The Centers for Medicare & Medicaid Services (CMS) took action that will allow nursing facilities, hospitals, ambulatory surgical centers and other health care facilities to install dispensers of alcohol-based hand rub sanitizers in exit corridors under specified conditions. This had not been allowed previously because of concerns that the alcohol rubs may serve as an accelerant in the event of a fire and block access to exits. Studies have shown that if certain conditions are met, the fire hazard is greatly reduced while there can be a significant benefit in reducing acquired infections.
Alcohol-based hand sanitizers may be installed in health care facilities, including exit corridors, if the following criteria are met:
– The dispensers are installed in a manner that minimizes leaks and spills that could lead to falls.
– The dispensers are installed in a manner that adequately protects against access by vulnerable populations, such as residents in dementia units.
– Where dispensers are installed in a corridor, the corridor must be at least 6 feet wide.
– The maximum individual dispenser fluid capacity is limited to 0.3 gallons (1.2 liters) for dispensers in rooms, corridors, and areas open to corridors.
– The maximum individual dispenser fluid capacity is limited to 0.5 gallons (2.0 liters) for dispensers in suites of rooms.
– The dispensers must be installed at least 4 feet apart.
– Not more than a total of 10 gallons (37.8 liters) of solution can be in use in a single smoke compartment outside of a storage cabinet.
– Storage of more than 5 gallons (18.9 liters) of solution in a single smoke compartment must meet the requirements of NFPA 30, Flammable and Combustible Liquids Code.
– The dispensers cannot be installed over or directly adjacent to an ignition source.
– Dispensers installed directly over carpeted floor surfaces are permitted only in smoke compartments protected by automatic sprinkler systems.
CMS has agreed that alcohol-based hand sanitizer dispensers, when installed properly in exit corridors, do not decrease fire safety. Any fire safety concerns from the use of the hand sanitizers are more than offset by the potential for health care facilities to improve their infection control practices. The availability of the dispensers will likely decrease the number of health care acquired infections, thus improving public health and safety in health care facilities.