Non-porous, cleanable hard surfaces may help in reducing the risk of infection. However, they can present other challenges. Many are not effective at absorbing sound, Stroupe says.

As most people who have spent time in a hospital know, the environment can become noisy. A 2012 article in the Journal of the American Medical Association reported that hospital noise can hit 67 decibels (dB) in the intensive care unit. That’s far above the World Health Organization (WHO) recommendations of 30 dB for patient rooms. (A normal conversation is about 60 decibels.) The sound is more than just an annoyance, as it can interfere with patients’ ability to rest.

Although the numbers of areas in which sound-absorbing materials can be used may be limited in a healthcare setting, designers often strive to use as much acoustic product as possible. For instance, they might use high-performing acoustic tile on the ceiling, says Stroupe.

Carpeting is another option, although it typically isn’t used in patient rooms or clinical areas. However, healthcare staff, patients and visitors often appreciate its ability to reduce the impact of sound and glare, Waggener says.

In addition, carpet may reduce the severity of injury from a fall, although more research on this is needed. Moreover, some studies indicate that carpet can hold particulates, keeping them from escaping into the indoor air, Sterling says. This may enhance indoor air quality by reducing the number of circulating dust particles.

If carpeting is chosen for an area, proper cleaning is required to ensure that bacteria won’t accumulate, Sterling says. “If a facility doesn’t have a staff that can clean it, we can’t put it in.”

Along with the materials selected in a clinical setting, the design also can be key to containing the risk of infection.

Even a simple switch, like moving from straight to slanted horizontal surfaces, can have an impact. For instance, slanting the tops of a row of lockers can not only simplify cleaning, but may keep people from using the spaces to store personal items, Dickey says.

Design elements that are intricate or hard to reach — say, a carved sculpture — also present cleaning and infection control challenges. Such items generally are better suited for use in lobbies or waiting areas, rather than in clinical settings.

Exploring Antimicrobial Options

One topic that recently has generated much attention, along with some controversy, is anti-microbial surfaces, such as copper or silver. Antimicrobial surfaces destroy or inhibit the growth of microorganisms. The idea is that such a surface may help to prevent the spread of microorganisms that may lead to disease or infection.

While a growing number of manufacturers offer antimicrobial products and coatings, some experts are sounding a note of caution. Dickey says that although some studies have found that certain elements contain properties that reduce the growth of organisms, it’s not clear whether the studies controlled for environmental cleaning differences.

It’s also not known where antimicrobial surfaces might be most effective and thus worth a greater investment of money. In addition, anti-microbial surfaces aren’t a substitute for proper sanitation efforts, she adds. 

Finally, “it’s not clear that you’ll see a decrease in infection,” says Dickey.

Stroupe adds that cleaning facility managers should be aware that some early research has shown that anti-microbial surfaces might require several hours before they become effective.

“It’s not really easy to make the claim that they are actually helpful,” she says.

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