physicians about fire code and their responsibilities on how to respond. No food or paper products should be stored under sinks. Cleaning supplies containers only, if anything is allowed. Stairways that exit up for egress, for example from a basement/ground level, should have a sign FROM the first floor going down, that this is not an exit.

10 If the E.R. is considered a suite, may have to move exit signs as well as making doors smoke barriers. (Latching and spacing as a fire door) No chairs may be kept in the fire stairwell. If the O.R. area is to be considered a suite, can have 42 corridor spacing.

11 Ascussions need to be sealed. If an area has been closed or shut down temporarily, make sure the toilets have water in them to keep the seals intact. -Sewer gas into the hospital could result if not done. Make sure all felt astricles are rated. For each smoke compartment there are only 31 hand sanitizer units allowed.

12 If the facility is 100% sprinkled, smoke damper do not require routine maintenance, but must have every six years inspections. (NFPA exception 2) ILSM due anytime there is an L.S. issue identified. -PFI for L.S. is evaluated for ILSM s.

13 When medical gases are interrupted, the lines must be tested and CERTIFIED by the AHJ! Policy must state this. Ensure the duct detectors actually shut down the air handlers.

14 Ensure all electrical circuit boxes have the 3 feet distance around them. Boxes must be marked for: Life Safety: =Fire alarms. =Dampers for fire/smoke suppression. =Sprinkler system alarms. Life Support: =ICU. =E.R. =Emergency plugs. Equipment: =HVAC. =Kitchen. =All others.

15 Gas cylinders, dietary soda machines for example, must have holding chains high up on the bottle, not low. Documents review specifics for the following: Supervisory signals: =Tamper switches =Fire pumps running. =Fire pumps failure.

16 Main Drain test: Record the time to return to static pressure. =Could indicate a blockage. Flow Test List the percent of flow: 90%, 100%. Document for standpipe tasting reviewed Needed every five years. Remove old inspection stickers on equipment once the new one is completed. For the activation hood suppression area signage. Make it similar to the stand off signs for fire extinguishers.

17 Environment of Care Review Sample Questions

18 Security: What is your highest security risk? HazMat Spills: Who handles them? How do you find out about hazards in the workplace? How do you minimize harm from radiation? Show documentation. Are you measuring nitrous oxide in the O.R. s?

19 Show air balance tests in the O.R. s. 15 changes per hour, 3 must be fresh air. Show fire safety inspections: Facility and AHJ s. Show fire drills. One per shift per quarter. Doing double for ILSM areas. How are you preventing bio hazards from getting to patients?

20 If you have them, how are the cooling towers being treated? (Chemicals?) What do you do if you lose potable water? What if it feeds your boilers? Lose sewer, what do you do? Contract company to pump it? If you heat boilers with gas, can you switch to diesel from the generator supply? Know how to do it. (Practice it)

21 Bio medical repairs: Have you done risk assessments? =Show how. What do you consider life support machines. If equipment problem, what do you do? =Sequester the machine away from the area it was used. =Sequester without changing settings. Use an independent testing firm to check out the machine