Consulting-Specifying Engineer - June 2008 - (Page 58)

Codes & Standards Beyond electrical codes for better healthcare Codes specify minimum acceptable levels of safety, but in many cases, electrical code minimums are not adequate for today’s electronic healthcare. BY DOUGLAS E. STOVER, PE, LEED AP, Principal, FreemanWhite, Charlotte, N.C. odes protect public health, safety, and general welfare as they relate to the construction and occupancy of buildings and structures. For healthcare facilities, patient safety is the backbone of the codes. Within the healthcare field, Article 517 of the National Electrical Code (NEC) is the standard electrical code for patient safety. While updated every three years, it can still lag behind the needs of the latest hospital care or situational needs. Codes only specify the minimum acceptable level of safety; they do not have the flexibility to envision future needs or anything beyond the average safety requirements. In light of this, it is worth examining a few code minimums and some examples of “flexing” the code for the future. When designing a hospital, electrical healthcare designers recommended to open the code book, find the code requirements, and use them on the plans, according to any guidelines. Achieving a design that reinforces the healthcare needs of an entire community is a complex process and revolves around the understandings of numerous “audiences.” It involves getting to know the facility and its mission within the community, the strategy of the hospital leadership, and the needs of patients and staff. It also involves communicating with the facilities staff to understand their maintenance methods. Assuring care for every patient One can analyze minimum code requirements versus design standards with an example as simple as receptacle design in patient rooms. NEC Article 517.18 places a minimum requirement for the number of receptacles at each general care patient bed. The code minimum is two duplex receptacles, one normal and one emergency. But this is likely not adequate for today’s highly electronic healthcare system. A typical C AT A GLANCE Codes are critically necessary in today’s healthcare design. But they are not the end of the discussion—only the beginning. Codes only specify the minimum acceptable level of safety, but this is not enough for the modern electronic healthcare facility. Achieving a design that reinforces the healthcare needs of an entire community is a complex process and revolves around the understandings of numerous “audiences.” It involves getting to know the facility and its mission. patient room can have the following devices plugged in at the headwall: patient bed, nurse computer, patient computer/game, patient monitor, oto/ophthalmoscope, infusion pump, extremity compression device, patient refrigerator, clock, television, and portable X-ray. That’s 13 different items that could be plugged in on the headwall. Going beyond the minimum requirements is recommended. Consider providing four duplex critical power and two normal powered receptacles. And when laying these receptacles out in the room, some of these devices should be placed 42 in. above finished floor for easy access by nursing staff. For critical care patient beds, the requirements are not much greater: The minimum is three duplex receptacles. There also is a requirement for one dedicated critical power circuit. As with the minimums for the general care bed, this number of outlets is likely inadequate to supply the following equipment that could be needed for the critical care patient: patient bed, nurse computer, patient computer, patient monitor, oto/ophthalmoscope, infusion pump (up to four), syringe pump, extremity compression device, patient refrigerator, clock, TV, ventilator, intraaortic balloon pump, “dedicated parameter” monitor, procedure light, electro-surgical unit, dialysis machine with an associated portable reverse osmosis water unit, portable X-ray, portable C-arm, electro encephalogram machine, or ultrasound machine. Again, we recommend going beyond the minimum code requirements. At least 13 duplex receptacles will fill a hospital’s current patient headwall needs. Reducing patient disruption A reality of hospital design is that projects and maintenance can disrupt patient care in these 58 Consulting-Specifying Engineer • JUNE 2008

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Consulting-Specifying Engineer - June 2008 Contents Viewpoint Letters News M/E Roundtable No Gambling Allowed on Smoke Control in Las Vegas Be Prepared: Hospital Protections for Catastrophic Events Ready for Retail Commissioning Documents: Necessary Evil Codes & Standards Codes & Standards Case Study Equipment Lifecycles New Products Advertiser Index Green Space

Consulting-Specifying Engineer - June 2008

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