Los Angeles Power Strips/Extension Cord Clinical Usage

PURPOSE:  This section supplements Stable regulation continued in the California Code of Regulations Title 8, 22, and National Electric Code (N.E.C.). Those who direct or perform electrical construction or repair are expected to be familiar with the following regulations and codes.

REFERENCES:     NFPA 99-2012 Section 3.3.7; NFPA 99-2012 Section 3.3.139; UL 1363; UL 1363A;

UL 60601-1; UL 1363.

POLICY: Use of extension cords might be regained when permanently installed receptacle outlets

are not accessible or adequate, temporary extension cords or power strips equipped with overload protection may be used if installed in accordance with the safety guidelines defined in this policy.

PROCEDURE:

1. Medical Usage Guidelines

1. Life Support Equipment

• Electrical power strips will not be used to power life support devices. Life support equipment must be connected directly to an emergency power outlet (Red). This would include life support equipment in storage
• All used power strips must be an approved type by facilities, Clinical Engineering and UL approved

1. Non-Life Support Equipment

• Strips will only be used for non-life support devices when both the Clinical Engineering Supervisor and Facilities Director approve the medical devices use. Power strips will be attached to a pole or cart. The power strip will be entered into the Facilities inventories and will be maintained in compliance with the NFPA Life Safety Code.
• Clinical staff will be trained on what devices can be powered by the strip and will be responsible for ensuring the strips are used per this policy.

2. Clinical Staff Responsibility

• Clinical staff shall ensure that power strips are not used to power life support equipment and must meet the usage guidelines outlined. If a medical device must be used and a wall receptacle is not available, the Clinical Director or Manager of the clinical area shall contact the Facilities Director to determine if a wall receptacle should be installed for future use. If the installation is not immediately possible and a power strip is required, the Clinical Manager must obtain written approval from Clinical/ Biomedical Supervisor for use is approved. Clinical area manager must obtain approval from the Clinical Engineer or Facilities Department to power the combination of medical devices.
• Clinical staff employees know and understand the potential electrical hazard associated with each instrument and the necessary safeguards to prevent a possible shock/ electrocution
  • Immediate shut off power from the source
  • Initiate lifesaving procedures immediately and continue them until professional medical assistance arrive
  • Call code if required
  • Safety precautions should be employed if working on electrical equipment
  • Do not hold electrical energized equipment with wet hands
  • Body moisture or perspiration lower resistance, which permits a greater current force. Keep body resistance high by keeping hands and feet dry
    • Prior to use, Clinical Engineer or Assigned Facilities Engineer shall identify the maximum number of amps used by the combination of devices. Engineer shall ensure that 80% of the power strips breaker capacity is not exceeded.

3.  Biomedical/ Clinical Responsibility

• Clinical/ Facilities staff is responsible for review and approval of requests to power non-life support equipment via electrical power strips.
• Clinical/ Facilities technicians shall report all violations of this policy to the Safety Compliance Officer and Clinical Area Manager to ensure that all medical devices are serviced by the appropriate power source in compliance with the National Electrical Code and the Life Safety Code.

4. Facilities/ Engineering Responsibility

• Facilities engineering shall review requests for outlets to power medical devices and make recommendations of correct code requirements and if request can be installed per industry standard to power non-life support device with-in patient defined areas.
• Facilities engineering shall ensure that all power strips are medical grade, and entered into a Medical Equipment Inventory and are maintained and regularly inspected (Annually) in compliance with a maintenance schedule approved by manufacturer standards and all related clinical and codes/ standards.

5. Policy Pre-cautions

• Extension cords of any type used as permanent wiring
• “Cheater” adapters
• Multiple outlet adapters
• “Daisy Chaining” of surge protector and/ or multiple outlet adapter
• Power strip cords placement becoming a tripping hazard
• Overloading of power strip with High Load devices
• Power strips which damaged such as; melted, burnt, frayed, discolored, hot to touch, hardware missing, chassis cracked or broken
• Extreme caution near wet locations such as Dialysis, surgical areas, and endoscopy. Ground fault interrupters (GFCI) may be regrouped
• Properly routed cords
• Use only electrical devices which have a three-wire plug (neutral, hot, ground)
• Never ignore a tingling sensation caused by a piece of equipment turn off devices – Place an “out of service” tag and report it to the appropriate nursing department for repair.
• In-patient care areas – Patients power strips may not be used as well no patient equipment shall be plugged into any power strip. All equipment must be approved by Biomed or Facilities Director.

6. Laboratories

• Scientific equipment including but not limited to heat blocks, water baths, and incubators must be plugged into code regulated outlets. If laboratory equipment requires the use of surge protector as additional protection, this should be reviewed by facilities director and be noted in the laboratories procedures.

7. Construction Policy

• In new healthcare facilities or facilities undergoing renovation or a change in occupancy patient care rooms shall be provided with receptacles as required in NFPA 99-2012, section 6.3.2.2.6

1. Definitions 
   1. Patient care room is defined in Section 3.3.138 of NFPA 99-2012 as “any room of health care facility wherein patients are intended to be examined or treated.” Note that this term replaces the term “patient care area” used in the 1999 edition of NFPA 99.
   2. Patient care vicinity is defined in Section 3.3.139 of NFPA 99-2012 as “a space, within a location intended for the examination and treatment of patients [i.e., patient care room], extended 1.8 m (6 ft.) beyond the normal location of the bed, chair, table, treadmill, or other device that supports the patient during examination and treatment and extends vertically to 2.3 m (7 ft. 6 in.) above the floor.”
   3. Power strip is a block of electrical sockets that attaches to the end of a flexible cable (typically with a grounded plug on the other end), allowing multiple electrical devices to be powered from a single electrical receptacle.
   4. Receptacle is defined in Section 3.3.154 of NFPA 99-2012 as “a contact device installed at the outlet for the connection of an attachment plug. A single receptacle is a single contact device with no other contact device on the same yoke. A multiple receptacle is two or more contact devices on the same yoke.”
   5. Relocatable power tap (RPT) is a power strip of the polarized or grounded type equipment with overcurrent protection and listed as in compliance with UL 1363.
   6. Patient-care-related electrical equipment is defined in Section 3.3.137 of NFPA 99-2012 as “electrical equipment…that is intended to be used for diagnostic, therapeutic, or monitoring purposes in a patient care vicinity.”
   7. Patient bed location is defined in Section 3.3.136 of NFPA 99-2012 as “the location of a patient sleeping bed, or the bed or procedure table of a critical care area.”
   8. Ampacity is defined in Section 3.3.7 of NFPA 99-2012: Health Care Facilities Code as “the current, in amperes, that a conductor can carry continuously under conditions of use exceeding its temperature rating.”
   9. “Cheater Adapters” a device used to allow a 3-prong electrical plug to be plugged into a 2-prong outlet. (removal of electrical grounding)
   10. “Daisy Chaining”
   11. Permanent Use is pertaining to the use of extension cords, “permanent” means used for longer than a single shift for an individual task and generally being used in lieu of permanent, fixed wiring and outlet.
   12. Polarized Prongs is when one prong is wider than the other
   13. Temporary Use is pertaining to the use of extension cords, “temporary” means in-use for the purpose of performing a limited duration task such as drilling holes, buffing a floor, etc. generally not to exceed one work shift.
   14. HFAP – Health care Facilities Accreditation Program
   15. CAP – College of American Pathologists
   16. Joint Commission