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Keeping Clean In Healthcare Facilities

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When specifying plumbing products, seek a balance between cleanliness, design, and water conservation.


Ken Martin, Delta Faucet Co.


In any commercial building, promoting cleanliness and proper hygiene through effective handwashing is important. It is crucial in hospitals, extended-care facilities, and other healthcare buildings frequented by patients with compromised immune systems.

In patient rooms, faucets and sinks should be specified to work together to allow proper hygiene. The faucet spout should have a higher, farther reach, placing the water stream in an easier-to-reach location for the users.

This makes the job of specifying faucets and other plumbing products for public restrooms, patient rooms, and other areas an important one. Indeed, specifiers have much to consider when choosing faucets, fixtures, and other products for restrooms or patient rooms. The trend toward warmer, more inviting interiors has increased the demand for faucets with a more residential look, as opposed to an institutional or commercial design. In addition, water conservation has become increasingly important.

Even so, hygiene and proper handwashing devices are of paramount importance in healthcare-facility design and construction.

There are several things a specifier and a building owner should know to promote and maintain cleanliness. In addition to adopting vigorous cleaning schedules, one of the best ways to promote cleanliness is to reduce the need for people to touch surfaces. Automatic doors and light switches not only make life easier, but also limit the need to touch them, helping keep facilities cleaner.

In public restrooms used by visitors, staff, and patients, this may be accomplished by using products with hands-free technology. A variety of touchless flush valves, faucets, soap and towel dispensers, and hand driers has been on the market for some time. These products are quite effective at promoting cleanliness, as they greatly reduce the need for users to touch any surface in the restroom. However, hands-free technology has evolved over the years, resulting in products that work better and help promote proper hygiene.

The first hands-free faucets contained infrared, intensity-based sensing technology, which measured the intensity of light reflected from a user’s hands or body. A problem with this technology, when integrated within a hand-washing station, is that it tends to operate inconsistently. The sensor’s field of vision can be quite narrow, requiring users to move their hands around in an attempt to activate the faucet. Also, the sensors can sometimes be confused by the environment; a user’s light-colored clothing, for example, can cause the faucet to not work properly. Both of these factors can have the effect of discouraging proper hand washing.

Cleaning the faucet itself also can be an issue. Infrared faucets typically have seams and corners that are difficult to clean, particularly around the sensor window.

One solution to these problems is a new kind of hands-free technology that does not use infrared at all, but instead uses capacitance to detect a user’s presence and activate the faucet. Capacitance is the ability of a body to hold an electrical charge. Developed by Delta Faucet Co., Indianapolis, the Proximity sensing technology, in essence, turns the whole faucet into an ultra-sensitive antenna and creates a 3- to 4-inch field around the faucet. When a user’s hands enter the field, the faucet turns on and maintains a steady stream until the hands leave the field, or until a set amount of time expires.

The benefits of this technology are twofold. First, the faucets are easier to operate, thus promoting more effective hand-washing practices. Second, the faucet body has no seams or sensor windows, making cleaning easier and helping to minimize vandalism.

Some faucets, such as a surgeon’s scrub-up faucet, do not have an outlet flow control, but instead have a non-aerated, laminar flow. This eliminates the column of standing water that remains in a faucet once it is turned off.

For flush valves on toilets and urinals, infrared sensing technology had been the industry standard but is subject to the same problems that the faucets exhibited. To address this, Delta introduced H2Optics technology in 2009, which uses the principles of triangulation to calculate a user’s distance from the flush valve. (The same technology is used in the auto-focus feature of digital cameras.) This technology is more accurate than standard infrared and is not affected by external factors, such as clothing color or skin dryness.

In patient rooms, where hands-free operation may not be desirable, it is crucial that faucets and sinks work together to allow proper hygiene and limit splashing outside the sink. The faucet spout should have a higher, farther reach, placing the water stream in an easier-to-reach location for the user. The sink bowl depth and design can also affect accessibility and splashing. The water stream should not fall directly into the sink drain, or the drain cover should be designed to limit splashing.

In some faucets, internal elements such as aerators are treated with antimicrobial silver compounds to help reduce the growth of microorganisms on the elements themselves. This has no sterilizing effect on the water, but is designed to protect the element that is being treated from microbial growth and degradation. Some faucets, such as a surgeon’s scrub-up faucet, do not have an outlet flow control, but instead have a non-aerated, laminar flow. This eliminates the column of standing water that remains in a faucet once it is turned off.

