November 18, 2009 | | Comments 1
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With OR humidity, follow CMS and risk assessment findings

There is a great deal of not-quite-controversy relative to humidity concerns in operating rooms (OR) because of the personal comfort aspect.

The American Institute of Architects’ 2001 Guidelines for Design and Construction of Hospital and Healthcare Facilities indicate a temperature range of 68° to 75° F and a humidity range of 30% to 60%, but there’s been a lot of discussion on how this impacts comfort with surgical teams wearing layered personal protective equipment (I can tell you from personal experience that Gore-Tex is hot as heck).

Anything in the way of specifics comes from the Centers for Medicare & Medicaid’s Conditions of Participation (CoPs), which I note as follows from the CMS State Operations Manual, Appendix A (not quoted in full):

482.41(c)(4) — There must be proper ventilation, light, and temperature controls in pharmaceutical, food preparation, and other appropriate areas.

  • Temperature, humidity, and airflow in the operating rooms must be maintained within acceptable standards to inhibit bacterial growth and prevent infection, and promote patient comfort. Excessive humidity in the operating room is conducive to bacterial growth and compromises the integrity of wrapped sterile instruments and supplies. Each operating room should have separate temperature control. Acceptable standards, such as from the Association of Operating Room Nurses or the American Institute of Architects, should be incorporated into hospital policy.
  • Verify that each operating room has temperature and humidity control mechanisms.
  • Review temperature and humidity tracking log(s) to ensure that appropriate temperature and humidity levels are maintained.

Since there is a fair amount of variability that comes into play, how you choose to manage the environmental conditions in the OR should be based on a thoughtful process — which you can feel free to interpret as a risk assessment — that identifies acceptable parameters and could include the variability of humidity at any given time.

Once you’ve identified how it’s going to happen, then you have to intervene when conditions are not appropriately managed — in other words, you need to be able to measure humidity in an OR.

Not being able to do so leaves you with some exposure relative to compliance with the CoPs, although I suppose as a stop-gap, you could assess the environment for comfort and document the conditions until such time as you can make more formal arrangements for humidity measurement (e.g., repair or replace the malfunctioning equipment).

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Filed Under: CDC/infection controlOSHA


Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at

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  1. Hello Steve,
    I am an independent leadership consultant working in Surgical Services for a client in San Francisco. Years back I recall the JC not permitting tape markings on floors in the operating room or other locations to indicate storage zones and semi-restricted from non-restricted zones. The facility where I was working at the time the JC surveyors had us remove the tape markings for infection control purposes. This particular facility has tape on the floor in the OR which has been worn and the black glue is exposed. Are there any regulations that you are aware of that prohibit use of tape as I’ve described?

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