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Medical Gas Pipeline Systems Testing Procedure513p1

The document provides testing protocols for medical gas pipeline systems at Bay of Plenty District Health Board facilities. It outlines standards that must be met for new installations and modifications, including testing the existing system, producing a design specification, and conducting inspections and tests during construction according to the relevant HTM. Upon project completion, comprehensive documentation including verified test results and drawings must be submitted.

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455 views

Medical Gas Pipeline Systems Testing Procedure513p1

The document provides testing protocols for medical gas pipeline systems at Bay of Plenty District Health Board facilities. It outlines standards that must be met for new installations and modifications, including testing the existing system, producing a design specification, and conducting inspections and tests during construction according to the relevant HTM. Upon project completion, comprehensive documentation including verified test results and drawings must be submitted.

Uploaded by

PrestoneK
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEDICAL GAS PIPELINE SYSTEMS - TESTING Policy 5.1.

3
MEDICAL GAS PROCEDURE Protocol 1
PIPELINE SYSTEMS
PROTOCOL

OBJECTIVE
To specify the requirements for testing of medical gas delivery systems as a result of new
installations or the modification to existing Bay of Plenty District Health Board (BOPDHB)
medical gas systems in order to ensure the safe and efficient delivery of medical gas
services.
The practices detailed in the relevant HTM are to be followed in all circumstances relating to
medical gas services at BOPDHB. A copy of the HTM is available on request from the
BOPDHB Property Services Department.

SCOPE
Intended for use by BOPDHB staff, contractors and all hospital facilities.

STANDARDS TO BE MET
If an existing system is to be modified or extended, the following should be established:
 The existing system should be tested and the performance noted.
 A design specification should be produced detailing total system performance.
 During construction, inspections and tests of the system are to be undertaken as
detailed in the relevant HTM. Verification of acceptable performance is to be
documented to form part of the overall handover documentation.
 Upon completion of works, performance tests of the total system are to be undertaken as
detailed in the relevant HTM with verification of acceptable performance witnessed by
the appropriate persons and documented before the system is used.
Before a system is used the appropriate persons must certify in writing that the tests and
procedures required in paragraphs 15.12 & 15.13 of HTM have been completed and that all
systems comply with the requirements. This must include certification that all drawings and
manuals required by the contract have been supplied and “as-fitted” drawings are correct.
1. Testing to HTM
1.1. The tests to be carried out at each stage of the installation programme are set out in
the relevant HTM together with requirements for personnel, instrumentation and
documentation required.
1.2. The HTM provides 30 specimen forms which should be used for the sequential
verification of the system development – refer Associated Documents.
1.3. Bespoke forms combining the requirements of the HTM may be used providing the
sequence and content of test information is retained. The use of such a form will
require the approval of the BOPDHB Authorised Person prior to use.
1.4. The BOPDHB has developed a checklist charting test responsibilities as a reference
tool.
1.5. BOPDHB - Property Services - MGPS Testing & Responsibility Schedule.
1.6. Regular reference to this checklist during project execution will promote best
practise.
1.7. When the project milestones arise, as each test document is completed and verified,
copies of the completed form must be handed immediately to the BOPDHB
Authorised Person and the Responsible Officer. This will ensure in the closing

Issue Date: Apr 2016 Page 1 of 3 NOTE: The electronic version of


Review Date: Apr 2018 Version No: 3 this document is the most current.
Protocol Steward: Site Engineer Authorised by: GM Property Any printed copy cannot be
Building Services Services assumed to be the current version.
MEDICAL GAS PIPELINE SYSTEMS - TESTING Policy 5.1.3
MEDICAL GAS PROCEDURE Protocol 1
PIPELINE SYSTEMS
PROTOCOL

stages of the project that a well constructed set of documentation has been retained
to allow confident completion of the HTM “Summary of Tests form” BO.
2. Project Completion
At handover, the contract supervising officer is to deliver a comprehensive set of
documentation to the BOPDHB Authorised Person. Notwithstanding the specific
deliverables, this documentation must contain compliant verified test results and verified
drawings (relevant to the scope of works).
3. Handover To BOPDHB Department (User)
Post project completion once all relevant documentation is verified, the Facilities
Management team will authorise the use of medical gas systems by presenting to the
user copies of test documentation capturing all BOPDHB authorities in accordance with
BOPDHB Medical Gas Pipeline Systems Testing & Responsibility Schedule.
4. Roles and Responsibilities

