Food Protection Connection: Handwashing — Training Aids

(reprinted from Dietary Manager, May 2001)

According to the American Society for Microbiology (ASM), only two out of three people wash their hands after using a restroom. However, 95% of men and women say they do it. The research presented by ASM also indicates that many people know they are supposed to wash hands, but still don't do it.

In addition, many people fail to wash hands after other events, says the ASM. For example, only 45% of adults know they should wash hands after touching an animal. Fewer than one-third know to wash hands after coughing or sneezing. And only one-out-of-five know to wash hands after handling money.

These findings illustrate two key points:

Many people do not realize all the situations that can contaminate their hands, and
Many people do not practice even the part(s) they know.
Another fact highlighted by ASM is that fewer men wash their hands after using a restroom today than did five years ago. That's right-handwashing is on the decline among men. In healthcare, the CDC says that handwashing rates are good, but fewer than one-third of healthcare professionals wash their hands long enough.

Despite the press handwashing has received as key food protection practice, it is still often overlooked, experts say. Unwashed or poorly washed hands can transfer harmful microorganisms from one food to another, from a food to a customer, or from a person to a food to a customer. For example, not washing hands after using the restroom can transfer E. coli bacteria to food and result in a foodborne illness, say officials.

Beyond food alone, the CDC says handwashing is one of the most important ways to prevent the spread of infection. Today, scientists are saying that regular handwashing could even help stop the spread of antibiotic-resistant bacteria. This is a concern, because antibiotics are heavily used in the U.S., and scientists fear that this heavy use will encourage development of bacterial illnesses that cannot be treated with antibiotics.

Additional research suggests more key facts:

Fingernails are a critical-and often overlooked-area for washing. A nail brush is the best tool for getting this area clean.

Scrubbing hands and using running water are very effective for removing bacteria. This is one reason for the guideline that handwashing go on for 20 seconds.

Antibacterial "soaps" are probably not necessary or significantly more effective for removing bacteria, except in medical environments.

Drying hands thoroughly after washing is important.

A Training Approach

Armed with this information, what can you do to make handwashing real for employees? Three approaches may be helpful. First, recognize the state-of-the-art. Without training, many people do not know when to wash hands. Take nothing for granted. As a manager, you need to spell out your expectations.

Secondly, explain how to wash hands. Emphasize the 20-second rule.

Thirdly, recognize that the results of handwashing are somewhat intangible. Most people cannot see a difference if they follow handwashing guidelines. So, your job is to find a way to provide feedback. One tool for doing this is Glo-Germ, a training aid. This is a product employees can place on their hands before washing. After washing hands, employees can place hands under an ultraviolet lamp. Areas of hands that were not thoroughly washed show up, or "glow." Suddenly, the effects of handwashing become visible and real to participants.

Another Glo-Germ activity allows participants to place Glo-Germ on hands, and then shake hands with others, touch utensils, etc. Afterwards, you can again turn on the ultraviolet lamp to show how particles have spread. This activity helps people understand the power of their own hands in controlling the spread of microorganisms.

Glo-Germ is not actually germs. Instead, it's just particles that show up under proper lighting. It represents one way to illustrate the effects of handwashing in the foodservice environment. Another way to accomplish this is to enlist the help of an infection control nurse in your own organization. Take swabs from employees' hands, before and after handwashing, and have the swabs cultured. After a few days, you can let employees see real bacteria that have grown from their own hands. The advantage of either of these techniques is that you make something that is ordinarily invisible to employees visible and real.

As you approach handwashing training, also consider the most effective way to train. Handwashing is best learned through watching and doing. There are many information sheets you can use to give background to employees. However, the most critical step in training is practice. So, demonstrate proper handwashing, step-by-step, and then ask employees to do it while you coach. Give feedback.

In day to day practice, your job as a manager is two-fold: Set an ongoing example, and watch what others are doing. Posters in the kitchen and handwashing areas can help. Some are available free from websites (see list below). To make handwashing an ongoing reality requires vigilant attention, not just an annual training session. Make your expectations clear, and cover every detail. With careful attention and continuous management, you can help your own employees break through the statistics and prevent foodborne illness.

By Sue Grossbauer