Better flooring, better hospitals

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

We are passionate about flooring products and their 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, increasing the risk. This is why it is so exciting to see new products enter the market that can be used successfully in veterinary practices.

Let’s begin with the basics. Slip resistance is measured by a coefficient of friction, a dimensionless value representing the friction between 2 surfaces in motion relative to the normal force at rest. This does not sound very exciting until we realize that the evolution of our understanding of these properties has enabled the development of flooring with measurable slip resistance, allowing consumers to choose safer products. Today, a new measurement, the dynamic coefficient of friction (DCOF), helps us understand how products will perform in different conditions, such as wet and dry. The new standards include the following:

• 0.42 or greater DCOF wet and dry for products used indoors
• 0.60 or greater DCOF wet and dry for products used outdoors.

We would also apply the outdoor 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 increases the risk 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

Nonslip vinyl products

Sheet vinyl flooring products have always been useful to veterinary spaces, as they are affordable, 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, which has a DCOF of 0.44. 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 nonslip 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, are a little more difficult to install because they must be installed over dry slabs, and need to be cleaned with gentle cleaners. This is doable because rubber is naturally antimicrobial. Although rubber products have not yet been evaluated for the DCOF standard, they tend to be very slip resistant when dry and adequately slip resistant when wet. This is why rubber flooring is used for basketball courts and other sports settings.

Two good product lines include the following:

• Nora rubber flooring for health care achieves coefficient of friction ratings greater than 0.90 under the old rating systems, making it one of the best nonslip products for health care.
• Ecore HydroGrip Motivate is extremely durable and is slip resistant when wet and dry. It would be too expensive for an entire health care space but would be perfect for a specialty room such as a canine rehabilitation suite.

For dog play areas

Recycled rubber products

These are less sanitary than sheet rubber products, but they are rugged. Because of 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. When specifying recycled rubber products, we look for the most sanitary versions because the way these spaces are used requires more cleanable flooring.

Our favorite is the Ecore Performance line, which has a sealed top surface that makes it more sanitary than some other recycled rubber products.

For lobbies, client areas, and hose-down areas

Porcelain tile

You heard that right! For those who have not looked at tile products recently, it is time to reevaluate them. Tile has advanced several generations, from a technical perspective, in the past 10 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 slip resistant and 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 0.60, ensuring their safety in wet and dry conditions.

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 more than 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 veterinary journalist and certified yoga therapist Portia Stewart, BS, RYT 500, RPYT, C-IAYT, on the Veterinary Joy Project. The Veterinary Joy Project focuses on sharing independent ideas, 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, CDC, 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