Harris is the author of “The Role of Flooring as a Design Element Affecting Patient and Healthcare Worker Safety,” an article published in the spring 2013 issue of Health Environments Research & Design Journal. She recently participated in the Evidence-Based Design Journal Club, an online webinar presented by The Center for Health Design in Concord that connects research authors with interested attendees.

The article discussed three main factors that are impacted by the choice of flooring design and materials. Those include health care-associated infection (HAI) control and cleanliness; patient safety and satisfaction; and worker safety and satisfaction.

The article pointed out that when it comes to flooring there isn’t a lot of research on the impact of its design. When research is done about patient safety, the focus is mostly on where there were errors and adverse events.

“It’s surprising that we really don’t know a whole lot of how various types [of flooring] perform in various types of factors,” Harris said. “I think that with the changes that health care reform has brought in and other issues like CMS reimbursement, health care systems are really challenged.”

HAIs affect, on average, an estimated 2 million people in the U.S. each year, according to the article. When thinking of floor cleanliness and infection control, one of the most common perceptions among hospital staff is that shinier is better. While most patients prefer carpet tiles, nurses prefer smooth vinyl. Research has shown flooring is not a concern as a vector of transmission, and in fact while carpet can become contaminated, it acts as a sink, preventing contaminates from becoming airborne. This might be why having a hall runner in any place, residential or commercial, might be a good thing – to catch the bacteria and keep it buried as soon as it comes in through the door on people’s feet. These can easily be washed too.

“Maintenance is always a factor [in choosing flooring],” Harris said. “Some hospital systems make decisions based on whether or not they think their maintenance crew can manage that flooring in terms of its effective cleaning and disinfecting rather than making a decision based on the benefits of the flooring.”

A game changer, Harris noted, in the process of commercial carpet cleaning services is to use hydrogen peroxide, which can clean three-dimensional surfaces.

In terms of patient safety, there is a huge incentive for health care organizations to reduce falls and injuries in their facilities, according to Harris. The facilities are responsible for paying for patient recovery, and falls account for $3.6 billion annually in health care settings. Overall, the article’s suggestion was to opt for carpeted flooring in patient rooms because they increase surface traction, act as a shock absorber and help with stability. It is, however, important that the carpet should be cleaned periodically to keep bacteria at bay. Companies that provide Rug Cleaning Melbourne Eastern Suburbs, or wherever the hospital is based should be used unless the hospital has onsite professionals.

What’s more, carpeted rooms may help boost a patient’s recovery by appealing to visitors, and that may promote the healing process. “There is a statistically significant difference in the amount of time that visitors stayed with their loved ones in rooms that had carpet compared to rooms that had vinyl,” Harris said.

Carpeted rooms can also help prevent worker slips, trips and falls (STFs), which account for the largest proportion of lost time for health care workers (21 percent). Also, ergonomics contribute to health care worker stress, and research implies that workers may benefit more from flooring that has flexibility and softer properties.

Another consideration in the choice of flooring is noise – something that affects both patients and health care staff. While noise can be a dangerous distraction and stress factor for health care workers, hospital noise that exceeds 30 to 35 decibels can cause sleep deprivation, sensory overload and reduced comfort for patients.

Many noise reflective surfaces, including the flooring, can contribute to noise level. Harris said it’s important to take a broad approach to help keep noises to an appropriate level.

“In an effort to reduce stress and create a positive health and work environment, design with a goal to limit sound transmission and noise and use as many sound-absorbing interior materials as possible, such as carpet in patient rooms and corridors,” Harris said.

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Water Woes

Maintaining hospitals and health care facilities requires significant water and energy use. The water used in hospitals and other health care facilities represents 7 percent of the total water use in commercial and institutional facilities in the U.S., according to WaterSense, a partnership program with the Environmental Protection Agency. Depending on size, location and other factors, water use in health care facilities can range from 68,750 to 298,013 gallons per year per bed.

Restrooms are blamed for much of the burden. Domestic and restroom uses of water account for 35 percent of hospitals overall consumption of water beating out all other end-use categories, such as heating and cooling.

Hospital facility managers can benefit from environmental and efficiency standpoints by auditing water usage, making operational improvements and upgrading plumbing fixtures. A team of plumbers that specialize in hot water installation in Brisbane are also going to install a hot water system into the hospital restrooms.

Low-flow, water-conserving fixtures have become the standard in commercial restrooms. For example, while high-efficiency toilets use less water to flush waste, dual-flush toilets conserve water by using different amounts of water for various flushing needs. Most models use 1.6 gallons per flush (GPF) for solid waste and 0.8 gallons for liquid waste. This ensures that water isn’t wasted, as restrooms are using only what they need to. Some commercial companies even look to services similar to Robinsons Facilities Services (https://www.robinsonsfs.com) to help ensure that commercial facilities are equipped for repairs and inspections if needed, ensuring that they are able to save water.

For even greater water savings, ultra-low flow toilets and waterless urinals may be used, while sensor-activated flush meters are an option for controlling water use at peak times. The facility has been showing interest in changing to this new water-saving measure for some time, seeking the aid of a local plumbing service (visit now for more information). In addition to this, the plan may include tankless water heaters instead of the traditional water heater. Tankless water heaters concealed within the pedestal of lavatory systems are another way to increase efficiency. Much like your home, you’ll need to have a hot water tank to drive up efficiency, for more information, you may want to check out the Hot Water Heater Expansion Tank How They Work & Do You Need One. These tankless units to heat only the amount of hot water needed for each use, which eliminates wasting electricity to heat an entire hot water tank for restrooms.

