NFPA 99 2012 EDITION

OVERVIEW AND DISCUSSION

Presented by

David Dagenais, SASHE, CHFM, CHSP

Tuesday September 27th, 2011

TUESDAY, SEPTEMBER 27TH, 2011 Please silence all pagers and cell

phones.

Not Speaking on behalf of NFPAor NFPA Technical Committees

Document is final and the NFPA Standards Council has approved

Available now, will ship in November

ITEMS DELETED-OVERVIEW

Laboratory requirements Manufacturers’ requirements on

electrical equipment Annexes B, D, & E are deleted. They

are technology not used any longer. All of the Occupancy Chapters

NEW ITEMS-OVERVIEW Standard becomes a Code Fundamentals Chapter on Risk Information Technology and Communication

Systems Plumbing Heating Emergency Management (new requirements) Security Fire Protection unique to Health Care Facilities

HOW THE CODE WORKS Determine the worst case

procedure. Select the Risk Category. Select the systems or procedures in

the Code that are prescribed by that level of risk Category

ADMINISTRATION(CHAPTER 1)• Scope:

• The scope of this code is to establish criteria to minimize the hazards of fire, explosion, and electricity in healthcare facilities providing services to human beings.

ADMINISTRATION(CHAPTER 1)• To provide minimum requirements for

the:• Performance• Maintenance, Testing and Inspection

• Safe practices based on risk

ADMINISTRATION(CHAPTER 1) Applies to all health care facilities

(other than home health) Applies to NEW construction and

equipment only• altered or renovated or modernized

Some testing and maintenance requirements apply to existing

Emergency Management and Security apply to existing

REFERENCED PUBLICATIONS (CHAPTER 2) All Referenced publication material

has been updated to most current version

DEFINITIONS(CHAPTER 3) 3.3.9 Anesthetizing location – General

anesthesia 3.3.17 Battery powered lighting units

– NFPA 70 3.3.63 General anesthesia and levels

of sedationDeep sedationGeneral anesthesiaMinimal sedationModerate sedation

3.3.109 Medical support gas

FUNDAMENTALS(CHAPTER 4) 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 requirements as defined in this code.

FUNDAMENTALS(CHAPTER 4) 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 requirements as defined in this code.

FUNDAMENTALS(CHAPTER 4) Category 3 - Facility systems in which

failure of such equipment is not likely to cause injury to the patients or caregivers, but can cause patient discomfort shall be designed to meet system Category 3 requirements as defined in this code.

FUNDAMENTALS(CHAPTER 4) 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 requirements as defined in this code.

FUNDAMENTALS(CHAPTER 4)

4.2* Risk Assessment. Categories shall be determined by following and documenting a defined risk assessment procedure.

A.4.2 Risk assessment should follow procedures such as those outlined in ISO 31010, NFPA 551, SEMI S10-0307 or other formal process. The results of the assessment procedure should be documented and records retained.

GAS AND VACUUM SYSTEMS(CHAPTER 5)

Working with NFPA 55 on bulk oxygen requirements

Tested for proper functionFor purity, alarm sensorsOperation of the control

sensors

• New Section on Cryogenic Systems

GAS AND VACUUM SYSTEMS(CHAPTER 5) Adding testing and inspection

requirements on existing non-stationary medical booms

Testing per manufacturers recommendations, every 18 months or based on risk assessment.

GAS AND VACUUM SYSTEMS(CHAPTER 5) 5.1.3.8* Instrument Air Supply

Systems.

5.1.3.8* Optional Instrument Air Supply Systems. FAILED ROP

FAILED ROCPASSED FLOOR

FAILED BALLOT

GAS AND VACUUM SYSTEMS(CHAPTER 5) 5.1.4.8 Zone Valves. All station outlets/inlets

shall be supplied through a zone valve as follows: (1) The zone valve shall be placed such that

a wall intervenes between the valve and outlets/inlets that it controls.

(2) The zone valve shall be placed such that a wall intervenes between the valve and outlets/inlets that it controls. The intervening wall shall be arranged such that it interrupts the line of site between the outlet/inlet and the zone valve.

MOTION 99-17

FAILED

GAS AND VACUUM SYSTEMS(CHAPTER 5)

ELECTRICAL SYSTEMS(CHAPTER 6) “Wet Location” changes to “Wet

Procedure Location” throughout the entire document

ELECTRICAL SYSTEMS(CHAPTER 6) Permits isolated power or ground fault

protection within operating rooms

ELECTRICAL SYSTEMS(CHAPTER 6) Requires that overcurrent

protection devices only be accessible to authorized personnel and not permitted in public access spaces

ELECTRICAL SYSTEMS(CHAPTER 6) Increases minimum number of receptacles

General Care – From 4 to 8Critical Care – From 6 to 14Operating Rooms – New requirement of 36

