Are waterless, alcohol-based hand-rub dispensers too great a fire hazard to mount in corridors? No, not at all. After much study and debate, fire safety and infection control experts agreed to amend the Life Safety Code and let facilities mount alcohol-rub dispensers in hallways outside patient rooms. Many applaud this, pleased that unfounded fire safety concerns will no longer impede hand hygiene.
Why the debate?
As you probably know, the CDC has endorsed waterless, alcohol-based hand rubs as integral to a good hand-hygiene regimen. Because they're quick and easy to use, rushed healthcare workers are more likely to squirt some gel into their hands, sanitize them and move on to the next task - and frequency is key to proper hand hygiene.
The problem: Alcohol is flammable. The National Fire Protection Association's (NFPA) 101 Life Safety Code (the 2000 edition of which healthcare facilities must comply with to maintain CMS certification) prohibited healthcare facilities from mounting containers with flammable substances in corridors. The result: Fewer alcohol-based hand rub dispensers in key locations and fewer opportunities to improve hand-hygiene compliance.
But a study commissioned by the American Society of Healthcare Engineers found that the risk of fire with the dispensers is quite low. Since then, the NFPA's Technical Committee on Healthcare Occupancies has worked to change the Life Safety Code, saying the increase in hand-hygiene compliance (more than 20 percent) would outweigh the fire risk. The changes passed the committee in early April and were passed by the full NFPA Standards Council April 15. They'll apply retroactively to the 2000 edition so healthcare facilities can take advantage of the dispensers. No implementation date has been set.
Six conditions you must meet
The NFPA 101 Life Safety Code will now allow alcohol-based hand-rub dispensers as long as you meet these six conditions:
- The corridor must be a minimum of 6-feet wide if you mount a dispenser in a hallway.
- Dispensers in rooms and corridors can hold, at most, 1.2 liters; they can hold up to 2 liters if they're mounted in suites of rooms (such as a pre-/post-op area).
- The dispensers must be at least 4 feet apart.
- They can project as much as 6 inches from the wall and may be installed above handrail height.
- Alcohol-based hand rub dispensers may not be mounted over or next to an ignition source.
- Dispensers may be over carpets only if the room is also a sprinklered smoke compartment.
It is hoped that the CMS will adapt its policy to enforce the current language, either in full or with a few tweaks. In addition to giving the changes weight, such a move by CMS would prompt many state- and local-level fire marshals to allow the dispensers.
With everyone on the same page, we'll remove one more barrier to good hand hygiene. Increased access, speed and convenience will have a real impact on many healthcare institutions in the form of better hand-washing compliance and, in that vein, lower infection rates.