Restroom Care: Encouraging Hand WashingBy Lauren Summerstone
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In 1847, in an effort to reduce his hospital’s mortality rate, Dr. Ignaz Semmelweis asked medical students who worked on cadavers in anatomy class to wash their hands before working with live patients. He observed a 500 percent drop in deaths. Incredulously, despite the sharing of these findings, it took the medical industry 50 years to adopt the practice of hand washing between patients. It even goes against the Hippocratic Oath, established in the 4th century BC: Above all, do no harm.
Today washing up between patients is standard practice in healthcare, yet the struggle to encourage the general public to wash their hands in order to remove harmful pathogenic bacteria remains a challenge. Several years ago the American Society for Microbiology conducted an experiment to find out how many people who said they washed their hands after using a public restroom actually did so, and discovered that only two-thirds were following through. The rest were potentially spreading illnesses like diarrhea, dysentery and hepatitis A.
But the risks of poor hand hygiene don’t stop in the restroom. Microbes carrying cold and influenza can lurk for days on door handles, light switches, desks and computer keyboards. Then one touch to the nose or mouth, and a person is ill. It’s a vicious cycle that can quickly escalate to an epidemic. Symptoms can be hard on a healthy adult, but for children, the elderly and people with compromised immune systems, they can be deadly, leading to flu and pneumonia, which together are the eighth-leading cause of death in America.
These facts present an opportunity for jan/san distributors to bring them to their customers’ attention, improve their bottom lines, and be seen as valuable business partners. Helping clients design systems and specify products that will help protect occupants and employees — and in turn families and communities — from disease, can reduce absenteeism and presenteeism (sick people coming to work), increase productivity, protect funding in schools and help contain escalating group health insurance premiums.
Creating The Right Environment
Aside from having hand sanitizer dispensers at doorways and on desks, the best opportunity to remove harmful microbes from hands is in the restroom, which is best achieved through a combination of a clean appearance, appealing products, the right equipment and appropriate signage.
The cleaner the restroom (even the perception of clean) can mean the difference between building occupants washing their hands with soap for the 15 seconds recommended by the Centers for Disease Control, or bolting out the door. Since people are more apt to spend time washing and drying their hands when the restroom feels healthful and appealing, creating that image is vital — especially during first impressions when people establish the mindsets and habits they’ll carry forward on a daily basis.
“People notice restrooms first in a facility, and that determines whether they go back,” says Daniel Josephs, general manager of Spruce Industries Inc., who works with a variety of New York City and New Jersey schools from kindergarten up through advanced institutions.
Hand hygiene is Spruce Industries’ number one talking point. At facilities where there aren’t sufficient budgets allocated for janitorial staff to keep restrooms consistently stocked, clean and tidy throughout the day, Josephs gives the school nurses statistics, slides and talking points, to make a case. He also gives a presentation to the principles and superintendents, who can then retool their budget.
“If bathrooms aren’t clean our kids aren’t getting an education,” Josephs explains. “Extending the school year — or more cleaning.Both equal more days that the kids are there.”
Matching Equipment And Products To Population
“The right product mix is based on volume,” explains Clarke Hall, senior facilities consultant for Custodial Partners, Newburyport, Mass. “The salesman should go in, ask questions, and make
suggestions on how they can save on labor and products. Low quality product can be just as detrimental as not having product. The first thing I would say is make it easy for them by using a product they would like to use.”
Hall’s first recommendation is foam soap, which he says people enjoy using, and also reduces labor costs by providing up to eight times the number of hand washes as traditional soap. No scent, or a very light scent is recommended for the most universal appeal, and so that it doesn’t aggravate allergy-prone noses. Sensitive skin should be kept in mind, too, especially in the winter, as soap that abrades already-dry skin may dampen enthusiasm for hand washing.
“It’s important to have everything available for hand cleaning,” says Mike Mims, sales representative for Brame Specialty, Durham, N.C. “The easier the dispenser is to use, the better. We’re doing a lot with battery-operated, hands-free dispensers now. They’re easy to load, don’t have the dripping that makes a mess on the counter, and they let you know when product or batteries are running out.”
Other distributors don’t have a preference, or believe that traditional push-style soap dispensers may fare better than automated dispensers, since sensors can falter or batteries can drain. Both can result in unavailable soap.
Hall suggests soap cartridge systems primarily because janitors don’t typically clean traditional receptacles between refills, which can breed bacteria.
“In healthcare it’s a code that you need to remove it and clean it out,” he says. “But that doesn’t happen as often in commercial settings, and then you’re dispensing germs on top of your hands.”
If people are aware of the green nature of products in the restroom, they may also be more apt to utilize them. Studies show that more and more of the public’s purchasing habits are pivoting on products’ environmental friendliness. Some manufacturers offer stickers for dispensers that communicate they’re dispensing a green or green certified product.
Positioning soap dispensers so that they’re easy to reach, and near water, hand-drying equipment, and trash receptacles is another way to make the task of washing easier. It also helps keep the restroom tidier.
Electric or battery-powered hand dryers can encourage hand washing because they don’t run out like towels can, and there is no risk of crumpled paper collecting on counters or floors, or spilling out of trash cans. They can also save on labor by removing the need to refill dispensers and taking the trash out less frequently. New, more powerful models can also dry hands in as little as 15 seconds.
Paper towels have positive attributes, too. Using hand dryers can be a noisy and lengthy process, however. Thus, paper towels provide quick drying, and if automatic dispensers are used, there are no buttons or leverage to touch helping to reduce cross-contamination. Towel dispensers can also be designed to coordinate with other products to dictate an overall tone in the restroom.
Raise Social Awareness
Posters from manufacturers explain the risks, benefits and techniques of proper hand washing, and can be another helpful component. Josephs says that kids have responded very well to posters hung at drinking fountains, and in gymnasiums, locker rooms and cafeterias.
“They are something to giggle about, but they still get the point,” Josephs says, adding that parts of North Carolina experienced a flu outbreak last year, which raised everyone’s awareness of hand hygiene. Commercial buildings were even creating and photocopying their own signs that say, “Please wash your hands.”
“Visible reminders are probably the best thing you can do,” he says.
Josephs reports that the New Jersey Board of Education adopted his company’s program of hand soap, hand sanitizer dispensers in each room, foam soap in restrooms, and posters for two years, and achieved a startling 43 percent drop in student absenteeism.
It’s not hard to imagine similar results in other types of facilities.
“They’ll look at the cost and benefit for themselves and employees,” explains Hall, whose focus on assessing situations and recommending the right equipment and products has earned him the status of a knowledgeable consultant who can help his clients achieve various corporate goals.
“If you can show the features and benefits sometimes you don’t have to worry about cost,” he advises. “I try to educate and do what’s best for the customer, and be a valuable resource for them. I get calls for all kinds of things. I think they trust my opinion.”
Lauren Summerstone is a freelance writer based in Madison, Wis.