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Healing from under your feet

How resilient flooring is helping fight hospital-associated infections

By Jim Bistolas / Special to Healthcare Facilities Today


Infection control practices are shaping today’s healthcare environments. Healthcare acquired infections (HAIs) are among the most prevalent complications of hospital care. At any given time, approximately one out of every 25 hospitalized patients in the U.S. has an HAI, according to a Center for Disease Control and Prevention (CDC) study. More than one million HAIs occur throughout the healthcare system every year, leading to tens of thousands of lives lost – and billions of dollars spent.

It’s a staggering and urgent problem, and one that hospitals and other care facilities are battling every day. It’s also one that is increasingly tied to reimbursements. In 2015, hospitals across the country experienced reimbursement reductions – by about $330 million – for infection rates that exceeded federal standards. The good news is some types of HAIs are already on the decline. And there’s consensus and increasing evidence that the design of the built environment can be a critical factor in infection control.

Preventing HAIs involves procedures as basic as hand washing and as high-tech as hydrogen peroxide vapor systems and UV light decontamination systems on wheels. But in recent years, infection control and environmental services professionals have brought to the forefront the importance of interior finishes – from furniture to flooring – and the role they play in the prevention, acquisition and spread of infections. 

Flooring is one of the most important surfaces in healthcare. It’s quite literally everywhere. Specifically, resilient vinyl flooring – including luxury vinyl tile (LVT) and homogenous sheet options – is reemerging as a proven solution, combining warm aesthetics with the durable performance healthcare facilities need. Here’s why.

Squash the superbugs

There’s a movement currently underway against the use of antimicrobial chemical agents added to materials to kill bacteria. These agents, essentially pesticides, aren’t effective; in fact, they don’t destroy bacteria, they give it opportunity to morph and become more resistant to efforts to eradicate them. While technology utilizing natural microbial treatments can be an effective alternative, it’s most important to select proper, dense, non-porous flooring and products that don’t allow bacteria to harbor in the first place.

For bacteria to grow – not just on the floor, but anywhere – it requires a food source, moisture and a temperate environment. Appropriate flooring for the healthcare environment is essential to providing fewer places for bacteria to hide and thrive. It is critical to select products that have a history of effectiveness in these applications. 

Additionally, certain third-party certifications are important indicators of product compliance with antibacterial standards. ISO-22196, for example, measures antibacterial activity on non-porous surfaces, such as resilient flooring. Compliant products such as Gerflor’s Mipolam homogeneous sheet flooring are proven more than 99 percent effective against spreading MRSA, E. coli and S. aureus – nearly eliminating surface contamination and potential risk of HAIs.

Stand up to heavy traffic

Hospitals and other care facilities are among the most highly trafficked environments in any industry – from foot and wheeled traffic, to permanent equipment and rolling machinery. One of the biggest issues for healthcare flooring is indentations from wheels on patient beds, chairs and medical equipment. Any depression in the floor can create a perfect environment for moisture to gather and microbes to proliferate. Appropriate density and wear layer-thickness are vital to protecting against and preventing such problems.

Vinyl flooring is referred to as “resilient” because it characteristically bounces back from the weight of objects compressing its surface. Products constructed using a very high-density, compact interlayer provides resistance to pressure from heavy, high traffic. The reduction of fillers in flooring will indicate better resilient qualities and impact the durability of the product.

Beyond safeguarding against microbes, very high density flooring provides additional benefits: reduced noise levels and staff fatigue. The sound management properties and comfort underfoot are essential for positive patient outcomes and for staff health, safety and satisfaction.

“If you can’t clean it, don’t buy it”

Overall ease of cleaning and maintenance is a critical consideration in the choice of all materials used in healthcare facilities, including flooring. Many vinyl flooring products are engineered to resist stains and wear prevalent in healthcare environments. Polyurethane surface treatments, for example, provide enhanced protection against micro scratches, stains and commonly used chemicals, such as betadine and methylene blue. Advanced technology also eliminates the need for wax or polish, which improves durability while decreasing maintenance costs. Reducing the need for chemicals in cleaning products (positively) effects indoor air quality, as well. 

Installation techniques contribute to cleanability, too. Heat-welded seams, and flash-coving and full coving systems help contaminants from being lodged in seams and crevices – making it easier to ensure a clean floor at all angles, even hard-to-reach corners. The floor-to-wall connection also gives a waterproof seal, which is important for maintenance and stopping the spread of harmful bacteria.

Health, above all else

Flooring literally provides the foundation for all other design and application decisions in the healthcare environment. It touches everyone – patients, visitors, clinicians, administrators, and more – who enters the door. While aesthetic trends are taking the clinical environment away from the sterile, institutional styles traditionally associated with healthcare facilities, form will never be the primary consideration when investing in new-builds, upgrades and renovations.

Above all else, the priorities of designers and facility managers are reducing HAIs, and improving the processes of care and healing. Research is critical. Look for solutions that meet and exceed industry standards and independent testing; ISO certifications are important proof that products will perform. Consider product history – and that of its manufacturer. Is it developed specifically for healthcare settings? And of course, ensure the product solutions are perfect matches with their intended applications. Specifying the right flooring for the right space is critical to infection control and patient safety.

Flooring alone will not solve healthcare’s problem with hospital-association infections. But it is an increasingly important prescription that will get us closer to a cure.

Jim Bistolas is Gerflor USA’s national sales director. 



July 17, 2017


Topic Area: Infection Control


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