CMS to approve hand-rub dispensers in hallways

Hospitals must meet NFPA conditions

Hospitals soon will get a green light from the Centers for Medicare & Medicaid Services (CMS) to install dispensers of alcohol-based hand rubs in hallways.

Last year, the National Fire Protection Association (NFPA) amended its 2000 and 2003 Life Safety Code to allow the convenient use of dispensers and set criteria for their installation, but CMS rules still prohibited the use.

CMS is expected to publish an interim final rule allowing the dispensers in the Dec. 23 Federal Register. The same rule is expected to require battery operated smoke detectors for patient sleeping rooms in existing nursing homes that do not have sprinklers. CMS then will issue a notice of proposed rulemaking to require sprinklers in all nursing homes, a CMS official said.

The CMS sanctioning of alcohol-based hand-rub dispensers removes a barrier to hospitals that were concerned about regulatory issues but wanted to use the dispensers to encourage hand hygiene. Hospitals still must follow the rules of state and local fire marshals, which means some still could be restricted from using the dispensers.

Employee health and infection control experts say the dispensers make the use of hand rubs convenient for health care workers. "[W]e consider these wall-mounted dispensers absolutely critical for assuring improved access and compliance with recommended hand-hygiene practices," the Association for Professionals in Infection Control and Epidemiology said in a statement.

The NFPA allows the dispensers in corridors with these conditions:

  • The corridor width must be 6 feet or greater and dispensers must be separated at least 4 feet apart.
  • The maximum individual dispenser fluid capacity is 1.2 liters for dispensers in rooms, corridors, and areas open to corridors, and 2 liters for dispensers in suites of rooms.
  • The dispensers may not be installed over or directly adjacent to electrical outlets and switches.
  • In locations with carpeted floor coverings, dispensers installed directly over carpeted surfaces are permitted only in sprinklered smoke compartments. Each smoke compartment may contain a maximum aggregate of 10 gallons of alcohol-based hand-rub solution in dispensers and a maximum of 5 gallons in storage.