Hospital Securty: Rules, Regulations, Awareness and Acts

Power door operators, antimicrobial door hardware, touchless switches, antiligature knobs, refrigerator locks and key control help secure patients, drugs and records.

According to code, push plates must be located at seven inches minimum above the floor and between 30 and 44 inches above the floor. Using column or bollard switches provide a long switch pad (36”) and satisfies the codes as well as two standard activation switches. The long switches enable disabled individuals to gain access using a wheel chair, foot, cane or crutch to provide contact.

Full automatic operators provide opening and closing for exterior doors to control air pressure requirements. Certain areas -- transplant, isolation, specific laboratories, operating rooms and patient care rooms -- must have sterile air. They have separate heating and air conditioning systems. To provide sterile air, and to resist non filtered air migration into these areas, the areas have positive air flow sufficient to stop the migration. However, because of the positive air flow, all separation doors must be equipped with full automatic door operators and safety and activation sensors to ensure doors close and latch reinstating the barrier.


Touchless Switches

Touchless switches provide contact-free door activation. These sensory switches can utilize an infrared (IR) or Doppler effect microwave technology. Waving your hand in range of the sensor activates the door operating mechanism. Touchless switch detection ranges from five inches for IR sensors to 24 inches for Doppler affect microwave sensors.


Antiligature Hardware

Patient safety is also a unique aspect of security for some hospitals. To prevent suicide, hospitals that have psychiatric departments are using antiligature knobs and levers on door locks as well as anti-ligature hardware on the hinges including continuous hinges. As an alternative, hospitals are also using push-pull handles installed in the upside down position to prevent patients from tying a bed sheet onto the handle and throwing it over the door to create a noose high enough.


Thermal Pins

When installing new doors, thermal pins can take the place of the bottom rod in surface and concealed vertical rod exit devices. This provides the hospital with the ability to remove the floor strike making it a safer for patient traffic. Depending upon the device manufacturer, thermal pins can be installed in single and double-door applications.

Variances can also be made by the different agencies and organizations. For example in one hospital, a variance was permitted that allowed stainless steel armor plates mounted onto fire rated doors be taller than the maximum 36” above the floor. The purpose of the armored plates is to protect the doors against cart, gurney and equipment causing damage.


Narcotic Storage

Hospitals have medicine refrigerators that are required to be monitored for temperature and can notify if the temperature is out of range. Depending upon the content and the method of controlling access, locks can be installed that provide audit trail. The refrigerator locks are available with different modes of access including keypad, magstripe card, proximity card or smart card. Some of these locks are Ethernet ready or wireless.

Some refrigerators contain “Scheduled Narcotics,” the highly addictive prescription medications. These refrigerators are monitored and audit trails are checked for authorized badges. At the beginning and end of each shift, an inventory is completed with cross checking to patients to insure proper dispensing. To ensure that patients are receiving the appropriate amount, blood tests may be performed that test for the medication received.


Access To Health Records

HIPAA, the Health Insurance Portability and Accountability Act, has a Privacy Rule enacted by the federal government that provides protection for personal health information held by covered entities. HIPAA was developed to ensure patient information is protected, while at the same time permitting disclosure of personal health information needed for patient care and other specified purposes. HIPAA specifies administrative, physical, and technical safeguards of electronic protected health information. Clear records must be kept for keys and active badges that have access to health records.


Badges & Badge Readers

A number of hospitals have moved from mechanical access control to electromechanical access control; specifically badges and badge readers. For some of the restricted areas, hospitals can institute dual credentials.

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