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There is a movement to make hospital environments less “sterile” and more “hotel-like.” Even so, hospitals must be built with finishes that are designed to withstand rigorous cleaning agents and processes, and that will encourage appropriate and frequent cleaning. Critically evaluate every surface in the PACU for its ease of and availability to cleaning and its compatibility with cleaning products. For example:

• Internal corners should be covered so that matter does not accumulate in 90° crevices.
• All furnishings and cabinetry should be solid and non-porous rather than wood or veneer (which can lift and trap matter).
• Determine the chemical components of the facility’s cleaning products used or planned for use in the PACU and choose furnishings, wall treatments, floor coverings, and cabinetry built to withstand the active components. Caution: Confirm that warranties of items considered for purchase will not be voided due to use of the facility’s routine, hospital-grade cleaning products. Do not expect to add to the facility’s routine hospital-grade cleaning products, as confusion and misuse can ensue. Review any changes to the menu of cleaning agents with the facility’s Infection Prevention and Control, Safety and Environmental Services leadership.
• Current and developing technologies often contain viewing screens and lenses with special cleaning requirements. See the following for a discussion on cleaning products appropriate for hospital environments, and ensure compatibility between equipment and cleaning products.
• Avoid unnecessary horizontal ledges (such as reveals, uneven abutments and ceilings that are not even) and shelving, as they will accumulate dust and supplies. Refer to the item above.
• Equipment suspended from ceiling-hung booms can be remarkably efficient. Ensure cleaning policies include specific instructions to clean the horizontal surfaces of the mounts/booms.
• Floor-mounted equipment and cabinetry must be either moveable or mounted such that the equipment and the floor beneath it can be easily and completely cleaned. Be wary of enclosed spaces that can obscure accumulated matter, such as under a cabinet, around floor-embedded shelving, seismic anchoring or under low shelving. Allow 10 inches between the floor and the solid bottom shelf to allow for floor cleaning.
• Ensure the bottom shelf (10 inches from the floor) is constructed of solid material rather than wire to prevent contamination from floor cleaning activities.
• Ensure that all finishes are wipeable, smooth, and nonporous.
• Semigloss painted surfaces are preferable to vinyl wall covering. Mold growth under vinyl wall covering has been reported, leading to poor patient outcomes (A. Streifel, personal communication, March 2007).
• Avoid carpeting. Floor coverings should be monolithic, such as welded seams or poured epoxy. Many current and developing flooring options provide a pleasant environment, are easy to clean, can withstand industrial cleaners, are noise-reducing, and can be ergonomically superior for healthcare personnel.
• Walls and cabinetry should be constructed using simple lines, without reveals or recesses. Work closely with architects to eliminate such crevices that will accumulate soil and dust, and are challenging to clean.
• Upholstered furniture must be wipeable and able to withstand fluid contaminants without soaking into the fabric or cushion material. There is no technology at present capable of adequately cleaning woven fabric upholstery contaminated with blood, urine, or liquid stool.