How to use NFPA 99


Steps to complying with NFPA 99

1. Start by stressing that this is not an engineering responsibility.

As engineers, we are traditionally “the smartest person in the room,” and as such, we are big targets for logical analysis and ultimately complicated math projects like this, usually without compensation. The engineer most likely has a role in the risk assessment process, but the effort is fruitless until a risk assessment team, including the folks mentioned in NFPA 99, is assembled.

NFPA specifically lists clinicians, biomedical engineering, staff, and facility safety engineering staff as required to be on the team. This group is going to be the source of the data that you’ll use to calculate the risk probabilities. I kept the group that I worked for accountable for supplying the data that I used in the calculations. Why is it necessary that the engineer perform the calculations? Reference the first sentence in the previous paragraph.

2. Lead the meetings, and ask the questions.

In my experience, this is an iterative process. The clinicians, biomedical engineers, etc., that I’ve worked with are normally confused as to why they are even participating in this process. As such, they will not arrive at the first meeting with suitable information that you need to perform the calculations. Set up a weekly conference call that lets the team get used to running down the data that you will need.

3. Explain why it’s different this time.

Participants often say, “It’s a general operating room! What else do you need to know?’’ Explain why we are doing the assessment and how much of the risk is driven by the number/types of medical procedures that will be performed in the room. The nursing/scheduling staff normally can give you a comprehensive list of the procedures with relative frequencies for an operating room (it is their business).

4. It’s all about fluid dynamics.

The biggest unknown and ultimately the largest risk factor is directly proportional to the quantity of fluid that can end up on the floor. Understand the fluid impact for every procedure. Questions to ask include:

  • How much (measured in milliliters) fluid do you use when you irrigate a cysto procedure?
  • When fluid is spilled, how much is spilled?
  • Do you have a special irrigation table?
  • Do you use special draping?

Are there inherent advantages/disadvantages to the electrical system the engineer has designed? Are there any cords on the floor? Have any of the cords been altered or require adapters? (These are all past reasons for reported microshock incidents.)

5. Give the team homework assignments.

Everyone is programmed to fill out forms. Table 1 is an example of the worksheet used recently. This helped the staff understand the needed information in an easy format.

6. Crunch the numbers.

Once the team has provided the basic information for the operating room procedures, it’s time to convert the data into something useful for the actual risk assessment portion of the exercise. The actual risk is directly proportional to the “pool” size on the floor. Using a linked Microsoft Excel sheet, it is easy to develop the information in Table 2.

7. Develop a fault tree.

The culmination of all this work is expressed in a fault tree. Table 3 shows an example.

8. Calculate risk results.

Table 1: Risk worksheet

Figure 1: This worksheet helped the staff understand the needed information in an easy format. Courtesy: TLC Engineering for Architecture

Table 2: Risk assessment (calculating event per year)

Figure 2: Data collected by the hospital can easily be imported into a sheet like this, which then helps calculate risk. Courtesy: TLC Engineering for Architecture

Table 3: Risk assessment (calculating event per year)

Figure 3: This is the final result of data collection. Courtesy: TLC Engineering for Architecture

Finally, combine all the information into an aggregate risk probability that is suitable for the published results of the risk assessment team that can be included in the final published report (by the facility) that will be reviewed by the hospital executive board as, eventually, the authority having jurisdiction.

Reviewing the results in Table 3, it looks like the chance of having an undesirable electrical result for either an arthroscopic or C-section procedure over a 30-year period is far less than a person’s chance of getting hit by lightning any given year. However, using the risk assessment, there is s a better chance of having an undesirable event (i.e., microshock) with a cysto procedure (over a 30-year period) than getting hit by lightning. This result isn’t surprising because a cysto procedure is a known “wet” procedure and often is considered the benchmark for when to install an isolated power system.

Interpreting and applying the code will be unique for each situation. It’s always better to err on the conservative side when lives are at stake; but realize that the code writers appear to be  evolving away from a prescriptive solution for many high-risk installations. As engineers, we often speak to the client about the relative costs, lead-time, installation method, on-going maintenance, etc. for a proposed engineered system. We will be compelled to address the associated risk in that conversation wherever NFPA 99-2012 has been adopted.

Gerald Versluys is a senior electrical engineer and principal at TLC Engineering for Architecture. His areas of expertise include sustainable health care design and campus distribution systems. He is a member of Consulting-Specifying Engineer's editorial advisory board.

<< First < Previous 1 2 Next > Last >>

Juan , Non-US/Not Applicable, Peru, 06/19/14 08:50 PM:

The Top Plant program honors outstanding manufacturing facilities in North America. View the 2015 Top Plant.
The Product of the Year program recognizes products newly released in the manufacturing industries.
The Engineering Leaders Under 40 program identifies and gives recognition to young engineers who...
Safety for 18 years, warehouse maintenance tips, Ethernet and the IIoT, GAMS 2016 recap
2016 Engineering Leaders Under 40; Future vision: Where is manufacturing headed?; Electrical distribution, redefined
Strategic outsourcing delivers efficiency; Sleeve bearing clearance; Causes of water hammer; Improve air quality; Maintenance safety; GAMS preview
SCADA at the junction, Managing risk through maintenance, Moving at the speed of data
Safety at every angle, Big Data's impact on operations, bridging the skills gap
The digital oilfield: Utilizing Big Data can yield big savings; Virtualization a real solution; Tracking SIS performance
Applying network redundancy; Overcoming loop tuning challenges; PID control and networks
Driving motor efficiency; Preventing arc flash in mission critical facilities; Integrating alternative power and existing electrical systems
Package boilers; Natural gas infrared heating; Thermal treasure; Standby generation; Natural gas supports green efforts

Annual Salary Survey

Before the calendar turned, 2016 already had the makings of a pivotal year for manufacturing, and for the world.

There were the big events for the year, including the United States as Partner Country at Hannover Messe in April and the 2016 International Manufacturing Technology Show in Chicago in September. There's also the matter of the U.S. presidential elections in November, which promise to shape policy in manufacturing for years to come.

But the year started with global economic turmoil, as a slowdown in Chinese manufacturing triggered a worldwide stock hiccup that sent values plummeting. The continued plunge in world oil prices has resulted in a slowdown in exploration and, by extension, the manufacture of exploration equipment.

Read more: 2015 Salary Survey

Maintenance and reliability tips and best practices from the maintenance and reliability coaches at Allied Reliability Group.
The One Voice for Manufacturing blog reports on federal public policy issues impacting the manufacturing sector. One Voice is a joint effort by the National Tooling and Machining...
The Society for Maintenance and Reliability Professionals an organization devoted...
Join this ongoing discussion of machine guarding topics, including solutions assessments, regulatory compliance, gap analysis...
IMS Research, recently acquired by IHS Inc., is a leading independent supplier of market research and consultancy to the global electronics industry.
Maintenance is not optional in manufacturing. It’s a profit center, driving productivity and uptime while reducing overall repair costs.
The Lachance on CMMS blog is about current maintenance topics. Blogger Paul Lachance is president and chief technology officer for Smartware Group.
This article collection contains several articles on the vital role of plant safety and offers advice on best practices.
This article collection contains several articles on the Industrial Internet of Things (IIoT) and how it is transforming manufacturing.
This article collection contains several articles on strategic maintenance and understanding all the parts of your plant.
click me