Healthcare Design - January 2014 - 22

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for fabrics that surpass 500,000 double rubs in a
Wyzenbeek Abrasion Resistant test, which looks at a
fabric's ability to withstand surface wear from rubbing
it with a piece of #10 cotton duck fabric.
Other important considerations are fabrics that are
ink-resistant or "graffiti free" and have moisture barriers that can stop liquid and stains on the surface.
Depending upon patient acuity levels, chairs with
sled bases are preferred to those with four legs, since
legs can be removed and used as weapons. Loose
furniture must be heavy enough to help prevent
patients from throwing it. Attached cushions without
crevices are best to keep patients from hiding contraband in or under them.
Springs, too, can be harmful if removed by a

bial wear layers and mattresses containing ballistic
materials to prevent rips are available. If desired,
beds can be secured to floors to prevent them from
being moved and edges can be sealed with tamperresistant sealant so liquids or contraband can't be
put underneath.
Electronics (TVs, tablets, computers) should be
properly protected with tamper-proof clear resin.
Special cases are available, but they can look too
institutional, making custom built-ins more appealing.
Ceilings and flooring
Sound control and noise mitigation are critical components of comfort and privacy in a health environment, and ceiling and flooring products play a big
role in addressing these issues.
Acoustical ceilings are designed to address sound
absorption and sound attenuation (blocking), but in
a behavioral health setting, specific safety consider22

HCDmagazine.com 02.14

ations need to be taken into account, such as
acuity of patients, level of supervision, and the
height of the ceilings. For instance, patients
have been known to chew and swallow
fiberglass ceiling tiles, fashion weapons out
of metal ceiling grids, and hide contraband in
ceiling plenums.
Conventional ceiling tiles can work if it's
a highly supervised area with low-acuity
patients. When greater security is needed,
security/tamper-proof acoustical metal ceilings are an option.
Specifying cushioned-back, resilient flooring can also help to dampen sound reverberation. For example, Brattleboro Retreat
(Brattleboro, Vt.) installed both security

Top: Creating a built-in seating
nook near the main nurses' station
at Brattleboro Retreat gives patients a place to gather. Acoustics
are addressed through the use of
cushioned-back resilient flooring
and security acoustical metal
ceilings. Above: An activity room
at Brattleboro Retreat incorporates
a mix of bench seating and built-in
and moveable furniture to accommodate a variety of patient needs.
Special attention was given to
millwork details, and integral blinds
within security windows avoid a
need for curtains.

COURTESY OF JOSEPH ST. PIERRE AT JSPHOTOGRAPHY (THIS PAGE AND OPPOSITE)

patient, so chairs that don't contain springs as part
of their construction, such as molded furniture, are
ideal. Soft upholstered foam furniture must not have
any plywood pieces hidden inside.
Furniture should also be free of exterior tags to
prevent patients from hurting someone if a piece is
tossed, and metal vents should be removed, since
they can be used to inflict bodily harm.
Edging details for counters and tables should be
reviewed to ensure that materials cannot be easily
removed. One-piece molded edging is preferred over
plastic laminate self-edging, which can be very sharp
if removed. Solid surface material with bullnosed
edges is a great option for horizontal surfaces,
including nurses' stations and built-in desks.
In the patient rooms, built-in wardrobes or bookcases should have sloped tops to deter ligature.
Some facilities may prefer open units with fixed
shelves over drawers and doors, or consider limiting
wardrobes to a height of 36 inches to avoid them
being used as ladders. Platform beds with antimicro-

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Healthcare Design - January 2014

Table of Contents for the Digital Edition of Healthcare Design - January 2014