Flooring for Healthcare CEU - Version II - Jan 2012

7/31/2019 Flooring for Healthcare CEU - Version II - Jan 2012

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Flooring for Healthcare: AnEvidence-Based Design Approach

Live WebinarWednesday, March 28, 2012


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Produced with our partners:


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Flooring for Healthcare:An Evidence-Based Design Approach

Joe MartereNational Healthcare Sales Director

IIDA

March 28, 2012


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Flooring Issues in Health Care

Environments

Different Floor Covering Options

Evidence Based Design Approach to

Evaluate Flooring (safety, comfort

and well being of patients & staff)

Installation Issues

Floor Coverings Strengths &

Weaknesses

Agenda


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Aesthetic Needs

Moisture Management

Indoor Air Quality (IAQ)

Odor/Infection Control

Antimicrobials

Safety (Slip/Fall)

Ergonomics/Comfort

Thermal Properties

Roller Mobility

Acoustics

Visual Comfort/GlareDurability

Environmental Impact

First Cost/Life-Cycle Costs

Maintenance

Installation

Flooring Issues in Healthcare


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Hard Surface

Wood

Bamboo

Laminate

Terrazzo

Stone

Marble

Porcelain Tile

Ceramic Tile

VCT

Flooring Types


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Hard Surface Resilient Flooring

Wood

Bamboo

Laminate

Terrazzo

Stone

Marble

Porcelain Tile

Ceramic Tile

VCT

Flooring Types

Cork

Linoleum

Sheet vinyl

LVTRubber


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Hard Surface Resilient

Wood

Bamboo

Laminate

Terrazzo

Stone

Marble

Porcelain Tile

Ceramic Tile

VCT

Flooring Types

Cork

Linoleum

Sheet vinylLVT

Rubber

Carpet

Broadloom Carpet (Tufted and Woven)

Printed Carpet

Axminsters (Woven wool carpets)

Performance-Back Carpet

Modular (Carpet Tile)


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Hard Surface Resilient

Wood Cork

Bamboo Linoleum

Laminate Sheet Vinyl

Terrazzo LVT

Stone Rubber

Marble

Porcelain Tile

Ceramic Tile

VCT

Flooring Types

Hybrids

Flocked Nylon Flooring

Woven Vinyl Flooring

Hybrid Resilient Sheet

Flooring

Carpet

Broadloom

Printed

Axminsters

Performance-Back

Modular


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Evidence-Based Design

Process of basing decisionsabout the built environment on

credible research to achieve the

best possible outcomes.


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Evidence-Based Design

Objectives:

Improve patient/resident as

well as visitor and staff

satisfaction

Improve quality & operational

effectiveness(clinical outcomes)

Lower cost of ownership


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Issues

1. Volatile Organic Compounds

2. Respiratory Contaminants

3. Microbial Growth

Indoor Air Quality


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How does flooring affect

IAQ/Infection Control?

Select floorcoverings thatare impermeable to

moisture.

Why?

Indoor Air Quality / Infection Control

Spills do not flow through to

subfloor

Easier to clean with less

chemicals

Does not provide food sourceand environment for micro

organisms including mold.


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Moisture Management / Infection Control

Flow Through vs.

Impermeable


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Moisture Management / Infection Control

Impermeable

Moisture Barrier


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How does flooring affect

IAQ/Infection Control?

Select floor coverings that can

serve as a sink to trap airborne

particulates and be easily and

effectively removed.

Why?

Shiny does not equal Clean.

It equals Shiny!

Indoor Air Quality / Infection Control

Is shiny clean?


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Hospital-Acquired/

Nosocomial Infections

90,000 deaths annually

Most important

preventative measure?

Infection Control


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Hospital-Acquired/


Surface Sanitation

High-Touch

(door handles, bed rails)

Low-Touch

(Floors and Ceilings)

Infection Control


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Hospital-Acquired/


Infection Control

Extraordinary cleaning and decontamination of floors in

health-care settings is unwarranted.

Centers for Disease Control


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Infection Control - Summary

CDC GUIDELINES:

Extraordinary cleaning and decontamination of floors in health-care

settings is unwarranted. Studies have demonstrated that disinfection of

floors offers no advantage over regular detergent/water cleaning

and has minimal or no impact on the occurrence ofhealth-careassociated infections.947, 948, 977980

Additionally, newly cleaned floors become rapidly recontaminated

from airborne microorganisms and those transferred from shoes,

equipment wheels, and body substances.971, 975, 981

Focus on those surfaces in close proximity to patient (e.g., bedrails)

and those that are frequently touched (e.g., doorknobs).

FLOORING IS CONSIDERED A LOW-TOUCH SURFACE


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Antimicrobial Treatments

What are they?

Do they work?Are they really needed?

Infection Control Use of Antimicrobials

CDC INFECTION CONTROL GUIDELINES (2003)

Over the last few years, some carpet manufacturers have treated their products with

fungicidal and/or bactericidal chemicals. Although these chemicals may help to reduce

the overall numbers of bacteria or fungi present in carpet, their use does not preclude

the routine care and maintenance of the carpeting.


