• EC: To Lock or Not to Lock? Guidelines for door locking in health care occupancies [PEARL: SFT] E C News Feb 2012, Pg 9 Vol 15, # 8

The need to have unobstructed egress and doors that open for fire safety versus the need to lock them to provide security and/or privacy sometimes conflict. Security alone has not always been considered a sufficient reason for locking doors. Psychiatric wards and areas housing patients that are prone to wandering (e.g., dementia) have generally been accepted as having a clinical need justification that has made the locking of doors permissible. The 2012 edition of NFPA 101 has expanded the locking criteria to address security needs in addition to clinical need for door locking. Although CMS does not yet recognize the 2012 LSC, TJC does address locking in the Basic Building Information (BBI) in its Statement of Conditions (SOC). As such, it may still be worthwhile for our facilities to be reminded of some of the basic requirements for allowable door locking such as:
• staff carry keys at all times (vs. have a set hanging at the nurses station), are available and well trained in the fire safety plan
• the hospital safety plan identifies staff that are to carry keys
• the hospital safety plan defines procedures and staff priorities for fire safety egress
Beyond this, one TIP mentioned in the article is to ensure that all locked doors are keyed the same. [PEARL] There is also a summary table of door locking options and allowable locking devices/circumstances with references to the related NFPA 101 2000 Edition exceptions on page 11. Finally, the article warns that a failure to address the essential issues in your Fire Safety Plan and to have appropriate rationale for locked doors in patient areas could result in an Evidence of Standards Compliance follow-up.