Some combination or all of the above options should be considered when specifying plumbing products for healthcare facilities.

A more residential look

In the past five to 10 years, healthcare facilities have been built or renovated with more of an eye toward design. Architects are designing facilities to look and feel more upscale and residential, especially in areas where patients and visitors spend the most time. Instead of the institutional, sterile-looking facilities of the past, new facilities are warmer and more inviting environments that have a positive psychological effect for patients.

This has led to the demand for more residential-looking faucets in patient rooms and public restrooms. Residential-grade faucets look attractive but they are not typically designed to withstand the constant use and harsh cleaning agents that commercial faucets endure. Any faucet placed in a healthcare facility-or any commercial building for that matter-must meet Americans with Disabilities Act (ADA) requirements. Until recently, architects and specifiers had few products from which to choose.

The most desired look is a clean-line, minimalist design. Often considered contemporary in residential-design vernacular, minimalist faucets are versatile. They can complement almost any room design. More importantly, they are easy to keep clean. Today, manufacturers offer several faucets that are taken from their residential lines and engineered to meet the needs of commercial and healthcare use. For example, Delta Faucet’s electronic faucets with Proximity sensing technology are fashioned after two of its most popular contemporary styles, Grail and Arzo. The faucets provide a refined, upscale look that many architects seek in public restrooms, especially in healthcare facilities.

Controlling water flow

Healthcare-facility managers are interested in reducing water consumption. This is especially true in the Southwest and Southeast, where water can be scarce. But water conservation cannot come at the expense of hygiene.

It’s Not As Simple As Just Swapping Showerheads

Water conservation is a growing concern in commercial buildings, and healthcare facilities are no exception. As healthcare-facility managers look to conserve water by changing out old faucets, showerheads are an easy target.

Water-efficient showerheads, such as Delta Faucet’s H2Okinetic, typically use as much as a gallon/minute less water than standard 2.5-gpm products. Because showerheads are easy to change, they are a simple fix that can yield dramatic water savings. However, changing the showerhead without regard to the installed compensating valve is inadvisable.

A compensating valve regulates the mix of hot and cold water. When a sudden change in pressure occurs, the valve automatically compensates to ensure the water temperature is maintained within +/-3.6 F.

A showerhead that flows at a lower rate than the compensating valve is designed to deliver could compromise the valve’s ability to react quickly to pressure changes and cause the water to arrive at a higher or lower temperature than the user would expect. To avoid this problem, the specifer must think of the valve and showerhead together as a system.

In new construction and major remodeling, the easiest solution is to specify showerheads and valves rated by the manufacturer to work together. In retrofits, where the showerhead is simply being replaced, specifiers should verify the valve’s designated flow rate and then check with the manufacturer to be sure that the existing valve will work properly with the new showerhead’s flow rate.&emdash;Ken Martin

The challenge for specifiers is to find areas where water conservation can be addressed. In public restrooms, this means specifying faucets with outlets that reduce flow to a half-gallon/minute, which is adequate for proper handwashing. Also, flush valves are available with a dual-flush feature that initiates a flush of 1.1 or 1.6 gallons, depending on the length of time the user is present and the distance from the valve. Together, these two products dramatically reduce water consumption in public restrooms and can contribute to a facility’s LEED certification points.

Other faucets, particularly those used by medical staff, need to give the user more control over the flow and temperature of the water. Examples include nurses’ stations and surgeons’ scrub sinks. In patient rooms, where water conservation is a concern but hygiene is still important, specifiers can look for lavatory faucets that operate at 1.5 gallons/minute but also give the user more control.

Another area to save water is in patient-room showers. It is easy for facilities to save water by retrofitting with water-efficient showerheads. However, it is important to match the showerheads to the compensating valves to ensure consistent water temperature. (See “It’s Not As Simple As Just Swapping Showerheads” for more information.)

Clearly, faucets and other plumbing products give specifying engineers a great deal to consider. While cleanliness is a primary concern, they must also think about the design of the building and water-conservation needs. Manufacturers’ websites, including Delta Faucet’s specselect (, are resources for education and information about sourcing commercial faucets.