The Wash Podcast: Manual Handwashing 101

by Meritech, on May 22, 2020 10:00:54 AM

Welcome to The Wash, your trusted resource for the latest and greatest in public health and hygiene, where we will tackle topics like hand hygiene, best practices in footwear sanitization, creating an employee hygiene program, and more!

On today’s episode, we invite Meritech CTO Paul Barnhill to discuss manual hand hygiene - what it is, what the different methods are, why this may not be the best method for your facility. 

You can listen to the podcast using the media player or read the podcast transcript below:

Podcast Transcript: Manual Handwashing 101

Abigail: Welcome to "The Wash" your trusted resource for the latest and greatest in public health and hygiene. I'm your host Abigail Owiesny and in today's  episode we're going to go over everything to deal with manual hand hygiene. We're going to cover, what it is, what the different methods are and why this may not be the best method for your facility.

All right, let's get started. Paul, can you tell us what the different manual hand hygiene methods are?

Paul: Well, you have a manual sink, so you'll have just a standard faucet sink that you go up to and so forth. You can also have what is called a knee or foot pedal sink that you operate and turn the water controls on with either your knee or your foot. Or you may have a multi-user sink, they may come in a flat line, they come as semi-circle or full circle or  they may be photo-eye operated, where you step on a bar and then the whole trough or the whole fountain part of the sink turns on automatically. Those are really the, the three main categories of manual hand washing sinks that are available in the market.

Learn more about different hand hygiene methods in our hand hygiene ebook!

Abigail: So we're talking about all these different manual handwashing sinks how effective are they for pathogen removal?

Paul: It really boils down to that human behavior piece that training of how long it takes to do it.  I've described this in many ways, but the manual hand hygiene process, when doing it right, you have to lather the hands for about 20 seconds it takes time, a few seconds at the beginning to wet the hands, get the water turned on, add the soap to the hands. Rub them together correctly, then rinsing portion that part of it takes that 40 to 60 seconds. One of the challenges when it comes to a manual washing method and pathogen removal is you get a lot of human variable.

With that human variable, are people washing the same way every time? One of the larger challenges when it comes to pathogen removal and really understanding the efficacy is when you go to measure that. So when you police that behavior, you get X amount of response. Okay, so people are doing their due diligence and so forth and so on.

But when you're not policing that behavior, you really get a varied outcome. And so that's one of the difficult things with it. The other thing that's really key about, manual hand hygiene and really when it comes down to the pathogen removal and this steps into a little bit of , the compliance it's really about you onboard that person. And when you onboard that person, you teach them how to do hand hygiene and they do it and so forth. And then as time goes by they kind of don't do it the same way. Maybe we'd be doing it quicker, you know, so forth. So you have to go back and retrain a little bit.

How effective is CleanTech® for pathogen removal? Find out here. 

And that takes time. That takes effort, energy, money, so forth to do it, and you have to go back and re onboard that person a little. Begin to get the hygiene standards you require. Those are factors that always will have to be considered. So you get a peak of people right after training, washing hands correctly, doing it the right way, so forth. That starts to slide down. So you go back and you start that retraining process again and you get that peak, and so you really get this large swings in compliance, which really affects your pathogen removal.

Abigail: So with human behavior it's really difficult for it to remain consistent and meet those different compliance requirements right ? 

Paul: Exactly what I was just kind of mentioning just a little bit ago. It's about that compliance of making sure I'm doing it the same every time, especially when they're not looking, when you're not looking to make sure that everybody is washing correctly and meeting those standards that you require. Using soap, using the right amount of water, doing it for the right length of time, getting all those touch points correctly every time they wash their hands. That really has to do with the compliance piece.

The documentation piece is really, really hard to do to document manual hand hygiene. Again, unless you're policing the behavior watching: how are my people doing? Well, as soon as they realize this, just like they do a, it's called a "secret shopper", but for hygiene in hospitals, they do use a lot. They sit there and watch people and so forth and they're documenting it and so forth. You really, once they figure that out, whenever they see you, that's what they're going to be doing.

Again, it's about policing that behavior. So documentation on a manual system is incredibly difficult ,  it's not easily measured.

Abigail: So really even if you put it perfectly in documentation it's really rare that they're actually going to follow it every single time?

Paul: Correct. It's again, that human behavior piece. Am I having a bad day? Am I having a great day and my buddy is right next to me when I'm washing my hands and I'm chit chatting with him and I'm not really washing my hands well because I'm chit-chatting. There's a lot of human variables in there that we have to take into account and keeping in mind that one of the largest risk factors coming into a food manufacturing plant are the people, and are we following the hygiene standards that corporations established to make sure that we're doing a quality job every time?

Abigail: And really, it's not just about pathogen removal. If you're not paying attention to exactly how you're washing your hands, it could use a lot of water and soap, right? 

Paul: So you're absolutely correct. You look at a manual faucet, you know, when you first turn it on, you turn on and, the water starts flowing and so forth, and you wet the hands that water continues to flow, you lather your hands. Keep in mind that water is still flowing and that water that is going down the drain, it's really never coming in contact with your hands. But that's a manual method, when you have a manual faucet, you have to turn that on and do it. You don't want to touch it again because you'll have a cross contamination event.

