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The ChallengeThe ChallengeHospital-associated infections (HAIs) likeMRSA continue to be a problem in healthcare facilities

It is estimated that each year in the US:• 1.7 million patients acquire HAIs• 99,000 patients die from these

infections• 5,000 HAI deaths result from

construction-related activities• Studies indicate invasive aspergillosis

can occur during construction and renovation

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The SituationThe Situation Feedback from our contractors indicated a

growing concern from health care customers over increased patient infections due to cross-contamination from renovations and additions

Health care organizations are in need of construction professionals with the skills to properly contain infectious agents on a job site

Specialized training – focusing on the health care environment – is needed in order for health care organizations to renovate, alter, or expand facilities with confidence

Best Practices in HealthcareBest Practices in Healthcare Construction Training Construction Training

Developed to train crews to minimize risk of hospital acquired infections related to construction activities

Training teaches the best way to protect the facility, workers, staff and most importantly – the patients

Goal is to create the most optimal flooring installation conditions as possible so that the floor does not fail and contaminants are contained

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87% of work is done without properly trained labor*

Improperly-installed floors lead to unsafe conditions for thestaff and patients, which causes...

Disruption to building operations Expensive repairs Loss of facility use Unsafe conditions

Flooring & Healthcare Facilities

*Bureau of Labor Statistics

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Moisture and/or alkalinity in the substrate Improper use of patch or leveling

compound Installation of flooring and adhesive over

poorly prepared subfloor

Improper training for floor installer in a healthcare environment

Main Failure Areas

7Moisture and Alkalinity Awareness

Moisture, and its

rate of movement

through a substrate,

is a critical factor in

the success or

failure a flooring

project.

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One obvious result of

excessive moisture is

the failure of an adhesive

to bond the flooring to

the substrate.

Moisture and Alkalinity Awareness

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When excess moisturemigrates through the

slab,it can carry excess salts

tothe surface. Excessalkalinity can crystallizecreating an extreme bondbreaker.

Moisture and Alkalinity Awareness

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Mold and bacteria

issues can arise from

excessive moisture.

Moisture and Alkalinity Awareness

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Inadequate drying time allotted

Applied too thick

Wrong primer for type of substrate

Gypsum product used on or below grade

Improper Patch or Leveling

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Low spots filled with adhesive, causing flooring to indent

Patch is used instead of underlayment board

Flatness tolerance is not achieved prior to floor installation

Substrate is not checked for flatness

Installed failed to detect surface imperfections prior to installing floor covering

Improper Floor Preparation

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85% of all healthcare 85% of all healthcare flooring installations flooring installations fail due to improperfail due to improper

subfloor preparationsubfloor preparation

Why Do Floors Fail?

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Jobsite Preparation

Substrate is examinedfor high spots or lowareas

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Considerations:

Floor should be smooth, clean, dry Floor should be free of ALL contaminants Examine for construction joints or saw cuts Check expansion joints Achieve flatness tolerance levels Use proper leveling products

Concrete Subfloor Prep

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Wood underlayments are used when the condition of the substrate is not acceptable

It is used to provide a dimensionally stable, smooth surface to receive the new floor covering

Failures arise from: Wood not structurally sound Inadequate fastening of wooden subfloor Use of poor quality lauan resulting in

staining

Wood Underlayments

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Conditions Impacting Adhesion and Contributing to Contaminant Transference:Dusting…Scaling…Flaking…Pop-outs...Delamination…Cracking…and ofcourse: Moisture & Alkalinity

Determine Appropriate Preparation Methods & EquipmentAbrasive-blasting…Scarifying…Bush-hammering…Hydro-blasting

Substrate Assessment for Healthcare

Recognize Presence of ContaminantsDust…Cure & Seal…Acid…Machine Oil…Micro-fractures

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Deliver a workforce of floor coveringprofessionals who understand how

toprotect the patients and staff during

abuilding project, while not disturbingdaily activities.

One Goal

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A Reliable Contractor Should…

Be dependable Perform quality work in a timely fashion Posses proper bonding and insurance Control their own workforce Have access to continuing education for their crews Have access to healthcare-specific training for their crew

Fulfill specification parameters:Fulfill specification parameters:

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SpecificationIt does matter who

installsyour floors.

Use this language to ensure aquality installation: General Quality AssuranceInstallers: Skilled trades people enrolled in a state-approved apprenticeship program, or certified by a program equal to the INSTALL program, which includes all of the following: • Four-year apprenticeship program at 160 hours per year• Career-long training opportunities• Manufacturer-endorsed training• Fundamental journeymen skills certification

This specification can be placed in

these sections of Division 09:

09 60 00 Flooring09 61 00 Flooring

Treatment09 62 00 Specialty

Flooring09 64 00 Wood Flooring09 65 00 Resilient

Flooring09 67 00 Fluid-Applied

Flooring09 68 00 Carpeting

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Healthcare facility managers who understand the proceduresinvolved in construction-related infection control can help toreduce the risks…

Architects who understand the specific risks involved canhelp communicate the facility’s needs to the contractor….

Contractors and workers who understand the issues involvedwhen working in a healthcare facility help to add value,safety and professionalism to healthcare constructionprojects.

Communication is key!Communication is key!

Working Together

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Questions?

215-569-3044 www.installphilly.com