NFPA Edition Healthcare Facility Management Society Of New Jersey June 18, 2009

2008 WSC&E on NFPA 99 History Committee decided to combine all documents under its jurisdiction –NFPA 56F, 76A, 76B-T, etc First issuance of NFPA Integrated all of the individual documents into chapters Complete evaluation and rewrite of current document.

2008 WSC&E on NFPA 99 Scope Establish criteria to minimize: –The hazards of fire, –Explosion, and –Electricity Facilities providing services to human beings.

2008 WSC&E on NFPA 99 Purpose To provide minimum requirements for the: –Performance, –Maintenance, –Testing, and –Safe practices for …

2008 WSC&E on NFPA 99 Application Applies to all health care facilities Construction and equipment requirements for new only Only altered or renovated or modernized portion of the building If above modifies the performance of a system it must be modified

2008 WSC&E on NFPA 99 So What is Going On? NFPA Standards Administration has extended the cycle to 5 years for the rewrite. Technical Committee members have been charged with stretching to modify chapters for the year 2020

2008 WSC&E on NFPA 99 Global Goals and Changes Modernize the document Clear and consistent set of criteria Establish three risk levels of patient care All chapters will have the same look Establish a section for existing system requirements

Categories of Patient Risk Category 1 Facility systems in which failure of such equipment or system is likely to cause major injury or death of patients or caregivers shall be designed to meet system category 1 as defined in this standard. Annex Material Systems are expected to work or be available at all times to support patient needs. 88

Categories of Patient Risk Category 2 Facility systems in which failure of such equipment is likely to cause minor injury to patients or caregivers shall be designed to meet system category 2 as defined in this standard. Annex Material Systems are expected to provide a high level of reliability; however, limited short durations of equipment downtime can be tolerated without significant impact on patient care. Category 2 systems support patient needs, but are not critical for life support. 9

Categories of Patient Risk Category 3 Facility systems in which failure of such equipment is not likely to cause injury to the patients or caregivers, but may cause patient discomfort shall be designed to meet system category 3 as defined in this standard. Annex Material Normal building system reliabilities are expected. Such systems support patient’s needs but failure of such equipment would not immediately effect patient care. Such equipment is not critical for life support. 10

Categories of Patient Risk Category 4 Facility systems in which failure of such equipment would have no impact on patient care shall be designed to meet system category 4 as defined in this standard. Annex Material Such systems have no impact on patient care and would not be noticeable to patients in the event of failure. There are no minimum requirements for such equipment. 11

2008 WSC&E on NFPA 99 TC on Fundamentals Definitions –Anesthetizing locations –Wet locations New chapter on fire protection features Revised section on flammable germicides and antiseptic (TIA)

2008 WSC&E on NFPA 99 TC – Piped Gas Systems Working with NFPA 55 on bulk oxygen requirements Testing requirements for cryogenic liquid systems and all other systems

Testing - Cryogenic Systems 2008 WSC&E on NFPA 99 Tested for proper function For purity, alarm sensors Operation of the control sensors

Maintenance Requirement Rejected an annual requirement for system testing by an ASSE 6030 verifier Rejected annual outlet/inlet testing Rejected requiring ASSE 6040 (certification of maintenance workers) but recommended it in the annex Added testing of medical booms in OR 2008 WSC&E on NFPA 99

Medical Gas Maintenance Facility shall develop and document periodic maintenance Program shall include an inventory of: –All source subsystems, control valves, alarms, manufactured assemblies, and outlets 2008 WSC&E on NFPA 99

Medical Gas Maintenance Inspection schedule shall be established through a risk assessment Inspection procedure established by the organization Maintenance schedule established through a risk assessment 2008 WSC&E on NFPA 99

Med Air Use Restriction Continue to prohibit the use of medical air for any other purpose: –Scope cleaning –Decontamination –Laser plume, etc WSC&E on NFPA 99

Level 3 – Med Gas Systems Completely revised the Level 3 section –Easier to read –Removed redundancies 2008 WSC&E on NFPA 99

TC - Electrical Systems Definition of Wet Location –Including all operating rooms –Annex language on spillage of liquids 2008 WSC&E on NFPA 99

TC - Electrical Systems Eliminated emergency system heading Changed equipment system to equipment branch Overcurrent protection devices –Accessible to authorized personnel –Not permitted in public access spaces Receptacles –Critical care - 14 outlets/seven duplex –Operating rooms- 36 outlets/eighteen duplex 2008 WSC&E on NFPA 99

TC - Electrical Systems Rejected receptacle testing of 3 year maximum interval Permit a single or multiple feeder between EES grouped distribution Fuel transfer pumps, receptacles, ventilation fans, louvers and cooling systems added to the life safety or critical branch – deleted from equipment 2008 WSC&E on NFPA 99

Selective Coordination Added text to permit a 0.1 second delay 2008 WSC&E on NFPA 99

TC - Electrical Systems Generator Testing –10 seconds is not required during monthly testing – annual confirmation 2008 WSC&E on NFPA 99

TC - Electrical Systems New chapter on low voltage systems being recommended New section on campus electrical systems being added 2008 WSC&E on NFPA 99

TC – Mechanical Systems Ventilation is addressed on a minimal basis Need to consolidate all the references to various systems and requirements Looking to be a resource by referencing other documents

TC – Mechanical Systems New Chapter on Plumbing –Water Potable Temperature Waste Special use –Set up in categories of patient risk 2008 WSC&E on NFPA 99

TC – Mechanical Systems New Chapter on Heating –Set up in patient risk categories –References other standards for ventilation and humidity –All references for ventilation are contained in this chapter Transfilling of liquid oxygen Medical gas storage rooms 2008 WSC&E on NFPA 99

TC – Medical Equipment Patient Care Vicinity –Rejected expanding the patient vicinity

TC – Medical Equipment Use of piped O 2 for ozone sterilizers 2008 WSC&E on NFPA 99

TC – Medical Equipment Reduced medical equipment testing –Patient care – removed testing frequencies –Non-patient care –Be careful as the requirements for current leakage have been relocated WSC&E on NFPA 99

TC – Medical Equipment Emergency cylinders in anesthetizing locations - Rejected 2008 WSC&E on NFPA 99

TC- Emergency Management Emergency management - completely rewritten and expanded for 2010 –Two categories of risk In-patient facility is expected to be operable In-patient and outpatient areas that augment the critical mission but not receive in-patients –Uses The Joint Commission standards as a basis for plan evaluation

New Chapter on Security –Based on the foundations of NFPA 730, Guide for Premises Security –Facility shall conduct a Security Vulnerability Assessment (SVA) –Defines responsible person 2008 WSC&E on NFPA 99 TC- Emergency Management

Security sensitive areas per SVA –Emergency Department –Pediatric and infant care area –Medication storage and work areas –Clinical and research laboratories –Dementia or behavioral health units –Forensic patient treatment area –Communications, data infrastructure, and medical records storage areas 2008 WSC&E on NFPA 99

TC- Emergency Management Other subjects covered –Media control –Crowd control –Security equipment – follow NFPA 731 –Employee practices –Security operations 2008 WSC&E on NFPA 99

I leave you with this last thought on NFPA 99 - NFPA Annual Meeting June 8-11, 2009 Chicago, IL