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Implications of Flooring

Selection

Impact of Slip/Fall Incidents

Ergonomic/Human Factor

Rolling Resistance/Mobility

Safety & Ergonomics


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Impact of Slip/Fall Incidents

1800 fatal falls per year in

nursing homes

29% of injured die with six

months

50% do not return home

(Source: Nursing Times Magazine)

Safety & Ergonomics


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Impact of Slip/Fall IncidentsStudy Summary

213 fall/accidents studied

27 Falls (13%) occurred on soft

surface (4 injured = 15%)

186 falls (87%) occurred on hard

surface (167 injured90%)

Safety & Ergonomics


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Effects on Staff

Safety & Ergonomics


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Safety & Ergonomics

Most common injuries

experienced by nurses.

Together, knee and ankle injuries

(sprains/strains) account for 10%

of workers compensation claims.


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Ergonomic/Human Factor

Univ. of Pittsburgh Study

Conclusions:

Safety & Ergonomics

1. Cushion and carpet pile density affectmuscle response.

2. Firm cushion provides lowest muscle

responses (less muscle fatigue).

3. Low pile height has the lowest muscle

response (less muscle fatigue).

4. Low pile height in conjunction with a

very firm cushion provided lowest

muscle response of all samples tested.


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Safety & Ergonomics

Hard wheel rolling on and deforming a

soft surface, resulting in the reaction

force from the surface having a

component that opposes the motion


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Gurney + 200 lbs.

Safety & Ergonomics

Movement of Gurney + 200lbs. VCT Modular Carpet/

Hard Backing

Hybrid Resilient

Sheet Flooring

Effort Required to Initiate Movement 10.6 lbs 14.6 lbs 17.85 lbs

Effort Required to Sustain Movement 8.2 lbs 11.8 lbs 13.3 lbs

Effort Required to Push Around Corner 11.0 lbs 14.7 lbs 14 .0 lbs


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Wheel Chair + 200 lbs.

Safety & Ergonomics

Movement of Wheel Chair + 200lbs. VCT Modular Carpet/

Hard Backing

Hybrid Resilient

Sheet Flooring

Effort Required to Initiate Movement 2.0 lbs 4.6 lbs 7.85 lbs

Effort Required to Sustain Movement 1.2 lbs 3.8 lbs 5.3 lbs

Effort Required to Push Around Corner 3.4 lbs 4.7 lbs 7 .5 lbs


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R-Values (h2 F/btu)

Thermal Properties


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Acoustics

Better acoustics

Lower stress

Lower blood pressure

Improved sleep

Higher patient satisfaction

Increased visitation

Lower error rates

Higher staff moral

Rise In Hospital Noise Poses

Problems For Patients And Staff,

Science Daily 2005


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Acoustics

Since 1960, daytime sound levels have risen

from 57 decibels to 72; nighttime has

jumped from 42 decibels to 60.

All exceed the World Health Organization's

1995 hospital noise guidelines, of 35

decibels. The measurements vary little

among different types of hospitals,

indicating the problem is universal.


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Closed Cell Cushion

reduced reverberation

times from 8% - 25%1.

1LEE SOUND DESIGN, Inc.

Consulting Engineers in Audio,

Acoustics and Video Acoustical

Report.wpd (classroom analysis)

Acoustics


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Glare plus compromised vision can

create eye pain

Wet/slippery appearance has

paralyzing effect

Resident can become immobile due

to fear, anxiety, confusion

Result is passive restraint

Glare can be measured

Light Reflectance Value (LRV)

Visual Comfort/Glare


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Installation

24/7 Occupancy

Floor Prep/Moisture Limits

VOCs (Adhesives & Sealers)

Adhesive set-up and cure time

Downtime/Lost Revenue


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Hard Surface Flooring

STRENGTHS WEAKNESSES

Lowest level of roller resistance Increased incidences of slips/falls and

related injuries

Easy to clean & disinfect High glare (waxed VCT / Marble)

Most Durable Maintenance costs (equipment, man

power and chemicals when waxed)

Impermeable to moisture Poor acoustical properties/increased noise

Low thermal insulation value

Undesirable ergonomics/comfort

Installation limitations


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Resilient Flooring


Low level of roller resistance Potential for slips/falls and related injuries

Easy to clean & disinfect Varying levels of glare (when waxed)

More Durable Maintenance costs (equipment, manpower & chemicals when waxed )

Impermeable to moisture Increased Airborne Particulates

Creative flexibility for inlays Varying levels of thermal value

Varying levels of ergonomics/comfort

Scuffing and scratching of no-wax finishes

Installation limitations


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Carpet


Lower incidences of slips/falls and related

injuries

High Level of roller resistance

Eliminates glare Less durable

Better acoustics Difficult to Maintain

Some thermal benefits Moisture permeable / Flow-thru

Better ergonomics/comfort Stains easily / Harbors Odors

Microbial Growth / Infection Control

Installation Limitations


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Hybrid Resilient Sheet Flooring


Lower incidences of slips/falls and related

injuries

Medium level of roller resistance

Eliminates glare Textile surface restricts use to non-clinical

spaces in acute care facilitiesImproved acoustics

Maximum thermal benefits

Impermeable moisture barrier / Weldedseams

Comfort under foot / Reduced fatigue

24/7 Installations / Immediate Occupancy


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Thank you

Flooring for Healthcare:An Evidence-Based Design ApproachCourse: TANHC1011

Joe [email protected]


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Disney Contemporary Resort | Orlando, FLwww.EnvironmentsforAging.com

A conference addressing the latest design strategies for creating attractive and

functional living environments that meet the needs of our aging population.

Earn up to 15 CEUs!

April 29

May 1, 2012
http://www.environmentsforaging.com/http://www.environmentsforaging.com/


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Flooring for Healthcare CEU - Version II - Jan 2012

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