“Nobody wants to get sick, especially when it’s cold and flu season,” Sansoni says. “That’s why facility cleaning managers should make sure the soap dispensers are filled and in proper working order. Properly maintained restrooms with sufficient soap supplies can go a long way to help prevent the spread of harmful germs that can make us sick.”

Choosing soap that occupants want to use also makes a big difference in compliance rates. Bar soap has long since fallen out of favor, leaving most facilities choosing between liquid and foam varieties.

“The perception is foam is better, but I don’t know of any statistical data indicating one is preferred over the other,” Hicks says.

Soap preference is exactly that — a preference. The best way to determine a favorite among building occupants is to perform tests and conduct user surveys. Barnes-Jewish Hospital chose foam soap after a trial run that showed users preferred the bubbles.

Gentle soap is acceptable (or even preferred) over antibacterial in many settings. That’s because the antibacterial properties only work after being on the hands for 15 to 20 seconds, Hicks says.

“If someone does a 3-second handwash, you’re wasting money because you pay more for antibacterial than you do regular, good lanolin soap.”

Also, many antibacterial soaps don’t include moisturizers. That means they can be harsh on hands, which can cause chapping if users don’t follow hand washing with lotion.

“My preference would be to have a good moisturizing hand soap that isn’t going to break down people’s skin, and encourage people to use it as often as they need to,” Hicks says.

The notable exception, of course, is healthcare environments where there are people with compromised immune systems. In those cases, antibacterial hand soap is a must, as is educating users that it takes 20 seconds of contact to be effective.

Also, for antibacterial soaps without a built-in moisturizer, it’s smart to offer hand lotion next to or near every soap dispenser.

“It’s important that healthcare workers have access to lotions that are compatible with the soap and gloves they use, especially in the winter, to avoid dried and cracked hands,” Couch says.

Hand sanitizer is playing a larger role than ever in the hand hygiene battle. It can provide protection when soap and water aren’t available or convenient. Many facilities now offer alcohol-based, antibacterial hand sanitizer gel or wipes in as many locations as possible.

“If it were up to me, there would be one every two feet,” Couch says.

In reality, however, there are limits on the number and placement of sanitizer dispensers. Hospitals, for example, have smoke compartments with strict codes on the amount of alcohol allowed within. Also, placing them next to soap dispensers can lead to confusion.

To be most effective, place sanitizers strategically at high-touch points, workstations, and areas where there are large gaps between restrooms or hand washing stations.