Through its advocacy efforts, it has come to the attention of the American Society for Health Care Engineering (ASHE) that the combination of a tamper-resistant receptacle (TRR), ground fault circuit interrupter receptacle (GFCI), and arc fault interrupter breaker (AFCI) has become a major discussion topic when talking about patient safety in a behavior health setting.

ASHE is informing its members and the health care field that it does not advocate for the use of a combination of TRR, GFCI and AFCI as this combination will significantly increase a risk of disruption to patient care through nuisance tripping, which will take staff attention away from the patients.

The Facility Guidelines Institute 2010 Guidelines for Design and Construction of Health Care Facilities only requires “electrical receptacles in psychiatric patient rooms shall be tamper-resistant or equipped with ground-fault circuit interrupters.” Both the 2014 and 2018 Guidelines expound further by stating for electrical receptacles provided in a patient bedroom, the receptacles shall only be:

  1. Tamper-resistant.
  2. All controlled by a single switch outside the room and under the control of staff.
  3. Either ground-fault circuit interrupter devices or on a circuit protected by a ground-fault circuit breaker.

ASHE is also aware that several states, including New York state, have additional requirements to use a combination of TR, GFCI and AFCI devices for the safety of mental health patients. ASHE members should consult with their state and local guidelines for additional requirements.

The risk associated with these devices is because the technology is not currently at an acceptable level to perform at a rate that would allow all three devices to work in a beneficial manner. ASHE will continue to monitor and evaluate technology for applicability as advances in these applications continues.

ASHE recommends that health care facilities perform assessments to determine the level of risk associated with electrical usage in behavioral health settings. Reduction or elimination of receptacles, providing lockable covers, switched receptacles in patient bedrooms, and one-on-one observation are all potential options.