What two types of med gas are required in a typical med/surg patient room?
vacuum and oxygen according to Guidelines for Design and Construction of Health Care Facilities.
When should medical equipment modality selections ideally be made during the planning, design, and construction process?
Before the end of SDs
When should medical equipment manufacturer selections ideally be made for each modality during the planning, design, and construction process?
Before the end of DDs
What is a medical equipment modality?
Refers to different types of imaging equipment
What are some examples of medical imaging modalities?
Conventional radiography
Fluoroscopy
Angiography
Mammography
Computed Tomography
Ultrasound and Ultrasound/Doppler
Magnetic resonance Imaging
Nuclear Medicine
NFPA 101-2000 details that “primary level of exit discharge of a building shall be the lowest story whose floor is level with or above finished grade on the exterior wall line for XX% or more of its perimeter.”
50%
Does an MRI machine use radiation to produce its images?
No, it uses magnetic and radio frequencies
Does an ultrasound use radiation to produce its images?
No, it uses sound waves
What does a CT scan machine use to produce its images?
Ionizing radiation
When should ICRA planning be complete when a new construction project is being built next to an existing building if the two will eventually connect?
Before construction starts
Before an employee enters a permit-required confined space, the internal atmosphere shall be tested with a calibrated direct-reading instrument for oxygen content and which of the following?
potential toxic air contaminants, and flammable gases and vapors
What are the 3 main components of the exterior wall system that keeps moisture out of the building?
weather barrier, air gap, exterior finish
What is the best contract type for an owner if a project is only 50% designed?
cost plus GMP
Is a facility in bad shape if it has a high FCI number?
Yes
Is self latching hardware required at doors within openings that are part of the smoke barrier?
No
How often should fire extinguishers be inspected at an HCF?
Monthly
How often should alternate exits caused by an ILSM plan be inspected during construction?
Daily
What wall type should separate renovation space from occupied space in a non-sprinklered?
1-hour
What is a sentinel event?
Any event that causes unanticipated harm to a patient not related to the natural course of the patient’s illness (according to TJC)
Acute is to ambulatory as…
inpatient is to outpatient
What is the most important ICRA requirement during a roof replacement?
Keeping the building dry to prevent mold growth
How many smoke compartments must a floor have if it is somewhere that patients sleep or patients are treated?
2 according to NFPA 101-2000
Does a general hospital or an ACC have a higher patient acuity? Why?
General hospital because it has an ER and an ICU. Ambulatory hospitals are outpatient hospitals.
When should an ILSM plan be implemented?
Anytime construction occurs, but also anytime a life safety issue is identified and cannon be immediately mitigated.
What is the most important patient safety feature in an inpatient behavioral health unit?
Suicide prevention
Is lead shielding required when constructing an MRI room?
No, no radiation is involved in the imaging process
What is the general procedure for when a hospitals fire alarm system is down during construction for an extended amount of time?
A hot work permit should be obtained, a fire watch implemented, and the system restored after closing out the hot work permit
How long does fire watch need to be implemented during hot work?
Fire watch must be implemented until the hot work permit is closed out
What specifies the duration of a fire watch during hot work?
The hot work permit
What type of radiation does a positron emission tomography (PET) Scan use for imaging?
intravenous radioactive materials
What does an electroencephalography (EEG) machine monitor?
Brainwaves
What is polysomnography (PSG) used for?
PSG monitors physiological data during sleep studies.
What is the Green Guide for Healthcare used for?
The Green Guide for Health Care is an agency that awards certification for buildings constructed to meet their standards.
Is temporary signage a required component in maintaining patient safety during construction?
No
What are some examples of patient safety requirements during construction?
back-up power, method of infection control, and fire/life safety
What typical cryogenic material is used to cool an MRI device?
Liquid helium
What is the danger to the patient if cryogenic material leaks?
it can displace air (starting at floor level because it is heavier than air) and cause asphyxiation
What is it called when cryogenic material is suddenly released?
Quenching
What is a risk associated with quenching a cryogen?
the liquid cryogen may rapidly turn to gas and release large amounts of energy resulting in an explosion.
Which of the following considerations is MOST important when selecting a construction delivery method for a project
Goals
What is the order of load shedding that should occur if a power outage occurs?
Equipment then critical then life safety
What is the purpose of having segregated branches of electrical systems?
load shedding that should occur if a power outage occurs
Place the following building envelope materials from the LEAST to MOST
expensive per square foot.
- masonry
- precast (tilt slab)
- curtain wall
precast, masonry, curtain wall
Is tilt wall construction more expensive than masonry type construction?
No
What are the 2 dangers of storing new IT equipment on a construction site?
Theft and dust
How many people die a year from hospital
acquired infections (HAI’s)
99,000
What percent of those that die from HAI’s can
be attributed to construction
5% to 7%
What are 4 main components of an ante room?
Hepa with magnehelic gauge, Sticky and walk off mats, Dedicated power, Signs with precaution levels
What class of construction requires an anteroom?
Class IV and whenever the ICRA plan specifies
What are some examples of construction activities that require a fire watch?
Cutting, torching, welding, Soldering, All open flame work, Fire alarm is inoperable for more than 4hrs in a 24 hour period, Using a chop saw
During an ILSM the Hospital Safety department
is required to conduct additional fire drills how
often?
Once per shift per quarter
How often are exits checked during an ILSM condition?
