By Christopher Walters
It’s hard to define NFPA99 without NFPA70 or the National Electric Code (NEC).
While they each have a different focus, they work together to help provide the highest achievable level of electrical safety for medical facilities. NFPA 99 puts its focus on the performance, maintenance and testing of electrical systems within health care facilities. The NEC provides the requirements needed to establish safe installations and materials of those electrical systems.
The overlap between the two is a shared goal for patient safety. It categorizes healthcare spaces based upon their risk to patients. Together, the NEC and NFPA 99 help create a safe electrical environment for healthcare workers and patients.
NFPA99 establishes guidelines for medical gas and vacuum systems, electrical systems, fire prevention, security, IT and emergency management. It tells us how to inspect them, and how often, based on risk categories with a risk-based approach instead of a one-size-fits-all approach.
The NEC gives the absolute minimum standards for electrical devices, installations, etc.
NFPA 99 covers healthcare-related codes and gives stricter guidelines. Every jurisdiction (city, county, state, etc.) can create rules/guidelines for electrical devices and systems, but no one can make a code that is less than the currently adopted NEC. Each state handles the NEC differently.
Although these two are the most significant, they do not operate in a bubble. There are a few NFPA guidelines that work together to create the safest possible environment for patient care, they are:
• NFPA1-Fire Code
• NFPA 70- National Electric Code (NEC)
• NFPA 101-Life Safety Code
• NFPA 99-Health Care Facilities Code
• NFPA 13-Sprinkler Systems
• NFPA72-National Fire Alarm and Signaling Code
• NFPA110-Standard for Emergency and Standby Power Systems
There may be more to be added to this list in the future.
NFPA70 is the “how” of safe electrical installations and NFPA99 is the “why” and “what if” of electrical system performance and patient safety.
NFPA99 creates 4 risk categories:
• RISK 1: highest level, devices that are required to work all the time (life support)
• RISK 2: expected to be available when needed but aren’t necessary in an emergency (patient support but not life support)
• RISK 3: failure would not affect patient care (medical gas, beds, lighting)
• RISK 4: no impact on patient care (computers, TVs, etc.)
Essential Electrical Systems (EES) is divided into 3 categories. The types of EES in Healthcare Facilities (NFPA Classifications) are:
• Type 1-EES (Hospital): Mandatory for Category 1 spaces (operating rooms, intensive care) where failure causes severe injury or death.
• Type 2-EES (Nursing Homes/Limited Care Facilities): Used in facilities with moderate risk where life support is not typically required.
• Type 3-EES (Clinics and Ambulatory Care Centers): Used in low-risk environments requiring basic backup power, often employing batteries.
HISTORY OF NFPA99
NFPA99 was first published in 1984, combining 12 separate health safety publications for consistency and ease of adoption. Originally these 12 documents would get individually updated at seemingly random times. This process would make it difficult for the user and the groups involved in design and maintenance of the facilities/devices. It was also dangerous for patients. Now, as a single document, it gets updated every three years to incorporate new technologies and safety practices, much like NFPA70. These updates are important as patient safety, and the healthcare environment is not stagnant. As the world advances, so does our knowledge and the need for electrical safety.
AAMI makes the updates easily available to members. NFPA recently started covering plumbing systems, patient information networks, HVAC, security and fire protection. The goal is to provide a cohesive, complete reference for architects, engineers and facility managers.
What does NFPA99 mean to me and my career?
The biomed career exists largely because of NFPA 99 and the recognized need for patient safety as well as repairing devices. As the medical world expands to meet the need for new diseases, new treatments, etc., so does the need for engineers to design new devices and qualified, trained service technicians to support those devices. We are the only field that covers every field of engineering. We cover electrical, electronics, pneumatics, hydraulics, plumbing, mechanics, physiology, etc. Who else can say that?
The guidelines laid down by NFPA99 help us direct our focuses to that ultimate goal. By performing electrical safety tests on medical devices and building utilities (electrical outlets, circuit breakers, line isolation monitors, battery backup power sources, medical gas systems, etc.), we keep patients safe. As we branch out into the IT field, we keep patient information safe.
