By Greg Freeman
EXECUTIVE SUMMARY
Fire safety requires extensive, ongoing education for staff. Hands-on training can be the most effective approach.
- Kitchens and laundry areas are at high risk of fire.
- Microwave ovens require more training than one might think.
- Staff often are intimidated by emergency equipment.
Fire safety is a major concern in healthcare facilities, but the most effective programs include constant education and training that expose staff to the conditions they might face in an emergency.
Creating an effective fire safety program is a top concern for Cynthia Crespo-Bonaparte, MS, safety manager of the Hospital and Clinical Safety Program at UTHealth Houston.
Fire safety in healthcare begins with proper building design, including the detection, alarm, and extinguishment systems. Fire alarm annunciation is particularly important in an environment in which the entire building cannot be easily evacuated for a general alarm. UTHealth uses a system that specifies where the alarm has been triggered. Crespo-Bonaparte trains staff on how to respond, depending on the location.
The key to healthcare fire prevention and response is to put clear guidelines and codes in place from the start, says Jonathan Hart, PE, technical lead in fire engineering at the National Fire Protection Association in Quincy, MA. Because healthcare facilities face unique infrastructure challenges, employees are required to learn relevant codes and standards — in addition to regular safety protocols — to ensure patient safety is always at the forefront.
Common mistakes in healthcare facilities can be as simple as inappropriately hanging new signage in corridors or a privacy curtain around a hospital bed, Hart notes. There are codes in place, such as NFPA 13, to ensure sprinklers remain unobstructed. An improperly placed curtain could interfere. More complicated oversights include challenges like maintaining power to circuits providing electrical life support equipment during a fire emergency.
“Healthcare facilities can be challenging to maintain because of the sheer number of codes and standards they must abide by to ensure proper infrastructure and a safe everyday environment for employees and patients,” Hart explains. “Because there is minimal room for error, facility managers must ensure that they’re leveraging the right tools that enable collaboration, communication, and abide by relevant codes and standards throughout the design and build process in addition to the day-to-day operations.”
Kitchens are a common source of fires, so Crespo-Bonaparte devotes substantial effort to preventing these fires and teaching staff how to respond. The hospital trains staff to recognize the different types of kitchen fires, which fire extinguisher is appropriate, and how to activate the overhead system that can extinguish the fryer.
Laundry rooms are another common fire risk. Crespo-Bonaparte frequently inspects these areas.
“We have to make sure that the washers are clean and the dryer lint traps are clean. Cleaning is important — particularly behind the dryers — because we don’t want anything to accumulate and cause a fire,” Crespo-Bonaparte notes. “Most hospitals will tell you that they’re a smoke-free building, but you will find it’s still done in some locations, and you have to check that. You will see the patients with their oxygen going outside to smoke, so that’s a pretty big risk.”
Psychiatric units can pose unique fire risks because they require more locked doors, Crespo-Bonaparte notes. The same hazard can be found on neonatal units, or areas in which inmates are treated. In those settings, each staff member should carry a main key that opens all doors.
“Even though I have a master key, I like to use my regular key, the one that everyone has, when I do inspections and make sure doors can open quickly,” Crespo-Bonaparte says. “We look also at doors to make sure those doors that we have as smoke and fire barriers are working correctly and not compromised.”
Some doors in the hospital open automatically when the fire alarm goes off, and others require a key. During fire drills, those doors are checked to ensure they are working correctly. Emergency lighting and generators also are inspected monthly.
Crespo-Bonaparte is a strong believer in hands-on training to build confidence in staff. She regularly conducts sessions in which staff members use a fire extinguisher on a small fire rather than simply being told how to use it.
Staff also are trained extensively on the location of extinguishers, fire alarm pull stations, and master cutoffs for oxygen and other gasses. They are routinely asked to point out those locations during fire safety inspections.
“Sometimes, the staff feel intimidated, like with alarm pull stations. I have a pull station that I use when we do new employee training, and I have them pull the lever so that they know what it feels like and are less intimidated,” Crespo-Bonaparte says. “When we do fire drills, we do not activate the alarm ourselves. We always find someone in the area so that they can actually practice putting the entire building into alarm.”
Crespo-Bonaparte also trains staff on the proper and safe use of microwaves in break rooms. Avoiding the dreaded burned popcorn is one lesson, but there are more mistakes to avoid, such as using foil or entering 20 minutes cook time instead of two minutes.
“I stress when we talk about microwave [safety] to stay with your food. Number two, if you see a person who is about to use a microwave incorrectly, please intervene,” Crespo-Bonaparte stresses. “We are now working with people who come from all over the world. I have encountered several people in my 20-plus years working with safety and fires who didn’t know how to use a microwave. I even had an intern about four years ago from Spain [who] had never actually used a microwave.”
UTHealth experienced fire incidents that were well contained and ended quickly because staff were well-trained and confident in their response.
“We’ve had patient sheets on fire, and we didn’t have to evacuate the unit because the staff knew what to do. They remembered their training and they took care of it,” Crespo-Bonaparte says. “However, I have had microwave fires with horrible smoke. We have had to evacuate a unit for more than two hours. That can be dangerous not just for those patients, but also for the staff, because now you’re taking patients out of the secure and safe environment to another environment.”
SOURCES
- Cynthia Crespo-Bonaparte, MS, Safety Manager, Hospital and Clinical Safety Program, UTHealth Houston. Phone: (713) 500-4472.
- Jonathan Hart, PE, Technical Lead, Fire Engineering, National Fire Protection Association, Quincy, MA. Phone: (800) 344-3555.
Fire safety is a major concern in healthcare facilities, but the most effective programs include constant education and training that expose staff to the conditions they might face in an emergency.
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