ELECTRICAL SYSTEMS(CHAPTER 6) Permits fuel transfer

pumps, receptacles, ventilation fans, louvers and cooling systems related to generators to be added to the life safety or critical branch (deleted from equipment branch)

ELECTRICAL SYSTEMS(CHAPTER 6)

Monthly Generator Testing - 10 second transfer not required (Annual Confirmation)

ELECTRICAL SYSTEMS(CHAPTER 6) New section which

permits switches in lighting circuits connected to Life Safety and critical branch as long as they don’t serve as illumination of egress as required by NFPA 101

ELECTRICAL SYSTEMS(CHAPTER 6) New section on campus

electrical systems being added

Attempts to clear up conflicts

with NEC

ELECTRICAL SYSTEMS(CHAPTER 6)

Requires all operating rooms to be wet procedure locations (unless risk assessment is done)

ELECTRICAL SYSTEMS(CHAPTER 6) Eliminates emergency system heading and

equipment system heading and utilizes branches

• Life Safety• Critical • Equipment

MOTIONS 99-6 AND 99-7

Submitters are attempting to retain the emergency system language

ELECTRICAL SYSTEMS(CHAPTER 6) Added text to permit a 0.1 second delay for

selective coordination

IT AND COMMUNICATION

(CHAPTER 7) New chapter covers

IT roomsFire protectionNurse callEmergency callStaff emergency assistance

PLUMBING(CHAPTER 8) TIA will cover plumbing requirements Essentially will refer to other

model codes or standards

HEATING, VENTILATION AND AIR CONDITIONING(CHAPTER 9)

New TIA will cover oxygen transfilling room requirements

Waste Anesthesia Gas Disposal (WAGD)

ELECTRICAL EQUIPMENT(CHAPTER 10) Chapter reorganized Testing requirements have been

updated Leakage requirements have been

updated

GAS EQUIPMENT(CHAPTER 11)• 11.3.2.5 Temperature limitations to

storage of cylinders must comply with 5.1.3.3.1.7 (temperatures not to exceed 54o C or 130o F.

• 11.4.3.1.1 Specifies the requirements for carts and hand trucks that transport cylinders (must be self supporting and have appropriate chains.)

GAS EQUIPMENT(CHAPTER 11) 9.5.2.4* Medical devices not for patient care

and requiring oxygen USP shall meet the following:(1) Be listed for the intended purpose by the United

States Food & Drug Administration(2) Be under the direction of a licensed medical

professional, if connected to the piped distribution system

(3) Be connected using a wall outlet and a flexible hose, if connected to the piped distribution system

(4) Not be permanently attached to the piped distribution system

(5) Be installed and used per the manufacturer's instructions

(6) Be equipped with a backflow prevention device

EMERGENCY MANAGEMENT(CHAPTER 12)• Completely rewritten and expanded for

2012▫ Two categories of risk

In-patient facility is expected to be operable

In-patient and out-patient areas that augment the critical mission but not receive in-patients

• Requires a Hazard Vulnerability Analysis (HVA)▫ Natural Hazards▫ Human-caused Events▫ Technological Events

EMERGENCY MANAGEMENT(CHAPTER 12) Requires plans to manage resources

and assets Requires Exercises Requires Evaluation of Exercises

Special Care was taken to avoid conflicts with the Joint Commission and CMS

SECURITY MANAGEMENT(CHAPTER 13) Planning for protection of the Staff

and Facility beyond disasters Requires a Security Vulnerability

Assessment (SVA) Requires a responsible person Education requirements of security

staff Customer Service Emergency Procedures Use of Force De-escalation Use of Restraints

SECURITY MANAGEMENT(CHAPTER 13)

Requires procedures for HostageBomb ThreatWorkplace ViolenceDisorderly ConductRestraining Orders

SECURITY MANAGEMENT(CHAPTER 13) Identifies known security sensitive

areas Emergency DepartmentsPediatric and Infant Care unitsMedication StorageClinical LabsForensic Patient Treatment AreasDementia or Behavior Health UnitsCommunications, data infrastructure and

medical records

SECURITY MANAGEMENT(CHAPTER 13) Other subjects covered

Media control Crowd control Security equipment – follow

NFPA 731 Employee practices Security operations

HYPERBARIC FACILITIES(CHAPTER 14) Piping requirements have been

updated New requirements for location of

shutoff valve Updated requirements for reserve to

central supply system New requirements for hyperbaric

medical air system

FEATURES OF FIRE PROTECTION(CHAPTER 15)

Chapter applies to new and existing Pulls most of text from NFPA 101 Fire alarm and detection Protection of gas cylinder storage HVAC detection requirements Defend in place requirements Closets sprinkler exception (less

than 6 sq. ft.) Orientation and training

requirements

THANK YOU FOR YOUR TIME.

QUESTIONS?

David Dagenais, SASHE, CHFM, CHSPDave.Dagenais@wdhospital.com