About this series

This series of tutorial articles is a joint project of the Association for the Healthcare Environment and Health Facilities Management.

Given the remodeling trends in health care today, a hospital likely has an area with a newer floor that might be less than six months old and other areas that could be as old as 10 or 15 years.

If environmental services (ES) professionals consider that their facilities probably contain several different flooring substrates, and they have to deal with a wide variety of floor conditions, it can be difficult to develop a consistent maintenance plan.

So, what should ES professionals do? How can they set up reliable systems that their crews can follow consistently to deliver superior results while maximizing a floor's lifespan?

Building a program

As styles change and building décor is updated, more cleaning professionals will find a variety of flooring substrates in the facilities they need to clean. While each flooring type can have some specific recommended care procedures, the basis for developing an efficient and effective cleaning program should be consistent.

Thus, ES professionals first need to identify the existing substrates by grouping them into four major categories: carpet, rubber, finished, and low- and no-maintenance. As they walk through their facilities, they need to map out the location of each substrate, its age, and the wear levels and traffic patterns. Once this information is compiled, ES professionals are ready to move to the next step.

This means building a general program with standard products and procedures that will cover most circumstances. For carpet, that includes regular vacuuming and using an encapsulation product. Rubber floors, on the other hand, need regular sweeping and cleaning with a neutral cleaner. For finished floors, the procedures should include regular sweeping and cleaning with a neutral cleaner and less-frequent cleaning with an alkaline cleaner. Finally, for low- and no-maintenance floors, regular sweeping and cleaning should be undertaken with a neutral cleaner and a fine mop or brush.

A secondary set of procedures also should be developed for circumstances in which general procedures are insufficient to deliver the desired cleaning results. For carpet stains, for instance, an appropriate spotter should be used. An alkaline or enzymatic cleaner should be used for more intensive cleaning on rubber floors. Likewise, ES professionals can use an alkaline cleaner or disinfectant for more intensive cleaning, or an alkaline cleaner at a higher concentration for a scrub and recoat procedure, for finished floors. For low- and no-maintenance floors, an alkaline cleaner and a disinfectant can be used for more intensive cleaning.

Specific characteristics

A closer look at the four major areas of flooring substrates and their specific characteristics provides ES professionals with the technical knowledge they need to carry out the general program. Each substrate presents its own strengths, weaknesses, problems and solutions, and a detailed explanation of each should be basic knowledge for any ES professional.

Carpet. Both natural and synthetic carpets can be used in health care facilities, with synthetic materials making up the vast majority. The most common natural material used in making carpet fibers is wool while the most common synthetics are acrylic, polyester, olefin and nylon.

While wool carpets are not very common in health care, it is important for ES professionals to properly identify them when they do exist. If ES professionals suspect they may have wool carpets, they can cut a few fibers from a discrete portion of the carpet and carefully burn them with a match or lighter. If the fibers burn with an orange flame, emit no smoke, smell like burning hair and produce ashes that crumble to an irregular, black, coarse powder, they are made of wool.

Once ES professionals have determined whether their carpets are synthetic or wool, they can choose compatible cleaning products. To properly care for a wool carpet, for instance, ES professionals should talk to their chemical suppliers to make sure they are using products certified as being wool-safe.

The key to caring for carpets is routine cleaning to reduce the need for more aggressive treatments, which require the use of a lot of water and may twist the carpet fibers significantly, both of which will damage carpets over time. This includes a regular vacuuming schedule and necessary spot treatments.

The carpet in a health care facility acts as a large air filter, trapping a significant amount of dust, pollen and dirt. Regular vacuuming removes many of those particulates, preventing them from either building up over time and making the carpets look dirty or being released back into the air where they can be inhaled. Regular use of an encapsulation product will increase the effectiveness of a vacuuming program with minimal additional work. The encapsulation product will coat sticky particulates and greasy soils trapped in the carpet, making them easier to remove with normal vacuuming.

Some of the most common spotters ES professionals will need are an enzyme spotter for bio-based soils and odors; a general-purpose spotter for unknown stains; a solvent-based spotter for greases, oils and inks; and a food and beverage spotter. The technique used when removing stains is almost as important as the chemistry behind the spotter. ES professionals should remember to use only as much product as needed to remove the stain — more is not always better. They also should blot with a clean terry towel to draw out the stain as opposed to rubbing.

Rubber floors. Synthetic rubber floors are becoming more popular in health care as manufacturers have developed better materials that hold their colors longer and withstand the wear and tear of a high-impact environment. Because rubber floors typically are used in physical therapy and rehab units, children's units, and kitchen or food service units, they take a beating beyond the normal foot traffic experienced by other areas.

