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NFPA accepts ASHE's amendment to NFPA 99 on Alcohol Based Surgical Prep Solutions

On August 8, the National Fire Protection Association (NFPA) notified ASHE of their acceptance of ASHE's proposed Tentative Interim Amendment (TIA) to NFPA 99 - Standard for Health Care Facilities - 2005 edition at the July 2005 Standards Council meeting. The TIA has an effective date of August 18, 2005, and will be subject to the review and approval by the full NFPA code development process for the 2009 edition of the standard.

ASHE proposed this amendment to NFPA 99 to permit the continued use of alcohol based surgical prep solutions even in the presence of an ignition source such as a laser, ESU, or cautery. The TIA contains strong guidance to health care organizations on reducing the potential risk of fire when this highly effective clinical preparation is used. ASHE proposed the TIA in response to enforcement of the existing NFPA 99 language earlier this year which prohibited the use of alcohol surgical prep when use of an ignition source was contemplated. The use of surgical prep is essential as an appropriate skin antisepsis before surgery and is a critical measure for prevention of surgical site infections. Enforcement of NFPA 99, leading to restriction or banning the use of these products in operating rooms, addresses the potential fire risk but creates the unintended consequence of potentially increased surgical site infection rates by the elimination of the use of alcohol based products. Both of these potential risks must be addressed to assure the safety of the patient.

The TIA emphasizes the need to use skip prep solutions according to manufacturer instructions and the introduction of a "time-out" before initiating activation of the ignition source to assure that there is no pooling of fluid or soaking of drapes and that the solution has fully dried. The TIA was developed through the collaborative efforts of ASHE, AHA, the Center for Medicare and Medicaid Service (CMS), the Association for Professionals in Infection Control and Epidemiology (APIC), the Association of periOperative Registered Nurses (AORN), and other professional societies.