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Indoor Environment Report — May 2006

Electrical testing requirements in healthcare facilities

As many healthcare facilities build new facilities or renovate existing buildings, they need to be concerned the Joint Council on the Accreditation of Healthcare Organizations (JCAHO) “standard of care” as it relates to the maintenance and verification of electrical receptacles serving patients.

Steve Rizzo, president of Synergy Consultants, Inc., a consulting engineering and commissioning firm, says, “People assume that a new or newly renovated building is working properly, but now they must test the electrical systems to be sure they are in fact functioning.”

Because JCAHO doesn’t create or codify testing standards, it looks to the standards, guidelines, and codes established by the National Fire Protection Association (NFPA) with regard to protecting people and property from fire.

NFPA 99 provides guidance regarding the types of electrical receptacles to be used, their numbers, from where they are fed, and, more importantly, how they are made safe through grounding.

The effectiveness of the grounding system is determined at the patient care receptacle by measuring the impedance and voltage , if any, of the hot and neutral receptacles with respect to the safety ground, and those same measurements for the safety ground with respect to a “reference point.”

Rizzo notes that the NFPA explicitly states that a reference ground point is the ground bus with that circuit’s panel board, a grounding point near or within the room that is remote from the receptacle under test; i.e. a cold water pipe, or a ground contact of a receptacle that is served from a different branch circuit.

Testing requirements

The testing required of a single patient care receptacle is:
  1. A visual inspection of the receptacle for physical integrity.
  2. The continuity of the ground circuit is verified.
  3. The receptacle’s hot and neutral connections are verified.
  4. The retention force of the ground pin is measured.
To meet this section’s testing criteria the receptacle needs to show not more than 20mV of voltage leakage and 0.1Ώ(ohms) of impedance between hot-to-safety ground, neutral-to-safety ground and the safety ground-to-reference point, with the circuit in a no fault condition. Systems using a special “quiet ground” are allowed to have an impedance of 0.2Ώ. The grounding pin is required to have a retention force of no less than 4 oz. or 115gm.

This receptacle acceptance testing is required of all patient care areas new or existing on an ongoing basis in order to constantly evaluate the condition and safety of the system.

Hospital grade receptacles, according to NPFA 99, need to be tested after initial installation, its replacement or servicing, and additional testing “shall be done based on the documented performance data” while non-hospital grade receptacles will be tested annually.

NFPA 99 further states that the grounding system of new construction “shall be evaluated before acceptance” and “Whenever the electrical system is altered or replaced, that portion shall be tested.”

Isolated power systems are used to provide another layer of protection for areas such as surgery suites. Isolated power systems generally utilize active Line Isolation Monitors that constantly verify the leakage between hot, neutral and ground circuits and will alarm if leakage occurs. These units require similar verification upon their installation and annual testing through an on-board test function.

Documentation is also required

Documentation, as always, is required as to which receptacles were tested, where they were located, what the testing results were, and if the receptacle passed or failed.

If the receptacle failed, documentation would be used to track those items. NFPA 99 requires that records be kept of “repairs and associated modification” to the electrical systems. With respect to Line Isolation Monitor testing, it requires that permanent records of the testing be kept.

Rizzo says, “As with any newly installed system it is wise to test and verify its performance, in this case the grounding system of a patient care area’s electrical system. By verifying performance you can prevent a fire hazard and an electrocution hazard.

“An ongoing program where this testing occurs will provide long term operational trends of system performance: voltage leakage changes indicating potential future failures or ground pin retention force changes that could indicate a failing receptacle.”

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