March 16, 2011 | | Comments 3
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Mac’s Safety Space: Electric blankets in patient care occupied rooms

Q: At my hospital, we do not allow electric blankets in patient rooms. Several Charge Nurse’s did ask where the reference was located regarding this issue. I could not find in anything referenced in The Joint Commission standards or in NFPA 101 LSC that referenced the use of electric blankets. Obviously, there is referenced information on prohibited use of electric space heaters. So can electric blankets be used in patient care occupied rooms?

Steve MacArthur: Well, it sounds like we’re in agreement that the thought of electric blankets is equally undesirable, but in looking at the regulatory landscape, there is no specific prohibition of the little blighters. So, the default setting is for them to be treated as any other piece of electrically-operated medical equipment that comes into contact with the patient, which means consideration has to be given to identifying a proper frequency for inspection, and then establishing a program for training end-users on the proper care and use. That said, some other considerations (courtesy of my esteemed colleague, Brad Keyes, CHSP) would be:

  • Why do the nurses want to use electric blankets? That implies a problem with maintaining adequate temperature for the patient, which is a violation of EC.02.06.01, EP 13. It seems to me to be a conundrum: You are not prohibited from using electric blankets, but if you do, that implies that you’re not maintaining proper temperature levels for the patient which is a violation of EC.02.06.01, EP 13.
  • What about the logistics of the electric cord? You can’t just drape it across the floor to an electrical outlet where someone can step on it or trip over it. You also would have the potential problem of the wheel on the bed rolling across the cord and pinching it, which is an electrical hazard. I absolutely agree with Brad’s points regarding the management of patient temperature, and I can tell you from personal experience (and you can try this at home) that clinical staff frequently do not use thermal blankets correctly. They just pile them on top of each other, resulting in one patient having five blankets and there being none on the linen cart for the rest of the unit. A single thermal blanket and a single sheet are really all you need to keep someone pretty toasty—the “holes” in the thermal blanket allows air flow, but if there’s nothing solid to cover the holes, the warmth just escapes.

In poking around the web, I don’t know that I found any evidence of a device that would be safe to use in the patient vicinity (within six feet of the patient). Also, in stumbling across the Electric Blanket Institute website (hwww.electricblanketinstitute.com/safety.html) they have a number of recommendations, one of which is not to use electric blankets on automatic beds because of the pretty significant risk of pinching damage.

Apparently there is also anecdotal information that electric blankets can have a deleterious effect on pacemakers, but they could provide no hard data in either direction. I think it comes down to there being no strict prohibition or a strict endorsement, which places it firmly in the land of the risk assessment. That said, if it were my house, I would say no, as much because there is no endorsement of the use of this product in hospitals. Now if someone were to identify one that is “safe” for use in hospitals, then we could have further discussion, but for the time being, I say stand firm and try the thermal blanket/sheet combination—low tech for sure, but if the patient is even “warmable” (and you know what I’m talking about), that should do the trick.

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant based in Bridgewater, 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 stevemacsafetyspace@gmail.com.

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  1. Great job Steve and Brad. You addressed the regulatory issue and also gave good information on why this may not be a good idea.

    Can’t tell you how many times I hear. “Well if there is no regulation, why can’t we”

    Your reader may want to look at systems such as the Bair Hugger or Bair Paw warming system. These work great for these issues.

  2. I agree- thanks to both of you. In Infection Control there is one big JC standard- prevention of infection. You need to constantly be able to educate staff as to what part of this is. One of the most common questions I get is the “standard that says we have to monitor refrig and freezer temps”. My answer is to cite the standard and then ask them what the relavance of carring this to the monitoring of temps relates to. You use it as one of your “teachable moments” and discuss what can happen if as an example a medication or vaccine gets too warm and you don’t know it- it may no longer be effective.” This helps them develop a deeper understanding of why all these parts of the policies are important.

  3. BTWw, I would not want to have one of these short out for any reason if the patient was on Oxygen? Our Safety Committee prohibits their use in the patient care environment for this reason among others….had anyone bring in critters from home with their personal belongings? Bedbugs for example?

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