Infection Control

The COVID-19 pandemic has brought infection prevention and control to the front of mind of design professionals. Healthcare settings have been a focus due to the increased risk of immunocompromised patients in hospitals, and the potential exposure of healthcare workers putting a strain on hospital resources. To combat the spread of infection in health and aged care facilities, an emphasis has been placed on environmental cleaning. This has lead to the increased use of disinfectants for surface cleaning and specification of antimicrobial materials to help maintain sanitary indoor environments. However, the risks associated with the overuse of disinfectants and antimicrobial materials is easily overlooked. COVID-19 is not the only threat as other types of pathogens can spread throughout the hospital, many of which are serious or life threatening. Not only is there no evidence to suggest that antimicrobial and biocidal products contribute to healthier populations, but they may actually contribute to the development of superbugs that are resistant to standard antibiotics. When selecting flooring solutions, designers must take a step back and consider what properties in a floor can contribute to healthier environments. It is time to look beyond antimicrobial and biocidal products, and assess how a floor will perform in the chosen environment. Selecting the right materials and implementing proper cleaning regimes are the prerequisite of a healthier long-term product that is less dependent on chemicals and disinfectants. In this whitepaper, we examine the critical role of flooring in creating safe hospital environments and the design considerations when specifying flooring solutions for such applications.

When designing healthcare environments, solutions that prevent healthcare-associated infections (HAI) and avoid the increase of antimicrobial resistance (AMR) are among the highest priorities. HAIs are infections acquired by patients during their stay at a hospital. The most common types of HAIs include infections affecting the bloodstream, urinary tract and open wounds, and lung infections (i.e. pneumonia).1 In Australian health facilities, HAIs are the most common complications affecting patients with around 165,000 infections occurring each year.2 The government reports that HAIs account for an estimated two million hospital bed days in Australia per annum.3 Closely related to the prevalence of HAIs, AMR refers to the ability of microorganisms to become resistant to antimicrobial agents such as antibiotics and biocides. Bacteria and fungi can change over time and develop the ability to defeat the antibiotics designed to kill them. This evolution can be spurred on in hospital environments where patients are exposed to antibiotics and receive lots of hands-on care. Common treatment-resistant strains include methicillin-resistant Staphylococcus aureus (also known as ‘golden staph’ or MRSA), vancomycin-resistant Enterococcus (VRE) and carbapenemase-producing Enterobacteriaceae (CPE). The rise of these so-called ‘superbugs’ has become a worldwide problem. Research indicates that treatmentresistant bacterial infections directly caused 1.27 million deaths worldwide in 2019 and were associated with an additional 4.95 million deaths.4 According to the World Health Organization, AMR-attributed deaths could reach 10 million per year in 2050.5

Hospitals create several factors that increase the risk of infections and AMR, including the presence of microorganisms, contamination between staff and among patients, and the presence of vulnerable patients with weakened immune systems. Surfaces in hospitals are frequently contaminated with harmful microbes, hence the focus on daily cleaning procedures and design solutions that limit bacterial growth, such as antimicrobial surface materials. Floors are an often overlooked bacteria source that highlights the need to improve infection control. Researchers with the Northeast Ohio VA Healthcare System found that the floors of hospitals can be easily contaminated with bacteria within hours of patient admission, allowing bacteria to move to patients’ socks, bedding, and nearby surfaces.6 A 2017 study published in the American Journal of Infection Control supports this finding, reporting that, as items in the patient’s room may touch the floor, pathogens on hospital floors can rapidly move to the hands and high-touch surfaces throughout a hospital room.7 There is also some evidence that pathogens on the floor can be resuspended in the air with the potential of inhalation, swallowing or contamination of surfaces or hands.

Tarkett is the world leader in the design, manufacture and distribution of commercial and residential floor coverings. Designed to meet the demanding requirements of healthcare, Tarkett iQ homogeneous vinyl flooring with its unique surface restoration properties, is renowned for delivering consistent long-term performance without compromising on design. Suitable for any hospital environment, Tarkett iQ is the only homogeneous vinyl flooring to provide consistent long-term performance without compromising on design. Its ease of installation, outstanding durability, lowest life-cycle cost and treatment with unique dry-buffing surface properties restoration mean iQ outperforms everything else on the market. Factor in a colour palette covering the full spectrum plus designs ranging from classic to contemporary, and you will see why iQ is the perfect choice. Tarkett iQ homogeneous flooring is not afraid of time and with the proper care and maintenance, it will look the same even after decades of use. The IQ ranges of homogeneous vinyl rolls are the best flooring solutions for demanding healthcare environments. 

The key benefits are summarised below: 

• Excellent cleanability. The smooth surface ensures the highest levels of hygiene, proven by the Fraunhofer Institute. 

• Perfect watertightness. Unmatchable flexibility allowing perfect coving, hot welding and easy repair. 

• Durable joints. Outstanding seam strength (three times above standard) preventing split joints. 

• High chemical resistance. Withstands the strongest disinfectants (quaternary ammonium, alcohol, bleach, hydrogen peroxide etc.). Best in class resistance to common healthcare chemicals such as betadine and iodine. 

• Comprehensive solution for floors and walls. Easy to match and heat-weld (ProtectWall and Wallgard) for a fully watertight system. 

• Cleanroom solutions. Options that meet the highest hygiene standards to ensure infection control and air cleanliness, with electrostatic control. 

Tarkett has identified the use of biocides as a major risk to health and the environment and have therefore stopped adding antimicrobials in their flooring production since 2013, and actively promote the importance of appropriate cleaning methods