The Joint Commission (TJC), recently published its answer to a Frequently Asked Question (FAQ) that asked, “Are Tamper Resistant Receptacles (TRR’s) required in a Behavior Health In-Patient Setting?”
The answer came back surprisingly more complex than might have been expected. The essence of the answer was that not only were tamper resistant receptacles required in all patient accessible areas of psychiatric hospitals and wards required, in fact they must also be provided with arc fault and ground fault interruption in all patient accessible areas of all psychiatric hospitals and wards as well .
TJC took the position that tamper resistant receptacles alone, did not in and of themselves, provide an adequate level of protection. Their response indicated, and rightly so, that tamper resistant receptacles were designed to prevent accidental access to the live outlet and not designed to prevent intentional acts like inserting paper clips and other foreign objects, which could easily result in personal injury, fires, electrical shorts, arc fault, etc.
Subsequent to arriving at this conclusion The Joint Commission then took the position that the only option was to require Tamper Resistant Receptacles (TRR), Ground Fault Circuit Interrupters (GFCI), and arc fault protection in all patient accessible areas of all psychiatric hospitals and wards. While The Joint Commission is clearly within their right to require this protection and may even be well justified in making this a requirement, it is interesting to note that they didn’t appear to make any effort in any of their literature to substantiate this action with actual data regarding the frequency of incidents and/or injury within behavioral organizations.
Another point of interest regarding this issue is that no where in their literature does TJC appear to address the issue of other electrically energized sources typically located within patient rooms and areas, such as light fixtures and light switches. While light fixtures may be a lesser issue since they are typically located in the ceiling (up high and presumed to be out of harms way by some), light switches are typically at 4 or 5 foot height and even with tamper proof screws, the plates are fairly easily removed and electrical contacts are easily reached. All of this begs the question, “Can we actually make a behavioral patient room electrically safe”. Perhaps we should also require that all electrical panels for behavioral patient units have GFCI’s at all electrical panels. Proper design, awareness, training, vigilance , can all help contribute to a safe environment