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The ChallengeThe ChallengeHospital-associated infections (HAIs) likeMRSA continue to be a problem in healthcare facilities
It is estimated that each year in the US:• 1.7 million patients acquire HAIs• 99,000 patients die from these
infections• 5,000 HAI deaths result from
construction-related activities• Studies indicate invasive aspergillosis
can occur during construction and renovation
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The SituationThe Situation Feedback from our contractors indicated a
growing concern from health care customers over increased patient infections due to cross-contamination from renovations and additions
Health care organizations are in need of construction professionals with the skills to properly contain infectious agents on a job site
Specialized training – focusing on the health care environment – is needed in order for health care organizations to renovate, alter, or expand facilities with confidence
Best Practices in HealthcareBest Practices in Healthcare Construction Training Construction Training
Developed to train crews to minimize risk of hospital acquired infections related to construction activities
Training teaches the best way to protect the facility, workers, staff and most importantly – the patients
Goal is to create the most optimal flooring installation conditions as possible so that the floor does not fail and contaminants are contained
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87% of work is done without properly trained labor*
Improperly-installed floors lead to unsafe conditions for thestaff and patients, which causes...
Disruption to building operations Expensive repairs Loss of facility use Unsafe conditions
Flooring & Healthcare Facilities
*Bureau of Labor Statistics
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Moisture and/or alkalinity in the substrate Improper use of patch or leveling
compound Installation of flooring and adhesive over
poorly prepared subfloor
Improper training for floor installer in a healthcare environment
Main Failure Areas
7Moisture and Alkalinity Awareness
Moisture, and its
rate of movement
through a substrate,
is a critical factor in
the success or
failure a flooring
project.
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One obvious result of
excessive moisture is
the failure of an adhesive
to bond the flooring to
the substrate.
Moisture and Alkalinity Awareness
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When excess moisturemigrates through the
slab,it can carry excess salts
tothe surface. Excessalkalinity can crystallizecreating an extreme bondbreaker.
Moisture and Alkalinity Awareness
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Mold and bacteria
issues can arise from
excessive moisture.
Moisture and Alkalinity Awareness
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Inadequate drying time allotted
Applied too thick
Wrong primer for type of substrate
Gypsum product used on or below grade
Improper Patch or Leveling
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Low spots filled with adhesive, causing flooring to indent
Patch is used instead of underlayment board
Flatness tolerance is not achieved prior to floor installation
Substrate is not checked for flatness
Installed failed to detect surface imperfections prior to installing floor covering
Improper Floor Preparation
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85% of all healthcare 85% of all healthcare flooring installations flooring installations fail due to improperfail due to improper
subfloor preparationsubfloor preparation
Why Do Floors Fail?
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Jobsite Preparation
Substrate is examinedfor high spots or lowareas
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Considerations:
Floor should be smooth, clean, dry Floor should be free of ALL contaminants Examine for construction joints or saw cuts Check expansion joints Achieve flatness tolerance levels Use proper leveling products
Concrete Subfloor Prep
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Wood underlayments are used when the condition of the substrate is not acceptable
It is used to provide a dimensionally stable, smooth surface to receive the new floor covering
Failures arise from: Wood not structurally sound Inadequate fastening of wooden subfloor Use of poor quality lauan resulting in
staining
Wood Underlayments
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Conditions Impacting Adhesion and Contributing to Contaminant Transference:Dusting…Scaling…Flaking…Pop-outs...Delamination…Cracking…and ofcourse: Moisture & Alkalinity
Determine Appropriate Preparation Methods & EquipmentAbrasive-blasting…Scarifying…Bush-hammering…Hydro-blasting
Substrate Assessment for Healthcare
Recognize Presence of ContaminantsDust…Cure & Seal…Acid…Machine Oil…Micro-fractures
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Deliver a workforce of floor coveringprofessionals who understand how
toprotect the patients and staff during
abuilding project, while not disturbingdaily activities.
One Goal
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A Reliable Contractor Should…
Be dependable Perform quality work in a timely fashion Posses proper bonding and insurance Control their own workforce Have access to continuing education for their crews Have access to healthcare-specific training for their crew
Fulfill specification parameters:Fulfill specification parameters:
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SpecificationIt does matter who
installsyour floors.
Use this language to ensure aquality installation: General Quality AssuranceInstallers: Skilled trades people enrolled in a state-approved apprenticeship program, or certified by a program equal to the INSTALL program, which includes all of the following: • Four-year apprenticeship program at 160 hours per year• Career-long training opportunities• Manufacturer-endorsed training• Fundamental journeymen skills certification
This specification can be placed in
these sections of Division 09:
09 60 00 Flooring09 61 00 Flooring
Treatment09 62 00 Specialty
Flooring09 64 00 Wood Flooring09 65 00 Resilient
Flooring09 67 00 Fluid-Applied
Flooring09 68 00 Carpeting
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Healthcare facility managers who understand the proceduresinvolved in construction-related infection control can help toreduce the risks…
Architects who understand the specific risks involved canhelp communicate the facility’s needs to the contractor….
Contractors and workers who understand the issues involvedwhen working in a healthcare facility help to add value,safety and professionalism to healthcare constructionprojects.
Communication is key!Communication is key!
Working Together
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Questions?
215-569-3044 www.installphilly.com
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