Resilient flooring in healthcare has always been the popular choice because of its durability, underfoot comfort, aesthetic appeal, long-lasting beauty and cost-effectiveness. With indisputable “green” qualities resilient floorcoverings is a main contender for these types of installations.
When one considers the healthcare aspects of floorcoverings in hospitals, clinics and other buildings related to the medical field, hygiene is the word that naturally springs to mind, but as the floor is where bacteria normally exists the risk is amplified in these environments because if the floors are not properly cleaned, or unable to be properly cleaned, diseases might spread and contaminate the patients.
So, apart from the strength, longevity, and other integral benefits of the selected floorcovering, the overriding purpose of a floor in a healthcare application is to provide a horizontal clean surface, whether a hard or soft floorcovering is chosen.
Although vinyl floorcoverings are still very much favoured in healthcare applications, it is interesting to look as some of the specialist developments that have taken place in flooring materials for these projects.
Greener flooring choices – those with renewable resources and low volatile organic compound (VOC) content – are being used in many new medical facilities and it is now becoming the norm to strive towards using green products whenever possible.
Antibacterial products are also in high demand, which has resulted in ceramic tiles being provided that are coated with antimicrobial glaze having highly active and positively charged ions, which react and bond to the microorganisms, thus inhibiting their multiplication and in many cases killing them.
Besides their antibacterial property these tiles are acid/alkali- and scratch-resistant. Moreover, the antibacterial property has a very long life. A specially developed antibacterial grout made of epoxy resin is also available to prevent growth of bacteria in the grout.
Another clean air and antibacterial ceramic tile now available has additional properties obtained by the high-temperature application of micrometric particles of titanium dioxide, which exploits photo-catalysis activated by sunlight or artificial light, to allow the production of anti-pollutant, anti-bacterial tiles for floor and wall covering that make an effective contribution to improving air quality.
Another range of floor tiles from Italy eliminates contaminating gases through its surface. The tiles contain titanium dioxide, an element which reacts to and eliminates polluting gases thus rendering them harmless.
When solar rays hit the surface of the tiles, the titanium dioxide produces active oxygen, which then oxidises polluting gases. The gases are transformed into nitrate ions which, combined with water or other elements, become eco-efficient. The photocatalytic properties of titanium dioxide have been well proven in their ability to quickly decompose bacteria.
Particularly suitable for external use, this will assist in the reduction of pollutants such as nitrogen oxides, PM10 particulate matter, VOCs, NH3 gas, polyaromatic compounds, formaldehyde and fine dust particles – which are all airborne pollutants that are formed in our everyday surrounds from vehicle emissions, tobacco smoke, paints, protective coatings and various other industrial and non-industrial processes and all pose hazards of varying severity to human health.
In many instances South African flooring design and product development use North America as a benchmark, but this is certainly not the case with the floorcoverings used in healthcare applications.
For example, in America low-density carpeting is regularly used in corridors, because it is felt that this helps with the movement of wheeled equipment, and assists patients who walk. To this effect, and realising that the control of infection is important in every hospital, specifiers say that carpeting in the corridors is a good choice since it serves to trap airborne germs, which can later be vacuumed away.
The use of carpeting is not prevalent in most South African hospitals, which seem to favour seamless vinyl throughout the facility, with the possible exemption of the reception areas and consulting rooms.
One area where the same flooring material is commonly used both locally and in North America is in operating theatres, where specially designed seamless vinyl is frequently installed. This type of product comes in large sheets that have welded seams for infection control, and have no joints between the wall and the floor where dirt and bacteria can hide.
However, floorcoverings in spaces like hospital reception areas go with a wide range of materials, such as ceramic tiles, porcelain and terrazzo, often decided upon by the marketing considerations of the facility. Polished concrete and the various types of resin flooring often make an appearance in South African facilities.
