Humidity in Anesthetizing
Locations
Where Mechanical Systems and Compliance Collide
Daniel Swanson | Project Director Healthcare | McKinstry
Currently Acting Director of Facility Services & Construction UW-Northwest Hospital & Medical Center, Seattle, WA
Agenda
• Why is this a topic?
• Science!
• System Evaluation
• Why does this matter?
• What are the rules?
• How do you ensure compliance?
Why is this a topic?
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Lots of recent cases of “hits” on inspections
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Engineering and Clinical have different ways of measuring humidity
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Engineering has no good way to stay within standards mechanically
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There are no records of actions being taken
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Decisions being made aren’t following the patient when a “Tracer” is done
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Staying in compliance is a waste of energy
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Operations are being affected / shut down
Just to pass inspection?
•
Patient Safety
•
Risk reduction
Humidity.
(h)yo͞oˈmidədē/
noun
noun: humidity
the state or quality of being humid.
a quantity representing the amount of water vapor in the atmosphere or a gas
Science!
•
Humidity vs Relative Humidity
Air
Water
Warmer Air
Science!
• Latent Heat vs Sensible Heat
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Sensible Heat
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Changes Temperature
Latent Heat
•
Changes phase
Science!
• Dry Bulb Temp
• It’s what you think of when you think of temp
• Wet Bulb Temp
• It’s the temp you feel when you are wet
Science!
Science!
Science!
Science!
OK, that’s some great theory.
Can my systems even do that?
Mechanical System Evaluation
Mechanical System Evaluation
What systems are affected
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AHUs
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Cooling Coil
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Reheat
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Air flow
Chiller
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Temp
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Capacity
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Flow
From an FM perspective
• Can I meet my setpoints? How often? What are you doing?
Mechanical System Evaluation
Iterative process
Decide on a set of parameters for criteria
Space temp, Design Day
Evaluate current systems
Coil performance (Using space temp, OAC, assumed load)
Criteria met?
Operational Evaluation
Commissioning, cleaning, flow, controls system
Redesign
Coil size, static, Sensible vs latent, chw temp
Cost? - Iterate
Service Level Agreement / Budget
Mechanical System Evaluation
Mechanical System Evaluation
Mechanical System Evaluation
That’s Great. Why do we care about
humidity again?
Why does humidity matter?
Why does this matter?
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High Humidity
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Infection Control
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Surgical Site Infections (SSI)
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Wound Care
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Supports Mold Growth
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Operating Room Comfort
Low Humidity
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Tissue impact
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Static Discharge
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Fire Potential ?
That sounds bad. Are there rules?
Codes and guidelines.
Codes and Guidelines
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FGI 2010
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•
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ASHRAE 170 Table 7-1
Humidity and Temp
Waiver
AORN
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Perioperative Stds and Recommended Practices
Safe Environment of Care - Recommendation V
• V.b and V.c
•
NFPA-99
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What’s DOH say?
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FGI standards
What do the docs say?
•
COLDER!!
ASHRAE 170 Table 7-1
AORN – Safe Environment of Care
NFPA 99
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CMS currently adopts NFPA 101 – 2000 edition, which refers to an
older version of NFPA-99 – which has a 35% rh low limit
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References to OR humidity have been removed from newer versions of
NFPA 99
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CMS intends to adopt the 2012 edition of NFPA 101, which would
eliminate the NFPA driven 35% low limit.
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CMS issued a waiver
Categorical Waiver
Seriously? How do I follow all those rules?
Compliance tools and ideas
Waiver
How to accept waiver
Where to put waiver letter
Example waiver letter
Service Level Agreement
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Get all stakeholders to the table
Determine which codes/standards/guidelines you will follow
Know how frequently you can or cannot stay in standards
Know what it will cost to stay within standards
Determine what standard to meet and how it will be met
Compliance vs being in standard
Work Orders
Work Order System Setup
How to reorganize
How to close the loop
Flagging work orders
Paperwork trail
What do you do as the Engineering Department
High side humidity vs low side humidity
OK, got it. I think. Can you summarize?
Summary
Summary
• Science
• Codes
• Compliance
• Mechanical Evaluation
Questions?
Thank you!
Daniel Swanson
(206) 762-3311
dans@mckinstry.com