Results

Objective

The purpose of this project is to review and synthesize findings in the literature pertaining to the safety of patients and healthcare workers as it relates to flooring in the healthcare environment.

Methodology

A mixed-method systemic review of the literature was conducted to identify studies that show a relationship between flooring and safety of patient and healthcare workers. This review searched various databases (e.g., MEDLINE, PsycINFO, ABI/INFORM, PubMED, EBSCO) and communicated with known experts to collect qualitative and quantitative data relevant to flooring in healthcare environments, using a rigorous protocol that can be replicated. Search parameters included the following terms: falls, slips, trips, injury, health care, healthcare, flooring, carpet, vinyl, linoleum, rubber, glare, acoustics, contaminants, bacteria, infection, infection prevention, and infection control.

Articles were included if they met the following criteria: 1) peer-reviewed; 2) published in English; 3) published in 1982 and later; 4) theoretical and empirical; 5) addressed healthcare settings; and 6) included attributes of the physical environment, even if specific environmental features were not the research focus. Selection of studies for inclusion was based on an assessment of the quality of each study using a 4-point ranking of evidence-based design research:

1. Systemic review, multi-center studies, and randomized controlled trials
2. Quasi-experimental studies, observational studies with paired data, and interpretive data
3. Non-randomized controlled studies, before and after studies, uncontrolled studies with dramatic results, focus groups, and action research
4. Descriptive studies, case studies, and expert opinion

Results

The evidence-base is emerging to support the business case that designing for safety and quality can improve patient outcomes and safety, promote healing, increase patient satisfaction, and reduce costs. Flooring plays a significant role in the environment, contributing to multiple factors impacting the risk of injury and safety, and contributing to the comfort and well-being of patients and staff. This literature review focuses on infection prevention, including vectors of transmission, recent advancements in antimicrobial treatments, and the role of maintenance in reducing hospital acquired illness; and issues related to injury, including slips, trips, and falls; stress, noise, fatigue, and cost implications to the healthcare system.

Expertise Provided: Independent Research