Focus: Fire-Life Safety / Column

How healthcare facilities can adjust to NFPA 70E 2018 revisions

By Corey Jasper / Special to Healthcare Facilities Today
November 1, 2017

In healthcare facilities, patient and staff safety goes beyond ensuring guards are on duty, surfaces and tools are clean and toxic waste is properly disposed of; it is critical that facility staff in healthcare environments follow protocols and guidelines that ensure they are working safely with electrical equipment. Electrical equipment supplying power to medical facilities carries dangerous threats that may lead to serious injury or death. In the event of safety issues, such as arc flash events, staff and patients alike may be put at risk if an outage disconnects critical machines, such as MRIs, operating lights or other medical devices, from power. Facility staff onsite should adhere to the National Fire Protection Association (NFPA) article 70E, Standard for Electrical Safety in the Workplace, which provides detailed steps to ensure electrical equipment is handled properly and maintained in order to avoid safety issues.

Every three years, NFPA issues updates to article 70E to address the evolution of electrical technologies and the way facilities staff must handle them. As technologies are updated, risk management strategies must also be updated to ensure dangerous situations are mitigated effectively.

The changes in the 2018 edition clarify processes that are already in place, with the most significant updates being the addition of a human error element for required electrical risk assessments as well as the need to implement the hierarchy of risk controls. As with the addition of any new guideline, staff will need to be trained on these adjustments.

Adjusting to human error assessments

Electrical risk assessments are critical to the successful operation of healthcare institutions. Historically, equipment functionality has been the main focus of these procedures. However, just as important is examining for any factor that could jeopardize the functionality of electrical equipment – including human-introduced risks. This need is reflected in the updates to NFPA 70E 2018, which require that evaluation go beyond the ‘present state’ of the equipment: individuals conducting these analyses will now be responsible for assessing risks associated with different job scenarios, such as the effect of water spilled on equipment, incorrect equipment operation and more. Also outlined in 2018 updates is that these assessments must be conducted by a qualified employee – either an on-staff employee or an outsourced third-party.

Implementing risk controls and adequate PPE

In addition, staff will also be required to determine and apply the appropriate risk controls for different situations. While NFPA 70E lists the risk controls in the order they should occur, facilities staff should understand that there may be a need to be use them in conjunction with each other to most effectively mitigate risk. These methods (found in Sec. 110.1(H)), include:

• Elimination
• Substitution
• Engineering controls
• Awareness
• Administrative controls
• Personal protective equipment (PPE)

It is important electrical staff follow the hierarchy of controls precisely and not skip steps. Often, electrical workers may immediately use PPE as a method of defense against an electrical hazard because it is quick and easy, but PPE does not actually mitigate the hazard, nor does it reduce the risk of exposure. Electrical personnel should be aiming first for hazard elimination, and using each of the subsequent control methods to decrease risk of exposure to the hazard. PPE should only be used as a last line of defense.

It is equally as important for staff to properly document everything to mitigate future risks. By referring to documentation regularly throughout working on the electrical system, equipment can be properly maintained and updated as needed.

Assessment success starts with culture change

While assessments have always been crucial to staff and patient safety, revisions to NFPA 70E make them increasingly thorough. However, time and resource constraints can lead employees to cut corners. Conducting assessments haphazardly can put not only electrical workers at risk, but healthcare staff and patients’ lives as well. And in healthcare environments, where what happens in one area can deeply affect what happens in another, outages, blown fuses and other electrical faults can seriously impact an institution’s success. Employees at every level should be wholeheartedly involved in making assessments a priority.

Management should be proactively engaging with staff to ensure that all members of the team are engaged in performing a safe electrical assessment. By providing training, conducting assessments of facilities staff and empowering employees to raise concerns if they feel something is amiss, facility staff will be more engaged in providing a safe working environment.


When facility personnel ignore proper safety protocols, patients and staff alike can be placed at unnecessary risk. As NFPA 70E moves specific aspects of electrical risk assessments into required territory for facility staff, it is crucial that they understand how to conduct them properly. Following these new NFPA guidelines will ensure that the safety of everyone in the healthcare facility – from the electrical worker to the doctor to the receptionist to the patient – are put first and foremost.

Corey Jasper is the principal power systems engineer for Schneider Electric.

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