devices of furniture and equipment. These inspections will ensure that they are maintained free of wax, lint, or other foreign material that may insulate them and defeat the purpose for which they are used. Excess lubrication of casters should be avoided to prevent accumulation of oil on conductive wheels. Dry graphite and graphite oil are the preferred lubricants. Rubber accessories for anesthesia machines should be of the conductive type, plainly labeled as such, and routinely tested to ensure that conductivity is maintained. It is essential that all replacement items be of conductive material. All personnel entering the operating room should be in electrical contact with the conductive floor by wearing conductive footwear or an alternative method of providing a path of conductivity. Conductive footwear and other personnel-to-floor conductive equipment should be tested on a regularly scheduled basis. All apparel worn in the operating room should be made of a nonstatic-producing material. Fabrics of 100 percent cotton are the most acceptable. Fabrics made of synthetic blends may be used only if they have been treated by the manufacturer for use in the operating room. Wool blankets and apparel made of untreated synthetic fabrics are not permitted in the operating room. O p e r a t i n g r o o m s m u s t h a v e a d e q u a t e air-conditioning equipment to maintain relative humidity and temperature within a constant range. The relative humidity should be kept at 55 to 60 percent. This level will reduce the possibility of electrostatic discharge and possible explosion of combustible gases. The temperature should be chosen on the basis of the well-being of the patient. The recommended temperature is between 65E and 74EF. The control of bacteria carried on dust particles is facilitated when the recommended humidity and temperature are maintained. All oxygen cylinders in use or in storage will be tagged with DD Form 1191, Warning Tag for Medical Oxygen Equipment, and measures will be taken to ensure compliance with instructions 1 through 7 printed on the form. An additional tag is required on all cylinders to indicate “EMPTY,” “IN USE,” or “FULL.” Safety precautions should be conspicuously posted in all areas in which oxygen cylinders are stored and in which oxygen therapy is being administered. This posting should be made so it will immediately make all personnel aware of the precautionary measures required in the area. All electrical service equipment, switchboards, or panelboards should be installed in a nonhazardous location. Devices or apparatus that tend to create an arc, sparks, or high temperatures must not be installed in hazardous locations unless these devices are in compliance with the National Electrical Code. Lamps in a fixed position will be enclosed and will be properly protected by substantial metal guards or other means where exposed to breakage. Cords for portable lamps or portable electrical appliances must be continuous and without switches from the appliance to the attachment plug. Such cords must contain an insulated conductor to form a grounding connection between the electrical outlet and the appliance. GENERAL SAFETY In addition to the specifics presented earlier, some other basic principles are relevant to patient safety. They are:  Ensure your patients are familiar with their environment, thus making it less hazardous to them. This familiarization can be accomplished in many ways, such as by showing your patients the floor plan of the ward they have been admitted to and by indicating key areas (lounge, bathrooms, nursing station, etc.) that may be of interest to them.  Be aware of patient sensory impairment and incorporate precautionary procedures into their patient-care plan. For example, this principle can be applied to patients who have been given a pain medication, such as morphine or Demerol®. Medications such as these dull body senses. If a patient in this condition wishes to walk around, precautionary actions dictate that you either be close at hand to prevent the patient from accidental falls or that you do not permit the patient to ambulate until the effects of the medication have stopped.  Understand that all diagnostic and therapeutic measures have the potential to cause a patient harm.  Ensure that all accidents and incidents are documented and analyzed to identify and correct high-risk safety hazards. 2-27