By Richard Parker, MBA, CHFM, CLSS-HC, FASHE, FACHE
Good lighting is crucial to the success of surgical procedures and the safety of the patient. Proper lighting in the ORs and the sterilization areas can help to reduce the risk of infection by allowing medical staff to accurately identify medications and properly clean and disinfect or sterilize equipment and surfaces. Additionally, good lighting can support a calming and comfortable environment for both patients and providers, and that can have a positive impact on overall outcomes.
To ensure that the lighting in a surgical or sterilization environment is effective, consider the combination of natural and artificial light sources. Natural light is often preferred because it is more comfortable and can help to reduce the risk of glare and other visual distractions. However, it is rarely possible to rely solely on natural light. This makes the selection of artificial light sources even more essential. It is important to choose illumination sources that are appropriately bright and placed to provide even distribution of light throughout the room. This ensures that every area of the space is well-lit, allowing staff to see and perform their tasks easily. Poor lighting can slow down retrieval of instrumentation, lead to errors in identifying supplies and result in medication error.
Finally, it is important to choose lighting fixtures that are easy to clean and maintain, as this will reduce maintenance and promote infection prevention.
Are you getting the amount of light intended?
Over time, the performance of a lighting lamp can decline, lessening the amount of light that it produces. This phenomenon is known as lamp degradation.
Fluorescent lighting degradation refers to the gradual decrease in light output and efficiency of fluorescent bulbs over time. This occurs due to a number of factors, including the accumulation of dirt and dust on the surface of the bulb, the natural aging of the phosphor coating on the inside of the bulb, and the loss of gas within the bulb. As the light output decreases, the bulb may become less effective at illuminating a space and may need to be replaced more frequently. Have you heard fluorescent lights buzzing or seen them flicker? That distracting and annoying condition is another sign of degradation which is less than ideal in the health care environment.
The individual lamps in multi-lamp fluorescent fixtures may burn out at different times. This can result in an area with measurably reduced light output over a period of time because the rate of decline is slow and may not be observed by staff in the area until the degradation is quite significant.
Tips for selection and maintenance
Florescent lamps come in different temperature/color spectrums. Be consistent in your choice of bulbs. “Cooler” white light can help reduce glare and improve visibility but is less pleasant in a setting intended to be relaxing, like a waiting room or recovery space.
Look up. Schedule a walk-through with your facility manager that includes a review of lighting at least once a year.
When lamps need to be changed, insist on changing all of the lamps in a fixture at the same time. This refreshes the full output and reduces the need for multiple maintenance events on the same fixture.
Lighting is rarely considered until it is a problem, but it is important to optimal functioning in surgical and sterilization areas. Proper lighting serves distinct purposes. It allows providers and support staff to see clearly and perform tasks with less eyestrain. It mitigates risk, especially of infection and medication error. It creates a calming and comfortable respite environment for both patients and staff who are under stress.
By considering the type and placement of lighting fixtures, the color temperature of the light, and the practicalities of maintenance, it is possible to create an effective lighting system that supports the safe and successful delivery of excellent medical care.
– Richard L. Parker is associate director, physical environment and life safety at Accreditation Commission for Health Care Inc. where he provides guidance to customers and surveyors in the ASC and hospital programs. Prior to joining ACHC fulltime, he was a surveyor in the HFAP program while serving as executive director of facilities for a 615-bed hospital system in Arizona.