In the USA, non-porous floorings such as limestone and travertine are often favoured, because they do not retain microorganisms on their surface, so alcohol-based cleaning products are more efficient against dirt. The possible stains that may appear from the use of iodine and other substances are also easy to remove. Where there is a considerable amount of foot traffic, non-slip tiles must be used to avoid causing further injuries to patients or to medical staff.
However, for a new or renovation project, selecting the proper flooring is critical for architects, environmental services and infection control.
Also, coping with the movement of equipment like wheelchairs, carts, gurneys and X-ray machines on a 24-hour basis, cleaning and maintenance performance and fire and non-slippery floors are prime elements that are essential for the design of hospital floors.
Patients with special requirements
The safety aspects of the floors, their accessibility, the correct lighting and demarcation are all aspects that are paramount in hospital design. But in specialised clinics and care centres that cater for patients with Alzheimer’s and other dementia-related complaints need special attention, where it is essential to maximise awareness and orientation.
Dementia often creates confusion with respect to time and place, particularly in unfamiliar settings, so signs must be kept simple to ensure the residents can understand them. Pictures or diagrams will help in some situations. Signs should also be situated at eye level or even repeated lower down if there are many wheelchair users.
Bright contrasting colours should be used that patients can recognise and relate to, and purpose-specific rooms should be constant, so residents always know what to expect when they enter. Signs to key destinations such as the dining room, bathroom and living rooms, must also be clearly visible.
Floors have a key role to play in these facilities: they must not be slippery; sharp colour contrasts in flooring must be kept to a minimum; and borders and strong, busy patterns must be avoided.
It is good practice to choose contrasting colours between the floor and chairs and tables, to assist the patients with orientation, and where flooring materials change from hard to soft surfaces, gradual transitions should be provided to minimise falls.
In general, the design of hospitals and other healthcare facilities in recent years has seen a move away from the stark institutional look to styles more user-friendly for patients, visitors and staff.
Hospital settings are more likely to include a range of colour schemes and designs based on enhancing the concentration of surgeons in operating suites; promoting recovery and rest; relieving stress in waiting areas, and so forth.
Use of colour
The correct use of colour for specific aspects of healthcare has become almost a science and varies with what it is expected to achieve.
Using cheerful and varied colours and textures is often a major requirement – particularly in childcare applications – but it should be kept in mind that some colours are inappropriate and can interfere with assessments of patients’ pallor and skin tone, can disorient some older or impaired patients, or agitate others, particularly so in some psychiatric cases.
In general a prime requirement is the provision of ample natural light wherever feasible and the use of colour-corrected lighting in interior spaces, which closely approximates natural daylight, is ideal.
Vinyl floorcoverings are also no slouch in new hygienic properties.
Calendered homogeneous vinyl rolls are available that are fully flexible and easy to weld for maximum hygiene in hospitals, clinics and general healthcare facilities where infection control, wear resistance and porosity are paramount.
These are permeated with a special antibacterial, fungicidal treatment that prevents moisture and growth of bacteria, making them ideal for floors constantly exposed to bacteria, bodily fluids and harsh cleaning agents, disinfectants and sterilising chemicals.
The special antibacterial/fungicidal treatment is provided throughout the thickness of the product that prevents moisture and growth of bacteria, and it is fully flexible and easy to weld for maximum hygiene.
The carpet sector is not one to be left behind either, and recent developments have produced a long-lasting protection system, based on silver ions that penetrate deeply and envelop carpet fibres with a protective coat that lasts the lifetime of the carpet.
The system acts at the heart of the carpet fibres, permanently inhibiting bacteria, reducing odours in the carpet and eliminating dust mites by destroying their food source, as well as sterilising over 650 types of bacteria. It is non-toxic and hypoallergenic, making it ideal for domestic use as well as for carpets in doctors’ consulting rooms.
If you are hospitalised or have any form of healthcare treatment, you expect the highest level of care, attention to detail and expertise to be applied to your problem.
When it comes to the flooring in these facilities the local flooring industry ensures that the products and services provided match the same stringent requirements.