Better Hygiene, Better Health

The CDC estimates that hospital patients in the United States acquire about 722,000 infections each year, which is equivalent to approximately one infection for every 25 patients. Germs that reside in restrooms exacerbate the situation, as a 2011 study at the University of Florida College of Medicine in Gainesville found that restrooms in three health care facilities yielded seven bugs that are responsible for two-thirds of healthcare-associated infections (HAIs).

Restroom design using updated and attractive hand-washing fixtures in addition to keeping a clean and well-maintained restroom environment can go a long way in helping to promote good hand hygiene by patients, staff and visitors.

Durable & Sustainable

Fixtures made of durable, natural and recycled materials are growing in popularity. One new example is a molded natural quartz material that can be sculpted into a range of design options and shapes. Composed of an eco-friendly resin made of soy and corn, natural quartz is Greenguard certified, virtually maintenance-free and doesnt require sealing or buffing. Its smooth, seamless finish also has a non-porous surface so it does not support microbial growth.

Hands-Free Fixtures

Touching conventional faucet handles, even after washing, recontaminates just-cleaned hands. Sensor-operated faucets, flush valves, soap dispensers and hand dryers help minimize touchpoints (faucet handles, door latches and damp areas) on germ-ridden restroom surfaces and reduce cross-contamination.

High-speed touchless hand dryers also promote hand drying with hygienic benefits but without excess paper waste, expense and extra maintenance. Newer models are also highly energy efficient, as they use 80 percent less electricity than older hand dryers, while drying hands in as little as 10 to 12 seconds.

Solid Surface

Lavatories made from smooth, non-porous solid surface material can help guard against dirt buildup, and the growth of mold or bacteria. Solid surface fixtures also feature an integrated bowl design that eliminates cracks and crevices in which microbes can hide and further helps prevent the spread of germs.

No matter what equipment is being specified for a hospitals or health care facilitys restroom, its essential to select high-quality durable restroom furnishings. Higher-quality washroom fixtures made of durable materials have hygienic qualities, are more resistant to wear and tear, and can significantly reduce upkeep and maintenance so staff can focus on other duties. While promoting hand-washing practices, these fixtures also save money on labor, materials and repairs costs over time.

Will Haas is product manager for Menomonee Falls, Wis.-based Bradley Corporation, a USGBC member and manufacturer of locker room products, plumbing fixtures, washroom accessories, partitions and emergency fixtures.

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Patients who undergo invasive procedures are at a higher risk of contracting HAIS. Invasive procedures that may contribute to the contraction of an HAI can range from surgery to simply having an IV placed.

With new health care technologies on the market, however, health care facilities are fighting to reduce the prevalence of HAIs to ensure the safety of patients, visitors and health care staff. Jacie Volkman, MPH, CIC, is an infection control consultant for MEIKO USA, a disinfection appliance manufacturer, who has seen firsthand the benefits of HAI fighting technologies and design techniques.

They not only protect patients from infections, but they can protect visitors and staff as well, since anyone in contact with a patient or contaminated equipment are also at risk of infection, Volkman said. They can also increase the efficiency of the health care provider by helping to establish best practices at the point of care.

The failure to appropriately clean hands, equipment or patient rooms in between patients can lead to HAIs. Effective and accessible disinfection technologies can reduce the likelihood of these infections, Volkman said.

Designing a room where PPE (personal protective equipment) is available where sinks are accessible for hand washing, surfaces are antimicrobial, equipment and supplies can be disinfected easily is a practical way to decrease the risk of infection, she said. With things like these Storemasta PPE Cabinets available, storing this safety equipment is easily done. Things like face masks, hand sanitizer, and medical equipment can be offered in these cabinets. Offering not only patients but also employees equipment like you can find on sites such as ppesuppliesdirect.com and others, will greatly decrease the likelihood of infection spreading.

Intensive Care Units in particular are considered the highest risk areas of the hospital due to the fact that most patients have some sort of invasive procedure or device, Volkman said.

Some new technologies, or reengineering of old technologies, include UV light disinfection, bedpan washers, antimicrobial surfaces and textiles, Shark pattern surfaces and automated hand-washing machines, Volkman said. The inclusion of these technologies can free up more time for health care staff to attend to patient needs more quickly and efficiently.

Making it easy to do the right thing, and to be able to do it at the bedside, makes care more efficient and increases the caregivers ability to focus on the patient, Volkman said.

Some examples of facilities focusing on the reduction of HAIs are Sentara Healthcare, which features copper infused surfaces, and the University of North Carolina Chapel Hill, which has used UV light for disinfection, Volkman said. More hospitals throughout the nation are also using bedpan washers.

Technologies and design strategies to reduce HAIs are an invaluable investment in hospitals, Volkman said.
The first step is figuring out how to make it easy for caregivers to do the right thing, she said. Facilities also need to understand that may mean a little work or cost up front, but in the end, you cant put a price on the lives you save.

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