Ask George

Abstract

In this column, BI&T features questions and answers between AAMI members and Joint Commission expert George Mills. Become part of the discussion and ask questions about those subjects that matter to you the most. You can submit your Joint Commission question at this link: www.aami.org/tmcconnect/askgeorge.html. Or to join AAMI's Joint Commission e-forum, which is open to all AAMI members, visit www.aami.org/tmcconnect/discussiongroups.html. Some of the questions and answers may have been edited for space, style, and clarity.In discussions around best practice maintenance strategies for endoscopes, there is some confusion regarding which scopes are involved. At first, it seemed all scopes of rigid and flexible origin, but then I heard that solid scopes were to be treated the same as OR instruments. I am assuming rigid scopes are solid scopes. Are they therefore handled the same as OR instruments with OR/central sterile oversight, and all flexible scopes are for clinical engineering oversight?The driving issue is the concern for cross contamination. I have consistently asked that both flexible and rigid endoscopes be added to the medical equipment inventory, on a voluntary basis, to create another look at the reprocessing environment affecting scopes.Is there a Joint Commission standard that requires life-support equipment be plugged into the red emergency power outlets? I've never heard of this, but a consultant is referencing EC.02.04.01 EP2 and EC.02.05.03 as the standards this requirement falls under.There is a requirement for emergency power to be supplied in the Utilities Management section for those items listed in EC.02.05.03, such as “equipment that could cause patient harm when it fails, including . . . blood, bone, and tissue storage systems.” The Joint Commission expects the organization to conduct a risk assessment whenever these decisions are required, to identify proper response to the potential risk.A few years ago, some people believed that The Joint Commission required defibrillators to be plugged into receptacles that were also powered by the emergency power system. This was never a Joint Commission requirement, but an opportunity for the organization to determine what best met the needs of the organization.I have a question related to relocatable power taps. Our hospital is installing a new electronic medical record system. They'll be integrating our ventilators so that data will flow into the patient record. The solution being used on mobile equipment is a small, 12-volt PC that will attach permanently to each vent. IT wants to use a hospital-grade, multiple-outlet adapter. The small transformer would be plugged into the strip. The outlet strip is hefty enough to handle the ventilator as well as the humidifier. We would then have only one power cord for the three devices. As long as we perform our electrical safety tests on the devices as a group, is it acceptable to use these for this purpose?This was discussed at a Healthcare Interpretation Task Force meeting without resolution. NFPA 70, 99 and 101 all have regulations that control the electrical components in a patient room, none supporting use with medical equipment. Pending formal action, The Joint Commission has allowed organizations to conduct a risk assessment to determine the appropriateness of these power taps. At a minimum, we have said that they should be hospital grade, prohibit “daisy-chaining” (linking one power tap from another), and confirm the circuits supplying power are adequate.Regarding rental equipment documentation: If we use a reputable company that we have used for many years and have a good relationship with, can we use their test and safety inspection documents as our own?This is up to your organization to manage, as The Joint Commission does not accredit the service company, but your organization. The requirement for the equipment to be tested and safety inspections completed is the accredited organization's responsibility, and you should be able to show why your process is acceptable. Some organizations conduct random sampling of the work performed by the contracted service to document effectiveness.