Daily
What should partitions be made out of in an ILSM condition?
non-combustible materials
What does the acronym ILSM stand for?
Interim life safety measurement
The ILSM will be established, implemented, documented and monitored during construction by:
The Director of Facilities & The Construction Manager
What are some examples of construction related educational concepts that a hospital might promote?
a) Building deficiencies
b) Construction hazards
c) Temporary measures are implemented
e) Maintaining fire safety
What are the two purposes of a fire watch?
-Supplement the existing fire detection
and response system
-To confirm all hot work has “cooled”
down and the safety of patients, staff and
visitors is not jeopardized
Corridor doors in a one hour smoke barrier must meet the following minimum requirements?
20 minute label, self-closing with non-latching hardware
According to the Life Safety Code, which of the following is correct in regard to corridor walls in a sprinklered occupancy?
The walls must limit transfer of smoke
In an Existing Facility, that is sprinklered, corridor doors must be able to resist X pounds of pressure from the latch side of the door?
5 pounds
Tubing for positive pressure medical gas systems delivered from the manufacturer shall have these 3 requirements:
Plugged or capped, Hard-drawn seamless, Identified as “oxy” or “med”
In positive pressure systems, area alarm sensors for vital life support and critical care areas shall be located on which 3 sides side of the
zone valve box assemblies?
patient room, outlet/inlet, and downstream
Where shall pressure indicators be provided for medical gas systems? (3 part answer)
On the main supply line, At the area alarm, Outlet/inlet side of zone valve
A level 1 dedicated WAGD source shall consist of ______or more producers, each shall be sufficient to serve the peak calculated
demand.
two
Level 1 medical-surgical vacuum sources shall consist of an automatic means to prevent __ through any off-cycle vacuum pump.
Backflow
Where medical air piping systems at different operation pressures are required, the piping shall separate after the __.
Filters
What is the required time that life safety equipment must be restored to power?
10 seconds
When using a metal clad cable for branch wiring in a Healthcare facility what type of cable is to be used?
HCF MC cable
What are the 4 basic test requirements associated with patient care area receptacles and what NFPA Code addresses the issue?
Physical integrity, continuity of grounding, correct polarity and retention force “NFPA 99”
How many receptacles are required at a patient bed location (headwall) in a General Care area? Critical Care area?
8 & 14
According to NFPA 99-1999, to which branch of the essential electrical system are the medical gas alarm panels connected:
Life Safety
Does a laundry room belong on the Critical Branch of the Essential Electrical System in a Patient Care area ?
No
The Joint Commission dates as far back as 1910 with Dr. Ernest Codman with
End Result System of Hospital Standardization
The premise on which TJC inspects is called
The Environment of Care
The three basic elements that make up the environment of Care are
Building, Equipment & Staff Support Services
When TJC is on site for an inspection they expect to see documentation for these 4 things:
-Signs and training for altered egress
-Fire & Smoke Barrier Management System
-Additional Fire Fighting Equipment in
Impaired Areas
-Continuous Debris Removal
What is 3 things are key to minimizing risk to the patient population
Planning, implementing & evaluating changes
When you in your accreditation cycle you can be inspected with in _ of your last inspection.
1.5 to 3 years
For the DOH book, certified subcontractor completion letters should have all of the following 4 attributes
a) Typed on subs company letterhead
c) Notarized, signed and dated
d) File number
e) Index number
If you fail the inspection how long must you typically wait before DOH will come back out?
4 weeks
What must you include in the follow up email after the inspection?
Corrective action with backup and photos
What NFPA code is required to be shown on the Fire Suppression Compliance Letter?
b) NFPA 13 and NFPA 25
What is NFPA 13?
Standard for the Installation of Sprinkler Systems
What is NFPA 25?
Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems
What 3 requirements must be met for Imaging equipment rooms to be permitted to open into a hybrid operating room?
a) It is physically separated from it with walls
and a door
b) Large enough to contain transformers and
power distribution equipment
c) Large enough to contain computers,
associated electronics, electrical gear, and
their associated clear floor areas
When replacing a CT system within an existing suite, which 2 parties must be coordinated with before tie-in of utilities and use of newly completed machine?
Coordinate with owner and appropriate facility personnel
What are the 3 main procedures of planning the utility interruption itself
a) owner notification / UIR form
b) ILS plan
e) EOP
MGPHO definition
Med gas professional healthcare organization
What 3 organizations address the qualification of med gas piping inspectors
a) NFPA
b) ASSE
c) MGPHO
Does the NITC address the qualification of med gas piping inspectors?
No
What kind of plan do you always need?
A back up plan
Which ASSE Standard outlines medical gas installer requirements
6010
Most Fires from Hot Work occur:
Within 5 minutes of the work
Who is responsible for confirming area conditions prior to issue of Hot Work Permit:
PAI
NPV=
CF0 + CF1/(1+DR) + CF2/(1+DR)^2 +…+ CFn/(1+DR)^n where DR is discount rate
ROI=
(Net Profit / Cost of Investment) x 100
Which project delivery method combines architectural and engineering services with construction performance under one contract (with the CM)?
Design-build
9) ___ is a tool used to reduce large scale projects into small, easy to manage parts.
PDC process
Name 3 things that are examples of a non-construction activity that should be included in the front end of a hospital renovation project?
ATP received, decant, EH&S Dept sign off