Operating Room Fires: Prevention and Preparation

Operating Room Fires: Prevention and Preparation

By Sandra Jones, LHRM, CPHRM, CASC
Ambulatory Strategies Inc. and ASD Management
[email protected]

During our recent Life Safety Code inspection, we were cited for not doing a scenario based fire drill for an operating room fire. The inspector said that has been a rule for a long time. Any tips on complying with this life safety code requirement?

Now that CMS has stated all surgery centers must follow the 2012 editions of the National Fire Protection Association Life Safety Code (NFPA 101) and Health Care Facilities Code (NFPA 99), life safety code surveyors have received some additional training.

While some states, such as Florida, have been on the 2012 editions of these codes for a few years, other states have just changed to the 2012 editions. As a consequence of the additional training of life safety code inspectors throughout the nation, some areas of compliance to the codes are receiving greater emphasis.

Fire loss prevention in operating room is one of those areas receiving more attention. Several surgical and patient safety organizations have developed educational materials and guidelines on assessing hazards, reviewing materials used in the operating room (including flammable liquid germicides or antiseptics, the use of electrosurgical, cautery or laser) and the appropriate training of physicians and operating room staff to reduce the risk of fires and to know how to respond should a fire occur.

If you are a member of AORN, there are free tools available, including a fire risk assessment worksheet, fire safety competency, examples of duties of the individual team members in case of a fire, and other resources. The Anesthesia Patient Safety Foundation (http://www.apsf.org) has a section devoted to Fire Safety, including a video that be watched online. Or, you can request a free DVD copy of the video. There are also printable posters, newsletters and other resources available on the APSF web site.

The FDA also has resources on preventing surgical fires with links to archived materials. (http://www.fda.gov/Drugs/DrugSafety/SafeUseInitiative/PreventingSurgicalFires/default.htm) The FDA page also refers to the initiative on preventing surgical fires led by Council on Surgical & Perioperative Safety (http://www.cspsteam.org) with member organizations of AORN, American Society of Anesthesiologists, ASPAN, and others.

There are abundant resources to use for education and development of policies and checklists. The Life Safety Code and the accrediting organizations require education of all those who are part of an operating room team, including the physicians, allied health professionals, and surgery center employees. Training should occur at hire for employees and when a physician or allied health professional is first credentialed and before providing care in the surgery center. Education should occur at least annually, including a drill in the operating room. If there should be a fire or a near miss, re-education should occur immediately. Though having staff read your policies and other materials helps to be clear on the duties of all team members for their safety and the safety of patients, fire drills are to be scenario based. Drills should not only be a review of policies and a discussion during a meeting. Develop tools for staff to use to check for risks of a fire and consider posting signs to remind them of precautions. Having staff perform their assigned duties during a drill to know how they would respond is essential to knowing what to do in the event of an actual fire. In addition to having a scenario based drill is the requirement to critique the drill with an action plan developed and implemented if the critique reveals an opportunity to improve performance.