Surfaces in Healthcare: How Complicated Can They Really Be?

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Over the last 15 years, I have been involved in many meetings with professionals about the selection of surfaces in healthcare. It may surprise you to learn that many of these professionals believe that surfaces are just surfaces. They look at them more as design features or pieces of furniture than as a critical aspect of the healthcare environment.

There has been a slight shift in this belief as more information has become available about the issue of Healthcare Acquired Infections (HAI), which has brought about a good deal of confusion in the selection of surfaces. Great sales people can be extremely convincing, but many really don’t understand the unique nature of healthcare needs. It is up to you to become informed about the issues associated with materials used for healthcare surfaces. How durable, maintainable, and cleanable is the material being considered? Then after evaluating the location of the surface, finish and color selection can be reviewed. Finish will affect the way the surface can be cleaned. The same is true for color.

Surface characteristics

The FGI Guidelines for Design and Construction of Healthcare Facilities created a list of preferred surface characteristics (of the ideal product) published for the first time in the 2006 edition. This list was further refined and clarified in the 2010 edition. Although this list is currently in the appendix, I do not expect it to remain there much longer. Defining these surface characteristics was the beginning of a request that specifiers and healthcare professionals take a serious look at which surface materials are being placed where.

Selecting surface materials is complicated in many ways. Not all laminates are the same, not all solid surfaces are the same, not all stainless steel or tile is the same. With the introduction of anti-microbial products, this has added a completely new set of concerns. Many manufacturers have not had their products tested by independent third party laboratories to ensure they meet necessary code requirements. In fact, I have spoken with manufacturers who didn’t know there are code requirements.

Are they cleanable?

Companies are entering the market seeing great opportunity to make money in healthcare, but do not understand the unique nature of the healthcare environment. One of the results of this situation is that many products being selected are extremely difficult to clean and keep clean. In fact, many manufacturers do not provide cleaning information that is pertinent to the healthcare environment. A careful review of manufacturer websites will reveal cleaning recommendations for your home, but I have not found any that refer specifically to healthcare.

All surfaces need to be cleaned well and, in some cases, often.  Solutions such as Betadine, alcohol-based hand washing products, as well as many others can stain, mar or otherwise damage many materials used for surfaces. Hospital-grade cleaning products and germicides may also damage or dissolve surface finishes or protective coatings. This, of course, may impact the durability and/or aesthetics of the material. Consider one last unique characteristic of a typical healthcare environment – large, heavy mobile objects. Gurneys, beds, mobile x-ray machines, the list goes on and on. Have you ever considered the impact of these devices on the materials used for walls and floors?

In my last blog I recommended a list of questions to ask when you begin to review surface materials. I also recommend you insist on cleaning documentation and review it carefully. Remember, the fight against HAI begins at the surface.