Consequently, rubber floors generally are not coated with a floor finish. If ES professionals need to coat their rubber floors with a finish to protect them from damage already present, they should make sure the floor finish supplier is able to deliver a product that is intended for use on a rubber floor. Standard floor finishes used in other parts of the facility typically will lose adhesion and peel off the floor, or crack and flake off under repeated contact from equipment.

Most rubber flooring just needs to be cleaned. Because dry soils and most liquids will sit on the top surface of the rubber, a neutral pH floor cleaner will be sufficient for most daily cleaning needs. As the floor wears and develops surface microcracks that allow soils to start to penetrate the floor, a stronger product such as an alkaline floor cleaner will give better results. If a rubber floor is in a kitchen or food service environment where it will be exposed to grease and other food soils, a chemical supplier can suggest the appropriate floor cleaner to remove the soils without damaging the floor. Typically, it will be either an alkaline or enzymatic product.

Finished floors. Whenever a floor is coated with a new finish, that finish then becomes the primary driver behind the maintenance process, regardless of whether the underlying substrate is vinyl composition tile, sheet vinyl, terrazzo or another material. There are many types of finishes with varying combinations of cleaning, burnishing and repair needs. They are also highly dependent upon the desired look of the floor and the amount of wear and tear the floor experiences.

There are three main types of finished floor cleaners ES professionals should keep: neutral, alkaline and disinfectant.

Neutral floor cleaners will provide a basic level of cleaning and are ideal for routine cleaning, especially in low- to medium-traffic areas. The cleaning performance of these products is almost entirely dependent on the surfactant used, and will vary somewhat with the floor finish being cleaned. Overdosing a neutral floor cleaner can cause minor problems such as streaking a shiny floor and excess foam in the autoscrubber.

For more significant cleaning needs, an alkaline floor cleaner should be used. Overdosing an alkaline floor cleaner actually will start to strip finish off the floor, but this can sometimes be an advantage by using that alkaline cleaner to strip off the top layer of the dirty or damaged finish, allowing ES professionals to do a quick recoat with a couple of coats of finish to refresh the floor.

For disinfecting floors, the most common types of products are quats and chlorine bleach. While they are effective against a broad range of organisms, ES professionals should read the label of any disinfectant to make sure they are following instructions and that the product is effective against the targeted organisms.

It also is important for ES professionals to know the types of disinfectant they are using because they will impact their floor finishes in different ways. Under most standard use conditions, disinfectants will not harm hospital floors. However, quats can leave a sticky residue on a finished floor when used repeatedly at high-dosage levels. If ES professionals run into this problem, they should clean the floor well with an alkaline floor cleaner to remove the residue. Likewise, bleach can damage or strip the finish. In such situations, ES professionals can use an alkaline cleaner at a high concentration to strip off the top finish layers, and then recoat with fresh finish.

Low- and no-maintenance floors. Cleaning procedures for low- and no-maintenance floors are much the same as for finished floors. For routine cleaning in low- to medium-traffic areas, a neutral floor cleaner should be sufficient, while an alkaline floor cleaner will work for more aggressive cleaning needs. The biggest difference between caring for a finished floor and a low- or no-maintenance floor is surface resistance to scratches and soils, and working with textures that are available on low- or no-maintenance floors.

The coating on a finished floor is intended to be a sacrificial wear layer. ES professionals know that, eventually, it will get too scratched and dirty to maintain and ultimately will need to be stripped off. However, a low- or no-maintenance floor substrate comes from the factory with a very hard coating that does not get scratched or soiled as easily as a floor finish. Therefore, it typically is easier to achieve high-quality cleaning results with a neutral floor cleaner than it would be for a finished floor.

A common challenge with a low- or no-maintenance floor is that the floor is often highly textured. Often, manufacturers try to simulate a wood grain or some other textured material that results in grooves or lines in the coating where dirt can stick and microorganisms flourish. If ES professionals have a textured floor, they must make sure to either use a mop with thin strands or a brush with flexible fibers to get into the depressions in the coating. Also, frequent rinsing of the mop or brush with fresh cleaning solution will help to ensure that cleaning efforts do more than just push dirt around the floor.

Getting the best

Floor cleaning and maintenance are successful when the right products and procedures are used under the right program. Hospital ES professionals should review their protocols to make sure they're getting the best out of their floor care programs.

Brian Leafblad is the R&D program leader for institutional facilities at Ecolab Inc., St. Paul, Minn. He can be reached at brian.leafblad@ecolab.com.

Sidebar - How to identify carpet fibers

The simplest test environmental services (ES) professionals can use to determine a carpet fiber's composition is a burn test.

This involves carefully cutting a small amount of fiber from an inconspicuous section of the carpet, holding the fibers with tweezers and burning them with a match or lighter.

As they burn, ES professionals should pay careful attention to the flame, smoke, odor and the ash produced. The most common types of fibers are listed in the accompanying table along with characteristic test results.