November 28, 2017 | | Comments 1
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Hyperbaric oxygen makes some noise. Also: Stop, in the name of…the law? Love? Sanity?

First off, a quick word for those of you with responsibilities relating to hyperbaric oxygen chambers: NFPA 99 (2012) 14.2.4.5.3 states, “A source of breathable gas allowing unrestricted mobility shall be available outside a Class A or Class B chamber for use by personnel in the event that the air in the vicinity of the chamber is fouled by smoke or other combustion products of fire.” Soooooo, if you have not yet ordered a smoke hood with integral filter/air supply (or similar equipment) available for staff to use in case of a fire, then I would advise you to take very quick action on this, particularly if you are anticipating a survey sooner rather than later. Just as the recent medical equipment EP changes relative to oxygen equipment for hyperbaric oxygen environments came down from the mountain on composite-stone tablets, so too must the intricacies of Chapter 14 of NFPA 99-2012 be absorbed. Nothing like more new stuff to figure out…

Next up, a few random thoughts (more or less) about education and ensuring effectiveness (which might very well be a lost cause, yet I remain stubbornly hopeful).

The item that I keep coming up against is the thought/assumption (and yes, I know all about that last one) that the folks I see driving cars in various parts of the country are in fact licensed drivers. With the extended thought that in order to procure said license, there was some level of rudimentary testing of the budding licensee’s knowledge of the rules of the road. Now I will stipulate for all time that there is probably enough focus on simple driving etiquette and likely never will be. But, but, but, I am confident that there are certain elements that are universally covered in driver education and competency evaluation. So, I ask you this simple question: What is octagonal in shape, red in color, and provides what used to be a very specific command? (Hint: It’s a four letter word that, when reversed, describes cookware or perhaps earthenware.)

If you don’t know, it would seem that you are not alone…

It appears to me from my simple (but fairly voluminous at this point) observations that adherence to the octagonal has morphed into a corollary of the traffic signal (green means “go”; yellow means “speed up”; red means “it’s for the person behind me”). It’s gotten to the point where I’ve been honked at for actually coming to a full stop at these points and, to be honest, I’m not really sure how it all came to be widespread. I know it’s not because folks weren’t taught the expectation when encountering a stop sign (though I’m pretty sure that “yield” isn’t covered), but it does lead me to the question of how effectively do we “do” education?

Dragging this out into the hospital realm, I’m sure you’ve all come up against those survey encounters in which you cringe because you can’t be certain that the proper (never mind correct!) response is hard-wired into staff (particularly entry-level). Every day you see people doing things they have been instructed time and time again not to do (parking equipment, etc., in front of fire extinguishers, pull stations—you know the drill). And with alarmingly increasing frequency, you see people acting in a freakishly unsafe manner (e.g., cell phone use while driving); it can’t be that they don’t know and it can’t be that they are not at least somewhat familiar with the consequences. As a boss once told me: “You can’t mandate intelligence” (Ron White made a gazillion dollars converting that to something a little more folksy), but if that’s the case, how big a “stick” do you need to carry? Does a stick even work effectively anymore?

One of the key elements of post-survey corrective action plans is an increasing focus on how we plan to keep whatever it was from happening again. And I look at a majority of the findings and I’m thinking how far does one have to go to resolve each and every little thing for all time? I believe we should always be working towards perfection, but I am not so crazy as to think we’re going to get there anytime soon…

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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. In 14.1.1 Applicability the code states 14.1.1.1 This chapter shall apply to new facilities but it also states 14.1.1.2 Portions of this chapter shall apply to existing facilities. (See 1.1.12.) When you look at 1.1.12 it doesn’t really provide any guidance as to what portions apply and which do not.

    Is there any indication the smoke hooks fall under 14.1.1.2?

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