The Use of Locks in Health Care Facilities for JCAHO Drawings

When can locks be used in Health Care Occupancies? Generally speaking all doors in the means of egress must be usable in the direction of egress travel without restricting the use of the door. Health Care Occupancies do permit special locking arrangements. These are: where the clinical needs of the patient require special security measures, when a facility wishes to install delayed egress locks, and when a facility elects to install card access locks.

Another consideration is where the clinical needs of the patient require special security measures. If we take a psychiatric unit, for example, there are several considerations. If locks are used in the required means of egress, all staff is required to carry keys at all times OR by use of a reliable method of remote release OR other equivalent system. Only one such locking device is permitted on each door. More than one lock would be subject to approval by the authority having jurisdiction.

Locks on patient sleeping room doors are prohibited in either direction. How about nurseries? Find security methods to secure area other than locking the patients in.

Delayed egress locks are another issue and the biggest deficiency I am finding in facilities is the installation of delayed egress locks in buildings that do not have the right amount of sprinklers or smoke detectors.. Having a partial amount of sprinklers or smoke detectors in a building or not having a full amount of sprinklers in smoke compartments is not acceptable.

You can not have more than one of these devices in any persons’ path to an exit. You only need to apply a force not to exceed 15 lbs for 3 seconds for the door to open in 15 seconds ( 30 seconds with authority having jurisdiction approval). This action will create an audible signal in the immediate area. The code calls for specific signage on the door adjacent to the device. Doors need to unlock upon loss of power and activation of the sprinkler and/or fire alarm system. Also, don’t forget to change the battery in your smoke detector, if applicable, preferably annually on your PM program.

Card access locks are being installed in many locations throughout hospital buildings in the means of egress, mostly for security reasons. The code specifies criteria that must be met when installing these locks. The must provide a sensor on the egress side to detect any person approaching the doors that will unlock. If the sensor loses power, the doors will unlock. If the access control system loses power the doors will automatically unlock in the direction of egress travel. There needs to be a manual release device located 40” to 48” above the floor and within 5 ft. of the door(s) that has a sign “PUSH TO EXIT”. This device will directly interrupt power to the lock independent of the access control system for at least 30 seconds.