Sanitation & Handwashing

Sanitation has many aspects, garbage disposal, pest control, infection control, and other topics that have to do with cleanliness and protecting health. One part of sanitation that affects all of us is handwashing. We all know about it, yet most of us don’t do what we know we should do.

Wirthlin Worldwide, a consulting company, performed a study on August 10th and 11th 1996 about handwashing. They sampled 6,333 individuals in public places in five major cities in the U.S. They found:

Only 60 percent of the 2,129 people observed in the restrooms of Penn Station in New York City washed their hands after using the facilities.

78% of Chicagoans washed their hands, making them more sanitary than New Yorkers.

74% of women washed their hands, in all of the cities studied, whereas, only 61% of men did.

Another study looked at middle and high school students. It found that after using the restroom:

58% of girls washed their hands, but only 28% of the girls used soap.

48% of boys washed their hands after using the restroom. But even worse, only 8% of the them used soap.

Actually the public does better than the medical profession. A study of doctors found that only 14% washed their hands between seeing office patients. According to a 1992 article in the New England Journal of Medicine handwashing rates in an Intensive Care Unit were as low as 30% and did no better 48%.

The Center for Disease Control (CDC) in Atlanta cites another study done in a long term care facility in Maryland. That study looked at 213 occurrences when staff should have washed their hands. Tasks the staff performed were oral feeding, bathing, transferring, excretory care, respiratory care, dispensing oral medications, wound care, soiled linen changes, and gastrostomy care.

1 of 5

C:\My Documents\DAVE SUN\Inservice Materials 2004\Inservice Materials 2004 Converted\Oregon Sanitatoin & Handwashing Training Packet\Sanitation & Handwashing Inservice.doc

The observers found that:

32% of the time, hands were washed before doing one of these tasks.

They were washed less than 1% of the time during the task, even when they should have been washed.

64% of the time hands were washed after doing one of the tasks.

Long term care employees did better than the general public or the acute care portion of the medical industry.

Some people think that wearing gloves takes the place of washing. Studies have shown that hospital grade vinyl or latex gloves are ripped, torn, or punctured while personnel perform their tasks.

The best way to protect yourself and others around you, is to:

Wash your hands

Put on vinyl or latex gloves

Perform the task

Remove the gloves

Wash your hands to wash away the germs

How you wash your hands is important. A poor job of handwashing help microbes to multiply. BioScience Laboratories observed that:

…without a proper handwash, microbes increased their population numbers when gloves were worn. In sharp contrast, when an effective hand wash was performed prior to gloving, no significant microbial growth was observed. If gloves are worn to prevent microbial contamination, the gloving should be preceded by an effective handwash.

Vinyl and latex gloves provide normal and contaminated microorganisms increased moisture, nutrients, and warmth. This environment helps these ‘bugs” to reproduce better than on bare hands alone.

You should wash your hands anytime that you feel there may be a risk of spreading germs to yourself or others. Many of you are experts in what you do and can help remind others, who may need a gentle hint, when they are performing a task and forget to wash. Some good examples of times when you should wash your hands are, when you:

Start work

Go into the med room

Pass or handle meds

Prepare foods

Serve foods

Before and after lunch and breaks

After you handle money

Before or after using tobacco products

Before assisting a resident

After assisting a resident

Before putting on or taking off makeup or contact lenses

Washing your hands takes time. However, going to the doctor and taking off of work, takes more time. 15% of long term care residents have infections at any given time, and each resident is likely to acquire an average of two infections per year, according to the CDC. For your sake and the sake of those around you, you need to wash your hands.

The proper way to wash your hands is to:

1)Use soap and warm, running water.

2)Wash all surfaces thoroughly, including wrists, palms, back of hands, fingers, cuticles, and under fingernails.

3)Rub hands together for at least 20 seconds.

4)When drying, if possible, use a clean or disposable towel. Pat your skin rather than rubbing to avoid chapping and cracking. Bacteria can enter your body if your hands are chapped and cracked.

5)Apply hand lotion after washing to help prevent or soothe dry skin.

Good handwashing, wearing vinyl or latex gloves, and following Bloodborne Pathogen standards will help protect you and those around you. Now your facility nurse or manager will demonstrate this important technique.

Demonstration:

Lead your staff through the following technique. You may do it with or without soap and water. However, I strongly recommend that you use soap and water. Not only will it reinforce these concepts, it can and will begin a pattern for staff to follow. Your staff should watch the technique, then demonstrate it to you. This is important. Be critical. Being critical does not mean being negative. It does mean watching staff carefully and giving them positive reinforcement and constructive criticism. I strongly suggest that the facility nurse leads the demonstration and the manager and assistant manager assist by watching employees demonstrate the task and by helping them to learn the proper way to wash their hands. Once the staff knows the proper technique management can continue with follow-up monitoring and the proper reinforcement. This can be a fun demonstration. Keep your staff focused on the subject, but do your best to encourage a light and fun atmosphere.

The best way to protect yourself, your residents, and others around you, is to:

Wash your hands:

Use soap and warm, running water.

Wash all surfaces thoroughly, including wrists, palms, back of hands, fingers, cuticles, and under fingernails.

Rub hands together for at least 20 seconds.

When drying, if possible, use a clean or disposable towel. Pat your skin rather than rubbing to avoid chapping and cracking. Bacteria can enter your body if your hands are chapped and cracked.

Apply hand lotion after washing to help prevent or soothe dry skin.

Put on vinyl or latex gloves.

Perform the task.

Remove the gloves.

Wash your hands to wash away the germs.

Always use Universal Precautions and follow the Bloodborne Pathogen Standards.

1 of 5

C:\My Documents\DAVE SUN\Inservice Materials 2004\Inservice Materials 2004 Converted\Oregon Sanitatoin & Handwashing Training Packet\Sanitation & Handwashing Inservice.doc