Guidelines for Hand Hygiene Process Control

A list of actions requiring a hand wash is created based on the FDA’s Model Food Code and passed around to be filled in independently. Each team member shares and defends an opinion on average number of hand washes expected per shift. After dividing that number by the hours, you now have an ideal number for hand washes per employee hour.

A preliminary standard is agreed upon and a pilot study is put in motion to capture the actual level. Inexpensive soap dispensers equipped with counting mechanisms are available. The best one has a patented system that captures multiple “pushes” as a single hand wash. Each kitchen hand sink station is equipped with the counting soap dispensers, preferably numbered in order to connect each work group to its most frequently used hand sink.

These units are set to zero at the start of the restaurant’s calendar week, typically the day after a pay period. At the end of that interval, when all the staff hours are readily available, readings are taken at each, then added together and divided by the total man-hours worked, providing an index of actual hand washes per employee hour.

A baseline is established over three reporting cycles, usually three weeks. This commonly produces a significant performance gap and sets the foundation for further actions with numeric goals.

Set Conditions for Success

A walk-through assessment of the space during peak periods is done at this stage. Blocked hand sinks, inefficiencies, and bottlenecks are noted. These “conditions for success” can be reviewed to make it easier for the food worker to do the right thing.

Touch-free faucets facilitate frequent and fast handwashing. Consider adding these to the project, starting with the busiest hand sink and adding the others as budgets permit.

Along with hand sink design choice, location can improve compliance. Too often, original food flows are lost to multiple menu changes over the years, resulting in the wrong sink being located nearest to a high-need hand wash location. Melons are being scrubbed while hand washers wait at this station, well labeled For Handwashing Only.

Hand soap criteria change when staff starts washing more often. Soap must not smell like a harsh chemical. It must be effective, fast rinsing, and kind to the skin. No-touch electronic dispensing is preferred.

Paper toweling, like soap, is no longer a decision weighted by value engineering and purchasing. Paper that is highly absorbent and strong when wet top the specifications. Designs that aid friction improve speed and attract frequent users.

Air dryers are sometimes specified to help keep premises, especially restrooms, clean and uncluttered. Hand drying with disposable paper toweling is not only faster, it is also preferred by the public and is more effective. The friction added by the paper towel typically adds a one log reduction of pathogens. Giving up this risk-reducing level of cleaning is a high price to pay in order to save a renewable resource and some janitorial costs.

Nail brushes can double the effectiveness of handwashing. Used at the start of a shift, a nail brush provides a solid cleanliness baseline for the day. Because of the prevalence of norovirus in restrooms and its low infectious dose, a policy to require nail brushing after use of the restroom is in order. The best practice solution is to choose a fused bristle product. Staple-free bristles eliminate a potential harbor for germ growth and make these brushes recyclable in a dish machine, a power soak system, or a microwave.

Single-use gloves are another key to improved hand hygiene. Here too, the criterion for success is not price. Original quality, fit, appropriateness for task, and durability are the keys.

Motivation and Training

Weight loss provides a useful metaphor for the operator looking to change handwashing behaviors. Dieters have demonstrated that their food choices are not knowledge driven. They know the difference between a celery stick and a French fry, but lapses in self-discipline cause them to favor the fry. Dieting success is far more likely for a dieter wrapped in the discipline provided by a structured program in which weights are watched by a support group.