With soap consumption, it's, really a human variable piece. It's really hard to deal with,  did I use one squirt, two squirts, five squirts? Do I have massive hands? I just sit and pump that 10 times.

How does soap actually work?

Or here's the other challenge with those methods is when it's empty, does somebody say something about it? For years I've said you can have the best soap in the world, but it doesn't do any good if it's still in the container. So you have to be able to make sure that you have it there, and have people dedicated to making sure that the supplies are ready to go, so you have an adequate way to wash your hands every time, especially when you have your peak people going through. Because when they run out, there's only one thing that usually happens and that's circumvention - they go around the process.

Abigail: And not only is circumvention an issue, but also going over and contaminating your hands just by innocently turning off the faucet, right?

Paul: That is actually a pitfall of a manual hand washing sink with a faucet , you do have those touch points. So when you first come up to the sink, you obviously have to turn on the water, you have to get it to the right temperature, you have to wet the hand, you have to then add soap, you have to done lather and so forth, and you have to rinse. Really then the proper methodology is then you need to reach for a paper product to then be able to shut off that faucet. That way you have a barrier, obviously, the paper towel between the sink and your hand.

Now if your facility that's running an air dryer, it's very hard to shut that faucet back off without touching that, and that's a cross contamination event for the simple fact that I just touched it with an unclean hand to turn it on. I just then redeposited any pathogens could've been left on that faucet back to my skin.

Abigail: Alright. So just a random question that I have: does the water temperature actually affect the pathogen removal and skin health ?

Paul: Well, actually water temperature does affect skin health. I mean, if you have overly hot water, you're actually wicking more oils and so forth from the hand that's going to dry the hand out. Again, when you come into contact with pathogens and you have really dry skin, you're going to absorb those pathogens more.

When you have well hydrated skin, you don't, you do want warm water. For a comfortable compliance hand-wash. one of the challenges of it says, "Oh, I need hot water to be able to remove and kill the pathogens." That's actually a little bit of a misnomer, a lot of the pathogens that we deal with actually have a greater temperature range than our human temperature range.

Why is skin health important for hand hygiene? 

Our human temperature range when it comes to a simple hand wash is really anywhere on the very low end, about 45 degrees, which is really cold water to really about 105 and that's really on the high end. These pathogens, some of these pathogens can live well beyond both ends of that spectrum on temperature.

So you really want it for compliance or if you're dealing with heavy oils and things like that, warmer water helps cause it helps break those fats and things in oils down easier to remove from the skin. But again, you're going to get continued dryness.

Abigail: So Paul is there ever a time when you would actually recommend a manual sink for a facility ?

Paul: When I would choose a manual sink is when I am maybe dealing with heavier soils and debris. I may need to have a little bit of that removal to be able to then wash my hands.

But again, if I'm washing in that manual sink, I'm back to that behavior piece. But there's better ways of dealing with heavy soils and debris, and I have this conversation a lot with a lot of of food processing plants when they're dealing with that. It's best in those situations to actually wear, a disposable glove, that way those soils and debris and so forth are remaining on that glove and they can be disposed of in a waste container.

Now, in those situations where you're not able to wear a glove, they would prefer you to have a bare hand. You can do it a different way, and what I highly recommend is that yes, I'm dealing with heavy soils and debris. I still want to go through a similar process where I actually want to use a paper towel to remove the bulk of that heavy soiling and debris, and I want to put it in a trash can.

Again, the reason for that is that, first of all, I don't want that in my sink for the simple fact that. All that heavy soil and debris could be a potential food source for pathogens. When you turn on manual sinks or automated washers you splash a little bit of  water, you could be splashing pathogens back up.

We don't want to do that. We want to protect the hand as best we can. So we want to look at this thing is how can I avoid risk? So my methodology is use a paper towel, remove those soils and debris, and then I would prefer to go to an automated hand washer at that time.

Abigail: All right, Paul, thank you so much for joining me today to talk about manual hand hygiene. As you guys know, we do try to be a resource for you guys at your facility. So we will have different manual, hand hygiene resources, including hand-washing posters and things down below that you can go over and download. We will also go over and provide a link to our Employee Hygiene Toolbox there we actually have a whole module all about hand washing and how to create a hand-washing culture at your facility so check that out and we will see you on the next episode.

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This podcast is brought to you by Meritech, the leader in automated employee hygiene. Meritech offers a complete line of fully-automated hygiene equipment that provides the only clinically-validated, technology-based approach to human hygiene in the world. Meritech’s line of CleanTech® Automated Handwashing Stations perform a fully-automated 12-second hand wash, sanitize and rinse cycle, removing over 99.9% of dangerous pathogens while using 75% less water than manual handwashing. Meritech delivers employee hygiene, contamination control, and infection prevention programs within a wide variety of markets, including food production, food service, cleanroom, healthcare, medical, theme parks, and cruise lines. For more information call 303-790-4670.

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