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Joint Commission now allows partially-used oxygen canisters in 'full' rack

Hospital Safety Insider, April 12, 2018

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Hospitals can now store partially used oxygen canisters in the same rack as full cylinders, but be prepared to adjust those racks and signs if you choose to make the change along with The Joint Commission (TJC).

If necessary, you will also have to adjust policies and to retrain staff on the requirements for storing oxygen cylinders, now that TJC has revised a frequently asked question (FAQ) about standards interpretation. However, in many cases the change is up to you. While storing full and partially full cylinders together is now permitted, it is not required.

So if you already use three racks to hold cylinders separated as to whether each is full, partially full or empty, the good news is that TJC still allows that, according to Patton Healthcare Consulting of Naperville, Ill. If you now use two racks — one for full cylinders and another for partially filled or empty cylinders and you choose to change that arrangement — be sure to change any signs used to note which rack is which.

The revised FAQ does not cite a TJC standard. However, it does cite the NFPA 99-2012 Health Care Facilities Code, section 11.6.5.2, which requires empty cylinders to be segregated from full cylinders if they are stored within the same smoke compartment. (The overall amount of oxygen allowed in one enclosure — up to 300 cubic feet or the equivalent of 12 E-cylinders — remains the same.)

The NFPA standard does not address partially filled cylinders, and for years TJC officials held that any cylinder that had been opened even briefly could not be considered full and for storage purposes should go with the empty cylinders.

Patient safety experts have also debated how best to designate when a partially used container should be labeled so that in a patient care emergency, someone switching out cylinders in a hurry doesn’t hook up an almost-empty tank.

Some hospitals set labeling standards and depended on staff to accurately mark when a tank was usable or not and then place it into whichever of the three racks the cylinder belonged. Others simply moved partially full tanks, even if barely used, into the “empty” rack.

Hospitals may see a cost savings if they now discover a way to make better use of the partially full tanks, says Ernest E. Allen, a patient safety executive with The Doctors Company in Columbus, Ohio. On the other hand, for some hospitals, “there would be some cost of buying more storage racks for three classifications and you need a little space for the partial rack,” says Allen.

“The big issue is training of staff and nurses on the new storage of full and partial. The hospital respiratory department should be consulted and the new Joint Commission FAQ reviewed in the safety committee before making the change,” he advises.

The FAQ does note that hospitals should implement storage according to their own policies and with patient safety in mind.

This article originally appeared in Environment of Care Leader, a DecisionHealth newsletter.
 

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