INTERIOR SURFACING


Figure 2: Some of the key design parameters for surface materials used in healthcare settings.


can also help prevent and mitigate infection spread – by helping to reduce the survival of microorganisms on surfaces, and preventing their spread by limiting the number of transmission routes. Choosing materials that are easy to clean and disinfect ensures a higher level of surface hygiene, and thus reduces infection risk. Good surface hygiene can also help prevent bacteria and other microorganisms accumulating – which can lead to the development of antibiotic- resistant strains. The selection of hygienic surface materials is thus an essential component of a comprehensive infection control strategy.3


This choice should be


made by a certified healthcare designer to ensure adherence to international standards. Figure 1 shows some of the key potential hygiene measures within hospital settings that designers should consider.


A complex decision-making process Choosing surfacing materials for healthcare facilities is a complex decision- making process that involves a number of stakeholders – e.g. architects, engineers, designers, Estates and Facilities personnel, and other healthcare professionals – including clinicians and Infection Prevention and Control teams. Each has different priorities. Architects may prioritise aesthetics and colour, whereas infection control practitioners may consider materials’ hygienic properties the most important. Conflict of interests can arise – making selection more challenging. However, the hygienic properties of materials should not be compromised for aesthetic reasons. The selection process must consider a range of factors, including durability, cost, ease of maintenance, and,


58 Health Estate Journal March 2024


most importantly, the hygienic properties of the materials.4-7


Alongside highlighting the importance


of hygienic surfacing materials, I will be looking to provide an overview of the current methods designers use to select such materials for hospitals. These include multiple-criteria decision-making (MCDM) and Choosing by Advantages. Hospitals are among the most challenging environments in which to maintain a clean, hygienic environment, due to the constant throughput of patients, visitors, and healthcare professionals. HAIs can be a major threat to patient safety, and hospitals must take all necessary steps to reduce infection risk. According to research by Otter et al,2 contaminated surfaces play a significant role in the transmission of certain pathogens which result in HAIs, both on a regular and epidemic basis. The increased risk of acquiring an infection in a room previously occupied by a patient with a hospital pathogen can be reduced via improved environmental decontamination. There is thus a clear need for enhanced surface decontamination to minimise the risk of transmission through contaminated surfaces.3 One effective way to reduce HAIs is


by using hygienic surfacing materials – and their design and selection play a crucial role in the extent of transmission. For instance, using smooth, non-porous surfaces such as glass, stainless steel, and certain plastics, can significantly reduce the adherence of microorganisms, minimising transmission risk. In contrast, textured surfaces – such as fabrics, carpets, and some types of paint – can trap contamination and microbes, making


them difficult to clean and disinfect.8 However, the relationship between surface roughness and cleanability is not always straightforward. While materials with rougher surfaces often demonstrate poor cleanability, the hygiene level of a material is primarily dependent on its surface texture’s capacity to retain contamination. It is important to consider the depth of the inwardly directed portion of the surface profile to accurately assess this.9


Inherent qualities Hygienic surfacing materials are designed to prevent the accumulation of contamination and microbes on surfaces, making them easy to clean and disinfect. Their effectiveness in reducing HAIs is due to their inherent qualities. Firstly, they are non-porous; secondly, they are resistant to chemical and physical damage – making them easier to clean and disinfect without damaging the surface, thirdly, they have antimicrobial properties that inhibit the growth and spread of microorganisms, and – lastly – hygienic surface materials are durable, which ensures that they remain effective for long periods. The use of hygienic surface materials in hospitals can significantly reduce the transmission of pathogens and prevent HAIs.3,10 When selecting hygienic surface


materials to reduce HAI risk, factors to consider include ease of cleaning and maintenance, durability, resistance to damage, and compatibility with cleaning agents.11


It is also important to consider the


type of surface, the frequency of contact, and the potential for contamination, plus the material’s ability to inhibit growth of bacteria, fungi, and viruses.12


Other factors, such as aesthetics and visual impact, cost,


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