All Entries Tagged With: "environmental services"

Do you remember? Or even yesterday…

Way back in September of last year, we were chatting about the importance of appropriately managing conditions in the patient environment, primarily the surgical environment. For those wishing for a refresher, you can find that post here. (I talked about how I’ve noticed recent citation in surveys regarding the surgical environment, including the maintenance of temperature and humidity, ensuring appropriate air exchange rates, and making sure that your HVAC systems are appropriately maintaining pressure relationships, etc.)

One of the things I didn’t really cover back then was when you have documented out-of-range values. Could be temperature, could be humidity, could be those pesky air exchanges and/or pressure relationships. The fact of the matter is that we live in an imperfect world and, more often than not, our success comes down to how effectively we manage those imperfections. And that can, and does, come down to how well we’ve prepared staff at the point of care/service to be able to respond to conditions in the environment. But, in order to get there, you have to undertake a collaborative approach, involving your infection preventionist and the folks in the surgical environment.

The management of risk in the environment doesn’t happen because we have (or don’t have) nifty technology at our disposal; it’s because we can work collaboratively in ways that no building automation system or self-regulating HVAC equipment can. This idea has become an increasingly important part of the survey process. We know that more folks are harmed by hospital-acquired infections and other related conditions and I’ve seen it become a fairly significant survey vulnerability. So, let’s start talking about this stuff with the end users and make sure that we’re ahead of the curve on the matters of the care environment.

Mac’s Safety Space: Humidity in the operating room

Q. I have a question regarding OR humidity. If OR humidity drops below the required range, can a portable reservoir type humidifier be used to bring the humidity back up within range? If not, what should the facility do? Should the facility stop surgeries?

I have been researching the World Wide Web to find additional information. What I have found is that reservoir type humidifiers should not be placed in duct work. Any additional help would be greatly appreciated.

A. The humidity levels are very much in the way of guidelines as opposed to strict regulations. Recently, ASHRAE (the American Society of Heating, Refrigeration and Air-Conditioning Engineers) dropped the lower control limit for humidity to 20%, basically because electrical systems and OR environments in general are much better designed and can safely tolerate a “drier” environment.

At the end of the day, it all comes down to the comfort of occupants, and as long as the OR rooms aren’t dripping condensation, the infection control risks are minimal. However, if you are dealing with humidity levels below 20%, I would contact your HVAC vendor and see what type of humidification is available.

You are correct in that reservoir-type humidifiers should not be placed in duct work, but there is humidification equipment that can be installed for those really dry days.

Absent regulations, it’s up to hospitals to determine trash compactor safeguards

The safety of operating trash compactors and locking them when not in use is yet another opportunity for a risk assessment.

Strictly speaking, there are no specific regulatory or code requirements for trash compactors in healthcare organizations. But we have learned over the years that [more]

“Wet Floor” signs bring fire safety and tripping risks

I was discussing “Wet Floor” signs with a risk management coordinator, and I told her this is yet another sterling example of the risk assessment process.

“Wet Floor” signs are a tripping hazard, but that hazard has been mitigated to a degree by [more]

Risk assessments are the way to go with power strip use

As you might guess, I’m in favor of using the risk assessment process to look at the issue of power strip use in hospitals.

And I’d start with a determination of whether a power strip is the most appropriate strategy, with the recognition that once you start with the power strip as opposed to additional electrical outlets, you’ve increased [more]

Regulatory gray areas around this series of less-than-best practices

I was asked about a clean utility room that is also an electrical storage closet, which contains electrical panels, many wires, and oxygen cylinder storage against the wires.

It sounds like the organization had to make use of the available space for its network cabling, and while this is not an optimal environment of care practice, there’s no real regulatory language that precludes it. That said, there are a couple of things I would cite as “other environmental concerns” to consider: [more]

Be wary of MSDS exemption for consumer cleaning products

My colleagues and I had a discussion recently about an OSHA reference for when material safety data sheets (MSDS) are not required when staff members use everyday consumer cleaning products.

This comes from OSHA’s hazard communications standard (1910.1200), in which [more]

It’s hard to precisely state what “clean” means, from a regulatory stance

From a practical standpoint, there are no specifically recognized standards for cleaning in hospitals. The closest thing to such a beast is the CDC’s Guideline for Environmental Infection Control in Healthcare Facilities.

Having worked with any number of environmental services outsourcing vendors (I’m not going to name names here, but you can probably figure out who they are), I know that each has [more]

What The Joint Commission says about housekeeping activities

I fielded a question recently about what housekeeping regulations are out there.

With the Joint Commission (which pretty much reflects the CMS Conditions of Participation concerns in this area), the applicable standards would be: [more]

Clean up cardboard boxes frequently to limit fire risks

As to the life safety implications of cardboard boxes, they are indeed made of a combustible material and we should do everything we can to minimize their presence, especially for extended periods of time.

Waste removal processes for cardboard should be effective. While there is no specific time measure, it’s generally demonstrable when the waste removal process is not working properly.