Developing a hospital floor cleaning program

Floor-cleaning equipment should be inspected before use to ensure safety. | Photo by Rock Jensen

In hospitals and health care facilities, there are few cleaning techniques that can make an impression like a well-maintained floor. From the moment visitors walk into the facility and glance around, their first impressions of the overall cleanliness are made by how the floors are presented.

Walk-off mats, though not a part of the physical act of cleaning floors, are essential aspects of the floor-cleaning process. They do more than just protect people from slips and falls in wet environments. They are the first line of defense in removing and preventing dirt from coming into a facility.

Matting placement should effectively remove the dirt in a systematic way. An aggressive scraping mat placed outside of the entrance can remove up to 50 percent of the soil before it enters the building. Designed to collect the bulk of the dirt, the scraper should be at least 6 feet long and as wide as the doorway so it allows two steps with each foot.

Key components

Floor care in hospitals includes key steps that combine to make the floor care process more efficient, reduce wear and abrasion and extend the life of the floor. Skipping these steps will only mean more long-term labor and expense.

The inside of the door should be followed by 15 feet of a wiping-type matting to remove any dust or soil that might remain on the shoes. This will ensure three steps per foot for the cleaning process. Environmental services (ES) managers must remember to change matting when it is soiled. This may require daily changing when soiling is heavy.

Finally, safety is paramount when performing any floor care maintenance. ES managers should ensure the appropriate use of “Wet Floor” or “Caution” signs anytime a wet-cleaning process is to be performed. Managers should ensure that the sign or caution tape is placed so that it will alert someone before entering the work area. Staff should wear appropriate protective equipment such as safety glasses, gloves and nonslip footwear.

Any equipment that might be used should be inspected to ensure its safety. Likewise, ES managers should think about the chemicals that will be used and their hazardous-response procedures.

Maintenance intervals

Using the appropriate tools and chemicals for each part of the floor care process will avoid damage to the floor care surface. Using the wrong product will void the floor manufacturer’s warranty and could mean significant expense to replace any damaged flooring.

In general, floor care maintenance is divided into three frequencies. These processes specifically are for vinyl composition tile and vinyl flooring surfaces:

Daily maintenance. As the name suggests, this is a routine process of removing dry soiling such as dust and dirt through vacuuming, dust mopping and damp mopping. By following these simple processes frequently, the hospital can extend the time between more aggressive and costly processes.

The first step is to remove the dry dust and soil not removed by the matting. This is most efficiently accomplished by vacuuming carpeted surfaces and dust mopping, then damp-mopping hard floors. This should be performed daily at a minimum and more often when conditions require. The dirt removed at this point in the process doesn’t have to be removed later with more aggressive processes and expense.

This daily cleaning should be performed more frequently at all entrances and less frequently farther into the center of the facility. Microfiber products are effective when used dry or with water because microfiber cleans surfaces mechanically, not chemically, by scraping the surface with microscopic precision.

The best chemical for mopping most hard-surface floors is a neutral — pH between 6 and 7 — floor cleaner that has no strong alkaline ingredients that might remove polish. Outside of surgical and invasive practice areas, floors in patient areas are not typically considered sterile environments.

If a health care institution requires that disinfectants be used on floors, a quaternary product should be used, followed by a neutral floor cleaner to rinse the floor after the disinfectant has dried. ES managers should ensure proper dilutions of all chemicals to prevent excess chemical residue on the dried floor.

Periodic maintenance. This consists of more aggressive methods, which incorporate scrubbing, buffing and burnishing. Depending on the traffic volume or location of the particular floor, this could require daily maintenance or it might be performed weekly or semi-weekly.

Again, higher-frequency scrubbing is performed in locations closer to facility entrances and in high-traffic areas vs. locations toward the center. When creating floor-cleaning schedules, this methodology should be utilized to ensure that time is spent where needed.

All floors should be dust mopped prior to using a floor-scrubbing process to prevent excess dirt from accumulating on the scrubbing pads and equipment, and being sucked into the vacuum motor system or scrubbed into the floor finish. After placing safety or caution signs in the area, the floor is ready to be cleaned. The floor scrubber uses a process of placing water or cleaner on the floor, scrubbing with moderately abrasive nonwoven pads, and then removing the water with a vacuum. This is typically done in one continuous process as the machine passes over the floor.

A pH-neutral floor cleaner or similar product can be used in the floor scrubber. If there are individuals with respiratory sensitivity in the area, water can be used. The operator should make overlapping passes with the machine in the center of hallways and corridors where most traffic occurs, and only one pass near the walls where there is less traffic. If this is performed late in the evenings, nursing can be consulted to see if patient room doors can be closed to limit disturbances.

Burnishing restores a gloss or shine to a clean, dry floor. A soft, light-colored pad that is less abrasive is used on the bottom of the burnisher to move across the floor surface. Burnishing is when the pad levels out any light scratches that could catch dirt, heating up the floor finish and mildly reshaping it before finally smoothing out the top layers. Care must be taken in this process to ensure that the burnishing pad is constantly changing locations so as not to “burn” the floor finish.

Spray buffing is a process that uses a specially formulated solution that is sprayed on the floor and then immediately buffed with the machine until dry. This process levels and fills scratches and reduces the need for more aggressive floor care maintenance, plus it enhances the floor’s glossy look. This process is more time-consuming than burnishing, but can be useful in high-traffic areas.

Restorative maintenance. Stripping is the most aggressive aspect of floor care and is performed when the finish has become degraded and cannot be maintained with scrubbing and burnishing to provide the desired shine and protection.

The restorative process consists of removing the remaining old finish from the floor surface and applying new layers of finish. Stripping solutions are aggressive and caustic. Care should be taken to protect skin, eyes and clothing from splashes. Nonslip protective shoe coverings should be used because the floor surface will become slippery during this process. The stripper’s pH should be between 8 and 9, but not exceed 10 to prevent damage to the floor surface.

The process consists of spreading the stripper onto the floor surface. The floor must remain wet the entire time ES professionals are working with the stripper so they should not spread out more stripper than they can work with in a few minutes. After applying the stripper, it should sit for a few minutes to start dissolving the remaining floor finish. While the floor is wet with stripper, ES professionals use a floor machine with an aggressive black pad on the bottom to scrub and remove the finish.

A putty knife or scraper also is useful in removing floor finish in corners, along walls or in tight locations. Before the stripper dries, it should be rewetted with additional stripper to continue working or removed with floor vacuums. The floor should be rinsed completely with water when stripping is complete.

Applying new floor finish is the most critical aspect of the entire process. Though floor finish application can change from different manufacturers, some aspects are the same. The first coat should be applied thinly. A flat-finish mop is good for this purpose. If the first layer is too thick, the finish can adhere or cure improperly, ruining the other coats.

The typical application process is to outline the room with finish, then work back and forth across the floor. ES professionals should allow time for the finish to dry completely before applying the next thin coat in the same manner. Six coats should be sufficient. Areas with less traffic require fewer coats. 

Rock Jensen is senior consultant for Soriant Healthcare in Milton, Ga. He can be reached at Rock.Jensen@sorianthealthcare.com.