Contact Details Role Responsibility


BOPDHB Site BOPDHB  Signs the Approved Medical Gas outlet
Engineer, Building Authorised Person Sticker on behalf of BOPDHB
Services  Responsible for the control of the
Approved Outlet register
BOPDHB Site Quality Control  Witnesses the tests associated with
Engineer, Building forms B14 & B15 in accordance with
Services BOPDHB Medical Gas Pipeline
Systems Testing & Responsibility
Schedule
5. Records
All electronic records will be stored on the Property Services DocMan site and hard
copies kept in the vital records file in the Property Services department. Records will be
kept for a period of seven (7) years from the date of last action then destroyed in
accordance with General Disposal Authority 20.10.

REFERENCES
 Health Technical Memorandum (HTM) 20/22, and 02/01 Piped medical gases, medical
compressed air and medical vacuum installations
 District Health Boards General Disposal Authority 20.10

Issue Date: Apr 2016 Page 2 of 3 NOTE: The electronic version of


Review Date: Apr 2018 Version No: 3 this document is the most current.
Protocol Steward: Site Engineer Authorised by: GM Property Any printed copy cannot be
Building Services Services assumed to be the current version.
MEDICAL GAS PIPELINE SYSTEMS - TESTING Policy 5.1.3
MEDICAL GAS PROCEDURE Protocol 1
PIPELINE SYSTEMS
PROTOCOL

ASSOCIATED DOCUMENTS
 Bay of Plenty District Health Board policy 5.1.3 Medical Gas Pipeline Systems Testing
 Bay of Plenty District Health Board policy 5.1.3 protocol 2 Medical Gas Outlet Control
 Bay of Plenty District Health Board policy 2.4.5 Records Management
 Medical Gas Pipeline Systems – Testing & Responsibility Schedule
 Medical Gas Pipeline Summary of Tests Form B0
 Medical Gas Pipeline Carcass – Labelling / Marking, Sleeving / Supports and Leakage
Test Form B1
 Medical Gas Pipeline Carcass – Cross Connection Test Form B2
 Medical Gas Pipeline System – Leakage Test Form B3
 Medical Gas Pipeline System – Vacuum Leakage Test Form B4
 Medical Gas Pipeline System – AVSUs – Closure & Zoning Tests Form B5B
 Medical Gas Pipeline System – Cross Connection Test Form B6
 Medical Gas Pipeline System – Functional Test of Terminal Units Form B7A
 Medical Gas Pipeline System – Functional Tests of NIST Connectors Form B7B
 Medical Gas Pipeline System – Design Flow Performance Test Form B8
 Medical Gas Pipeline System – Functional Test of Supply System Form B9
 Medical Gas Pipeline System – Pressure Safety Valves Form B10
 Medical Gas Pipeline System – Warning Systems Form B11
 Medical Gas Pipeline System – Verification of Drawings Form B12
 Medical Gas Pipeline System – Purging and Filling Form B13
 Medical Gas Pipeline System – Quality Form B14
 Medical Gas Pipeline System – Gas Identification Form B15
 Medical Gas Pipeline System – Certificate of Completion Form B16

Issue Date: Apr 2016 Page 3 of 3 NOTE: The electronic version of


Review Date: Apr 2018 Version No: 3 this document is the most current.
Protocol Steward: Site Engineer Authorised by: GM Property Any printed copy cannot be
Building Services Services assumed to be the current version.

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