POLICY # 13.15 TITLE: Hand Washing
ORIGINATION DATE: 12/05
REVISED:
POLICY STATEMENT:
To ensure the
ongoing health, safety, and welfare and children who reside in Satilla Community
Services’ Garden Gate residential program.
BACKGROUND / PURPOSE:
Hand washing
is the most important way to reduce the spread of infection. Many studies have
shown that unwashed or improperly washed hands are the primary carriers of
infections. Deficiencies in hand washing have contributed to
many outbreaks of diarrhea among children and care givers in child care
centers.
IMPLEMENTATION / PROCEDURE:
Situations
That Require Hand Washing
All staff,
volunteers, and children shall follow the procedures for hand washing at the
following times:
a) Upon
arrival for the day or when moving from one child care group to another;
b) Before and
after:
Eating, handling food, or feeding a child;
Giving medication;
Playing in water that is
used by more than one person.
c) After:
Diapering;
Using the toilet or helping a child use a toilet;
Handling bodily fluid (mucus, blood,
vomit), from sneezing, wiping and blowing
noses, from
mouths, or from sores;
Handling uncooked food, especially raw meat
and poultry;
Handling pets and other animals;
Playing in sandboxes;
Cleaning or handling the
garbage.
In child care
centers that have implemented a hand-washing training program, the incidence of
diarrhea illness has decreased by 50%. One study found that hand washing helped
to reduce colds when frequent and proper hand washing practices were
incorporated into a child care center’s curriculum.
Good hand
washing after playing in sandboxes will help prevent ingesting zoonotic parasites that could be present in contaminated
sand and soil.
Washing hands
after eating is especially important for children who eat with their hands, to
decrease the amount of saliva (which may contain organisms) on their hands.
Illnesses may be spread in a variety of ways:
In human waste
(urine, stood);
In body fluids
(saliva, nasal discharge, secretions from open injuries; eye discharge, blood);
Cuts or skin
sores;
By direct
skin-to-skin contact;
By touching an
object that has germs on it;
In drops of
water, such as those produced by sneezing and coughing, that travel through the
air.
Since many
infected people carry communicable diseases without having symptoms and many
are contagions before they experience a symptom, staff members need to protect
themselves and the children they serve by carrying out hygienic procedures on a
routine basis.
Hand Washing Procedure
Children and
staff members shall wash their hands using the following method:
a) Check to be
sure a clean, disposable paper (or single-use cloth) towel is available.
b) Turn on
warm water, no less than 60 degrees F and no more than 120 degrees F, to a
comfortable temperature.
c) Moisten
hands with water and apply liquid soap to hands.
d) Rub hands
together vigorously until a soapy lather appears, and continue for at least 10
seconds. Rub areas between fingers, around nail beds, under fingernails,
jewelry, and back of hands.
e) Rinse hands
under running water, no less than 60 degrees F and no more than 120 degrees F,
until they are free of soap and dirt. Leave the water running while drying
hands.
f) Dry hands
with the clean, disposable paper or single use cloth towel.
g) If taps do
not shut off automatically, turn taps off with a disposable paper or single use
cloth towel.
h) Throw the
disposable paper towel into a lined trash container; or place single-use cloth
towels in the laundry hamper; or hang individually labeled cloth towels to dry.
Use hand lotion to prevent chapping of hands, if desired.
Children and staff
members should use liquid soap. Although adequately drained bar soap has not
been incriminated in transmission of bacteria; bar soaps sitting in water have
been shown to be heavily contaminated with Pseudomonas and other bacteria. Many
children do not have the dexterity to handle a bar of soap. Many adults and
children do not take the time to rinse the soil they have applied to the soap
bar before putting down the soap bar.
By using a
paper towel to turn off the water faucet, people who have just completed hand
washing prevent recontamination of their hands.
Pre-moistened cleansing towlettes do not
effectively clean hands and should not be used as a substitute for washing
hands with soap and running water. When running water is unavailable, such as during
an outing, towlettes may be used as a temporary measure until hands can be
washed under running water. Antibacterial soaps may be used but are not
required.
Water basins
should not be used as an alternative to running water. If running water from an
approved central plumbing source is unavailable, the staff should use a large
container fitted with a spigot and fill it daily with a supply of safe water to
run water over the hands, which are held above a water basin as a temporary
measure. Camp sinks and portable commercial sinks with foot or hand pumps
dispense water as for a plumbed sink and are satisfactory if filled with fresh
water daily. The staff should clean and disinfect the water reservoir container
and water catch basin daily. Outbreaks of disease have been linked to shared
wash water and wash basins.
Single-use
towels can be used. Shared cloth towels can transmit infectious disease. Even
though a child may use a cloth towel that is solely for that child’s use,
preventing shared use of towels is difficult. Disposable towels prevent this
problem, but once used, must be discarded. Many communicable diseases can be
prevented through appropriate hygiene and sanitation. Taps that turn off
automatically or those that can be turned off without using hands avoid the
recontamination problem.
The use of
cloth roller towels is not recommended for the following reasons:
a) Children
often use cloth roll dispensors improperly, resulting
in more than one child using the same section of towel.
b) Incidents of
accidental strangulation have been reported (oral communication, U.S. Consumer
Product Safety Commission Data Office, September 2000).
Assisting Children with Hand Washing
Care givers
shall provide assistance with hand washing at a sink for infants who can be
safely cradled in one arm and for children who can stand but not wash their
hands independently. A child who can stand shall either use a child-size sink
or stand on a safety step at a height at which the child’s hands can hang
freely under the running water. After assisting the child with hand washing,
the staff member shall wash his or her own hands.
If a child is
unable to stand and is too heavy to hold safely to wash the hands at the sink
care givers shall use the following method:
a) Wipe the
child’s hands with a damp paper towel moistened with a drop of liquid soap.
Then discard the towel.
b) Wipe the
child’s hands with a clean, wet, paper towel until the hands are free of soap.
Then discard the towel.
c) Dry the
child’s hands with a clean paper towel.
Encouraging
and teaching children good hand washing practices must be done in a safe
manner. Washing the hands of infants helps reduce the spread of infection, and
washing under water is best.
The facility shall
ensure that staff members and children who are developmentally able to learn
personal hygiene are instructed in, and monitored on, the use of running water,
soap, and single-use or disposable towels in hand washing. Staff training and monitoring have been shown
to reduce the spread of infections of the gastrointestinal tract (often with
diarrhea) or liver. Studies suggest that
training combined with outside monitoring of child care practices can modify
staff behavior as well as the occurrence of disease. Involving the children in
similar education can be expected to improve the effectiveness of staff
training in controlling the spread of infectious disease.