The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.
|UNIVERSITY OF WASHINGTON MEDICAL CTR||1959 NE PACIFIC ST BOX 356151 SEATTLE, WA 98195||Dec. 1, 2016|
|VIOLATION: VENTILATION, LIGHT, TEMPERATURE CONTROLS||Tag No: A0726|
Based on interview and document review, the hospital failed to ensure that rooms where ortho-Phthalaldehyde (OPA) was used had the required air exchanges per hour.
Failure to perform the required number of air exchanges per hour places staff at risk of exposure to potentially toxic vapors from OPA.
1. The Material Safety Data Sheet for Cidex OPA (a disinfectant) states in part, "Handling: Technical measures/precautions: Use in well-ventilated area and use with appropriate exhaust ventilation, for example a minimum of 10 air exchanges per hour ..."
2. On 12/1/2016 at 9:35 AM, Surveyor #2 asked the Facilities Manager (Staff Member #5) for the Eastside Specialty Center for documentation that the endoscope reprocessing room was achieving at least 10 air changes per hour (ACH). A document titled "DOH Design Parameters" was provided specifying that the reprocessing room was designed to achieve 21 ACH, but no documentation was provided that showed that the ACH had been verified. A ventilation station was present in the room, but staff were not placing the CIDEX beneath it during reprocessing.