Volume 2025 | No. 2
SURVEYOR
CLINICAL LABORATORY
CHAPTER 01: GENERAL LABORATORY 01.04.07 Eyewash/Emergency Shower Facilities Frequency of the citation: 15%
Overview of the requirement: An ANSI-compliant eyewash station or emergency shower is provided for immediate use within a 10-second travel time of locations where corrosive materials exist. Plumbed eyewash stations are tested weekly. Comment on deficiencies: Compliance is evaluated through observation and document review. Most deficiencies noted that the operation of the eyewash station was not with a single action to deliver tepid water. Other surveyors noted testing lapses. Examples of ACHC Surveyor findings: ■ The eyewash station does not have a mixing valve to deliver tepid water or single-action activation required by ANSI 358.1-2014. ■ Testing of the eyewash station is being performed monthly rather than on the required weekly schedule.
CLINICAL LABORATORY ACCREDITATION
FREQUENT DEFICIENCIES FROM CLINICAL LABORATORY SURVEYS
Compliance tips for:
30%
A documented risk assessment is expected to drive the decision regarding the need for ANSI-compliant eyewash stations and/or emergency showers. When a plumbed eyewash station is present, it must deliver tepid water using a single- action fixture. Testing through weekly station activation must be logged. ■ Audit for a documented risk assessment in locations without eyewash/ emergency shower within 55 feet of an area with corrosive chemicals. ■ Audit weekly activation logs. ■ Educate staff to alert facilities staff anytime corrosive chemical use is added to a new location. ■ Educate staff to alert facilities whenever a station activation fails (no flushing fluid, temperature out of 60-100⁰F range , etc.)
Nerd Newbies (understand the requirement)
25%
20%
Nerd Apprentices (audit for excellence)
15%
Nerd Trailblazers (prepare the path for others)
10%
5%
0%
01.04.07
02.02.04
02.02.05
03.02.07
05.05.04
06.02.01
06.08.01
Analytic Systems
General Systems
General Laboratory
Laboratory Personnel
Provider Performed Microscopy and Waived Testing
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