There are many devices and equipment in the marketplace that claim to be “hospital-grade,” but what is hospital-grade and when is it required?
It is important not to confuse the generic use of “hospital-grade,” which is typically used for marketing or to describe a robust product good for use in a hospital, with requirements found in various building codes. Simply put, true hospital-grade equipment is only required when referring to electrical devices such as the nonlocking 15- or 20-amp/125-volt electrical receptacle (per the National Fire Protection Association’s NFPA 99 Health Care Facilities Code Section 6.3.2.2.1(C)) or the plug and cord that would plug into that receptacle. These are required anywhere a patient can come into contact with the cord or for patient care equipment within the patient care vicinity.
This is important to remember as we see a proliferation of USB-powered devices requiring a USB port into which they can be plugged. For convenience, many may opt to install combination receptacle/USB ports in the patient care vicinity. In these cases, the 125-volt receptacle needs to meet NFPA 99 code requirements, but the USB does not. Although a manufacturer may market their product as being a “hospital-grade” USB receptacle, in reality, no such thing exists. What’s more, even if a manufacturer created a more robust USB port and described it using that term, there is no code or reason for it to be required.
A code-required 125-volt receptacle incorporates additional construction requirements that help the receptacle withstand the use and abuse it will see in the hospital environment. The casing is much stronger than a typical receptacle, and the internal conductive components are more robust. The design of the receptacle ensures grounding path integrity is maintained through the receptacle. All these design elements are important to reduce the risk of electrical shock to patients who may be in contact with these devices, specifically those patients who may be connected to these devices in a way that provides a direct electrical pathway to their hearts.
Although some of the common USB ports used in public spaces, such as airports, could very well benefit from better construction so that the cord doesn’t fall out under its own weight, USB ports are typically limited to 5 to 20 volts, nowhere near a shock hazard for anyone, including patients. By design, USB devices do not require robust grounding.
Facilities opting to use a stronger USB port will eliminate frustrating issues associated with charging devices such as a smartphone, but it doesn’t impact much beyond that. This is because health care facilities do not plug critical equipment like infusion pumps and ventilators, which require a certain level of construction integrity, into USB ports.
This is not the first time we have seen an over-interpretation of the term “hospital-grade.” In 2013, several surveyors started citing the need for hospital-grade microwaves. These citations stemmed from a well-worded advertisement promoting a company’s “hospital-grade” microwaves, which were nothing more than a commercial-grade microwave. Unfortunately, the surveyors correlated the term “hospital-grade” as a requirement from NFPA 70®, National Electrical Code®, and several hospitals didn’t fact-check this need prior to replacing their microwaves, even in areas where a commercial-grade microwave wouldn’t be required.
Codes and standards are complex, and the words used within them have specific meanings; there is a reason the terms “125-volt receptacle,” “USB port” and “direct pathway to [the heart]” are used in this article. Each of these terms and phrases (all worthy of their own articles, by the way) mean something.
When surveying a hospital, it’s difficult to consider the intent of every single item. Sometimes surveyors have to go with what they know, or what they think they know. As facilities managers, however, an important part of the surveying process is to question a citation if there are doubts about its accuracy. Do the homework on citations to understand the intent behind the requirement. If all else fails, rely on colleagues and professional associations to help out.
Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, is deputy executive director of regulatory affairs for the American Society for Health Care Engineering.
