News - April 2019
The changing face of bathrooms
With the growing trend for self-contained single-room patient bed spaces in hospitals and care facilities; en-suite bathrooms are now the norm.
And, with sick and often-frail people using these environments, more and more estates managers are opting for wetroom facilities over conventional bathrooms.
The key differential is that wetrooms, on the whole, do away with the need for baths and instead offer step-free shower access, much more suited to those with mobility problems; and perfect for smaller spaces.
A spokesman for washroom specialist, Impey, said: “This approach allows complete showering freedom for those who would struggle to use a conventional bathroom, including wheelchair users or individuals with specific mobility requirements.
“But an adaptable, accessible wetroom relies on the cohesive integration of a collection of skilfully-engineered products which contribute to the user feeling safe, supported and able to carry out simple bathing and toileting tasks with as much freedom as possible.”
Within a wetroom, every piece of accessible showering equipment can be individually important; from the level-access floor former, to a strategically-placed grab rail.
“Importantly, a wetroom must be quick and simple to keep clean and offer easy maintenance,” said Impey.
He advises incorporating the design of the wetroom into the services specification as early as possible as the location of joists, pipework, and concrete flooring will determine the siting of the drain, vents and soil pipes.
“Retrospective fitting is not always possible and can result in delays on site and increased costs, so it is best to formulate a schematic of exactly where the waste outlet will need to be and the positioning of pipes for all bathroom facilities,” he added.
If the wetroom is to be used by people in wheelchairs then there will need to be enough space for a turning circle and potentially a carer to assist.
And, while lighting and electrical works must comply with Building Regulations, they must also be ergonomical and aimed at people with specific health problems such as dementia.
Peter Eckhardt, chief executive of Gainsborough Specialist Bathrooms, told hdm: “Considered lighting is very important, but particularly in environments used by dementia patients.
“Lights activated by motion sensors reduce utility costs and provide the advantage of autonomous use, so are becoming increasingly popular.”
In addition, the choice of surface material is crucial, particularly in terms of infection prevention and control.
Eckhardt said: “Infection control is a key deliverable so that patient and carer wellness is protected. In recent years this has meant that product ranges have evolved to maximise efficient cleaning and to incorporate antimicrobial technology.”
A clean sweep
Ranges from brands such as Altro, Gerflor, and Forbo Flooring Systems offer durable, slip-resistant surface materials that enable thorough cleaning right to the edges of the room. Eckhardt advises:
- Choose products with no pronounced textures or nodules that could harbour bacteria
- Opt for colours that help with wayfinding and identification, particularly when environments will be used by people with dementia
- Use at least a 30 Light Reflection Value (LRV) difference between the colour of wall and floor surfaces and that of walls and doors
- Colour coding of door frames promotes orientation and increases use of toilet facilities
- When choosing flooring, there should be minimal tonal change, typically only a difference of 8-10 LRV, between the wetroom and bed space
In recent years traditional ceramic wall tiles, which were a mainstay of washroom design for decades, have been replaced by modern advanced wall boarding. Examples include Altro Whiterock wall covering with welded seams, and Gainsborough’s BioClad antimicrobial PVC Wall Cladding with BioCote antimicrobial technology.
Moving onto fixtures and fittings, and Impey has fast become leader in fully-accessible wetroom design.
Its Level-Dec EasyFit floor former, which has been fitted in more than 250,000 installations, offers creation of level-access showering facilities across hospital and healthcare settings; creating the ideal drainage gradient to quickly and easily expel waste water quickly and efficiently.
Able to withstand up to 47 stones; it has been designed to meet the key healthcare drivers of strength, durability, and ease of installation.
Eckhardt also advises considering the use of ergonomic shower seats, safety shower screens, and specifying coloured grab rails and handles. These should be installed at pre-determined heights to ensure accessibility to users of all ages and mobilities.
And TMV temperature-controlled mixer or electric units and cool bar technologies are popular as they protect against scalding.
“Showers can be fitted with longer hoses so effective personal care can be provided, whether service users are sitting or standing,” said Eckhardt.
“And smooth walled hoses reduce the risk of skin abrasion and facilitate easier disinfection.
But he warns: “Many older residents and patients, or individuals with complex needs, can find water from overhead rain or rose heads distressing and disorientating. Hence, hand-held shower heads provide more control for carers, so bather anxiety is reduced.”
While there are many toilet designs, simplicity of use is the main priority for the health sector, with Eckhardt advising specifiers to consider compatibility with commode chairs or wheelchairs.
And he recommends the use of back-to-wall toilet pans and simple lever flushing mechanisms as some older people, particularly those with dementia, can be confused by push-button or flush-plate operation.
“The positioning of sanitaryware is critical,” warns Impey, “and proximity to a door must be considered to avoid the risk of crossing a wet floor.
“These considerations are crucial in the design of wetrooms for hospital or healthcare environments, where increased usage will need to be factored in, as well as health and safety requirements.”
Your flexible friend
If incorporating a hoist system, mobile hoists are flexible and can be used in multiple locations, but require more floor space; while overhead ceiling tracks mean hoists are always available, but there are greater cost implications and installation time is longer.
“With the correct system in place, seamless movement between toilet, shower or bath, basin and transfer device is achievable - increasing care efficiency and reducing bather cycle times,” said Eckhardt.
But it’s not just the things you can see that need to be carefully considered.
The combination of warm air and high humidity makes it imperative to provide adequate extraction, not just ventilation.
Eckhardt advises: “De-centralised mechanical extract ventilation (dMEV) fans are ideal as they provide a preventative form of ventilation - continuously extracting humid, moist air, as opposed to traditional intermittent ventilation systems.
“Where possible we prefer to supply an inline fan and site it inside a wall mounted unit/cupboard for straightforward maintenance and servicing.”
He concludes: “There are many variable elements within a bathroom that can affect safety, comfort and dignity for service users along with practical ergonomics for carers.
“To ensure the most-effective specialist facility is delivered, choosing a supplier that provides a complete service is the answer.
“Only by combining detailed surveys, robust planning and design, quality product provision, precision installation, and ongoing servicing; can care provision be high quality and consistent.
“A single source capable of managing all aspects of implementation will reduce hassle and time for internal procurement personnel - ultimately resulting in a more-effective bathroom outcome.”
Looking to the future and Impey said: “Impey’s design philosophy incorporates a pioneering programme of evolution and innovation.
“We value our partnerships with healthcare practitioners who are able to offer insights into the use of products on the ground; which is a hugely-valuable part of the design process and consideration.”