Better flooring, better hospitals

Accidents involving slips, trips, and falls occur 90% more often in human healthcare settings than in average commercial settings, making this a major concern.¹ Enormous effort has been put into reducing these risks, and this has led to the development of amazing flooring products with new technologies that make them safer, as well as sanitary.

We are passionate about flooring products and its technical evolution because slips, trips, and falls are also problematic in veterinary hospitals. A veterinary floor might be more likely than a human medical floor to be wet, which increases risks. This is why it is so exciting to see new products enter the market that can be used in veterinary practices with great success.

Let’s begin with the basics. Slip resistance is measured by a coefficient of friction, which is a dimensionless value representing the friction of moving 2 surfaces against each other relative to the normal force of them at rest. This does not sound very exciting until we understand that the evolution of our understanding of these properties helps create flooring with measurable slip resistance, so consumers can choose safer products. Today, a new measurement, dynamic coefficient of friction (DCOF) helps us understand how products will perform in different conditions, such as wet and dry. The new standards are:

• .42 or greater DCOF wet and dry for products used indoors.
• .60 or greater DCOF wet and dry for products used outdoors. We would also apply this standard to indoor surfaces cleaned with water and chemicals, such as in dog kennels.

Let us consider animals, veterinary teammates, and clients. Temple Grandin, PhD, MS, explains that the fear of falling is a primal fear.² When an animal slips on the floor, this provokes an instinctive fear response. It is difficult for an animal to recover from this type of fear. For teammates, slipping raises risks of workplace injuries. Clients slipping creates liability.

Below we have compiled a list of some of our favorite products on the market to reduce slips and falls.

For non-hose-cleaned medical areas

Non-slip vinyl products

Sheet vinyl flooring products have always been useful to veterinary spaces. They are affordable. They are both sanitary and seamless. Sheet vinyl products have improved over the years, and now there are many products with sealed top surfaces, meaning they do not have to be waxed and stripped like the floors of yesterday. But they are slippery, particularly when wet. Fortunately, the need to develop cost-effective, sanitary products has led to many more nonslip sheet vinyl options.

One great example is:

• Altro Symphonia, achieving a DCOF of .44. Altro Symphonia Smooth vinyl flooring. Please note, Altro has other lines of flooring with even greater slip resistance, but they are too difficult to clean in a veterinary setting.

Sheet rubber products

Rubber products are very interesting because they are both non-slip and resilient, which means they have natural cushioning. They can be used in medical spaces in the same places we would use sheet vinyl. However, rubber products are more expensive, a little more difficult to install as they must be installed over dry slabs, and they need to be cleaned with gentle cleaners. This is doable because rubber is naturally antimicrobial. While rubber products have not yet been evaluated for the Dynamic Coefficient of Friction standard, they tend to be very non-slip when dry, and adequately non-slip when wet.

This is why rubber flooring is used for basketball courts and other sports settings. Two good product lines are:

• Nora Healthcare Rubber Flooring Products Healthcare Floor Rubber Floor Covering nora achieve coefficient of friction ratings of greater than .90, under the old rating systems. This makes them one of the best non-slip healthcare-appropriate products.
• ECORE HydroGrip Motivate. This product is extremely durable and is nonslip when wet and dry. It would be too expensive for an entire healthcare space but would be perfect for a specialty room such as a canine rehabilitation suite. HydroGrip Motivate Ecore Flooring

For dog play areas

Recycled rubber products

These are less sanitary than sheet rubber products, but they are rugged. With rubber’s natural antimicrobial properties, recycled products are great in spaces from your favorite workout studio to a dog playroom. In dog play areas, we want a product that is going to be grippy enough for the dogs to run around without slipping. We look for the most sanitary versions of these recycled products when specifying them, as they need to be more cleanable due to their usage.

Our favorite is:

• Ecore Performance line of flooring Performance Motivate Ecore Flooring. We like this one because it is sealed on the top, making it more sanitary than some recycled rubber products.

For lobbies and client areas, as well as hose-down areas

Porcelain tile

You heard that right! For those who have not looked at tile products recently, it is time to re-evaluate them. Tile has advanced several generations, from a technical perspective, in the last ten years. There are endless aesthetic options, price points, and characteristics. If you are worried about grout and dirt, fear not, as this problem has been solved with high-performance epoxy grouts. These grout joints are just as sanitary as the tile. Most importantly, tile is a great product for tough environments, including wet spaces, retrofits, where the existing slabs are in poor condition, and even outdoors. Of course, when choosing a tile, it is especially important for it to be both nonslip, as well as cleanable, as it is likely to be used in areas that will get wet.

One certification we love is Stepwise by Daltile. This label is evaluated for wet and dry slip resistance, and it applies to a wide variety of aesthetic tile options. All options under this label can be used in wet and dry conditions, outside, and inside, and they all meet DCOF criteria of greater than .60, ensuring their safety in wet and dry conditions. StepWise: Superior Slip Resistant Tile Daltile

We expect the science of nonslip flooring to continue to grow rapidly in the next few years. Keep your eye out for amazing products that help keep your team and your animals safe and healthy, so you can focus on caring for animals instead of on your flooring.

Heather E. Lewis, AIA, NCARB, AAA, is an architect with over 24 years of experience designing spaces for the care of animals and the people who care for them. She works with veterinary leadership consultant and professional coach Marnette Falley, MS, PCC, and Portia Stewart, BS, RYT 500, RPYT, C-IAYT, a veterinary journalist and a certified yoga therapist, on the Veterinary Joy Project. The Veterinary Joy Project focuses on sharing independent ideas and insights and innovative thinking to help people who provide care for pets find ease, meaning, and joy in their work. Learn more at www.facebook.com/veterinaryjoyproject.

References

1. Bell J, Collins J, Dalsey E, Sublet V. Slip, Trip, and Fall Prevention for Healthcare Workers DEPARTMENT of HEALTH and HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health.; 2010. Accessed November 15, 2024. https://www.cdc.gov/niosh/docs/2011-123/pdfs/2011-123.pdf
2. Alaburda B. Leverage how animals think differently to handle them with less fear stress. dvm360. August 28, 2022. Accessed November 15, 2024. https://www.dvm360.com/view/leverage-how-animals-think-differently-to-handle-them-with-less-fear-stress