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
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Why is this a topic? Science! System Evaluation Why does this
matter? What are the rules? How do you ensure compliance?
Agenda
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Why is this a topic? Lots of recent cases of hits on
inspections Engineering and Clinical have different ways of
measuring humidity Engineering has no good way to stay within
standards mechanically There are no records of actions being taken
Decisions being made arent following the patient when a Tracer is
done Staying in compliance is a waste of energy Operations are
being affected / shut down Just to pass inspection? Patient Safety
Risk reduction
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Humidity. (h)yoo midd/ noun noun: humidity the state or quality
of being humid. a quantity representing the amount of water vapor
in the atmosphere or a gas
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Science! Humidity vs Relative Humidity Water Warmer Air
Air
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Science! Latent Heat vs Sensible Heat Sensible Heat Changes
Temperature Latent Heat Changes phase
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Science! Dry Bulb Temp Its what you think of when you think of
temp Wet Bulb Temp Its the temp you feel when you are wet
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Science!
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OK, thats some great theory. Can my systems even do that?
Mechanical System Evaluation
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What systems are affected AHUs Cooling Coil Reheat Air flow
Chiller Temp Capacity Flow From an FM perspective Can I meet my
setpoints? How often? What are you doing?
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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
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Mechanical System Evaluation
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Thats Great. Why do we care about humidity again? Why does
humidity matter?
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Why does this matter? High Humidity Infection Control Surgical
Site Infections (SSI) Wound Care Supports Mold Growth Operating
Room Comfort Low Humidity Tissue impact Static Discharge Fire
Potential ?
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That sounds bad. Are there rules? Codes and guidelines.
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Codes and Guidelines FGI 2010 ASHRAE 170 Table 7-1 Humidity and
Temp Waiver AORN Perioperative Stds and Recommended Practices Safe
Environment of Care - Recommendation V V.b and V.c NFPA-99 Whats
DOH say? FGI standards What do the docs say? COLDER!!
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ASHRAE 170 Table 7-1
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AORN Safe Environment of Care
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NFPA 99 CMS currently adopts NFPA 101 2000 edition, which
refers to an older version of NFPA-99 which has a 35% rh low limit
References to OR humidity have been removed from newer versions of
NFPA 99 CMS intends to adopt the 2012 edition of NFPA 101, which
would eliminate the NFPA driven 35% low limit. CMS issued a
waiver
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Categorical Waiver
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Seriously? How do I follow all those rules? Compliance tools
and ideas
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Waiver How to accept waiver Where to put waiver letter Example
waiver letter
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Service Level Agreement 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
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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