Electrical Safety in Healthcare Facilities: Clarifying the Standards

In the healthcare realm, efforts to ensure the electrical safety of devices are primarily addressed by the National Fire Protection Association's NFPA 99,Health Care Facilities Code, and the International Electrotechnical Commission's (IEC) Medical Equipment Standards, including IEC 60601-1:2020. It can be difficult to keep track of these documents' requirements as they evolve over time. Also, different authorities to which a hospital is subject might use different editions of a standard (editions that might contain conflicting information on a given topic), making it hard for the hospital to know which requirements to follow.

ECRI routinely receives questions about the IEC and NFPA standards from our member facilities. The discussions that follow are intended to address many of these questions. We explain the standards and clarify a number of the vexing issues concerning them. In particular, we explain which electrical safety requirements have changed in the most recent editions, list each standard's key testing requirements, and discuss some common areas of confusion.

The National Fire Protection Association's NFPA 99 is used by hospitals in the United States as well as those in other countries that follow US standards. It addresses electrical safety in healthcare facilities and includes sections on electrical power systems, inspection intervals for use by healthcare facilities, and leakage current limits and test methods. (Other topics covered include electrical distribution systems, gas and vacuum systems, environmental systems, materials, electrical equipment, and gas equipment.) NFPA 99 is referenced or adopted by many organizations (including the US Centers for Medicare & Medicaid Services CMS and the Joint Commission) and by state and local authorities, and is therefore binding on many US healthcare facilities.

NFPA 99 underwent a major overhaul with the release of the 2012 edition. Changes included less restrictive leakage current limits compared to the prior (2005) edition to make the document more consistent with international requirements, as well as reduced testing requirements (these changes are discussed in greater detail below). Note that this edition also included changes to make NFPA 99 more of a risk-based document, in which applicable requirements may vary, for example, by the location of the system or...