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Healthy
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Hand Washing Works
In this age of technology, there is still no substitute for hand washing. Research shows that children who wash their hands frequently throughout the day have fewer sick days due to colds and stomach illnesses. This translates into healthier children in your program, lower staff absences because the adults have less exposure to illnesses, and parents with fewer absences from work to care for sick children.
Why does hand washing work? People, not objects, are the number one carriers in the spread of "germs" (i.e., bacteria, virus, or fungi). Both adults and children collect germs on their hands each time a contaminated surface is touched, and all surfaces in a childcare environment should be considered contaminated. Scrubbing the hands with soap and warm running water can remove up to 90 percent of germs on the hands.
Most children are exposed to and transfer more germs than adults because they have not established hygiene routines, and they put their hands and many objects into their mouths. Children have an immature immune system and have not developed resistance for many common illnesses, so germs can easily lead to disease.
When to wash hands
Children should wash hands thoroughly and frequently throughout the day, and especially at the following times:
- When they first come to your home or center; you do not know what their hands touched before they arrived!
- Before meals, snacks, or food activities. Children eat many finger foods such as sandwiches, and even "fork foods" may become "finger foods" in childcare!
- After meals; children often put their fingers in and around their mouths while eating, and can then transfer germs from their mouths to other children or toys.
- After outside play, even if hands do not look dirty.
- Before and after playing with art or sensory materials such as water, sand, or modeling clay. These substances can become breeding grounds for germs!
- After toileting or diapering.
- After sneezing or blowing the nose, even if a tissue is used.
- After playing with pets or animals or pet supplies.
Adults also should wash their hands at these times and others, such as:
- Before giving medications;
- Before performing any medical procedures, such as changing dressing, blood glucose testing, etc.
- Before diapering or assisting with toileting.
- After wiping noses.
- Before and after giving first aid.
- After cleaning spills.
Latex gloves are recommended for certain activities to protect both the adult and the child. When diapering a child, for example, the gloves help protect your hands from contamination, and also help protect the child's diaper area from germs or infection from your hands. Gloves help prevent contamination, but wearing gloves does not eliminate the need to wash hands. Sometimes you need to wash your hands before you put on the gloves, such as when giving medication. It is also recommended that you wash your hands when the gloves are removed. Why? Gloves may have small holes in them and bacteria multiply rapidly in the warm environment of the glove. Also, hands are often contaminated from the outside of the gloves when removing the gloves.
How to wash hands?
Soap and running water is the best! Here are some guidelines:
Specify hand washing areas. If possible, identify a sink for hand washing and do not use it for food preparation or other activities.
Check the water temperature. Water temperature should be less than 120 degrees F. to prevent burns. Children have tender skin and can receive serious burns in just a few seconds if the water is too hot. Warm or cool running water is fine.
Rub soap to create a lather over the hands, between fingers, and around nail beds and fingernails for at least 10 seconds. There are many choices in soaps: liquid or bar, fragrances, colors, and antibacterial. Liquid soap can be more useful than bar soap with young children. Bar soap, unless rinsed well after washing, can harbor microorganisms. The liquid pump is easier to keep clean, however, the spout should not touch the skin when soap is being squeezed out.
Children may be more likely to use soaps in fun colors or dispensers, or those with fragrances such as bubble gum or fruits. However, check children's medical information files to be sure they are not allergic to any fragrances, dyes, or other ingredients.
It is not necessary to use "antibacterial" soaps, since germs are easily removed by the rubbing action and running water. Antibacterial soaps contain ingredients that can help kill some disease causing bacteria; however, different ingredients are effective on different bacteria. Further, the antibacterial ingredients may not affect viruses or fungi, which are responsible for most of children's illnesses (e.g., colds, "stomach flu," etc.) Finally, to be effective, the antibacterial lather must be on the hands for several seconds to have any effect.
Hold the hands under running water until the soap lather is gone. Hold hands in a downward position so that the water flows from the back of the hands to the fingertips.
Dry hands thoroughly. To reduce the chance of contamination, use disposable paper towels or an air hand dryer to dry hands. Cloth towels that are reused can harbor and transmit microorganisms.
Use the paper towel to turn off the faucet. Remember, when you went to wash your hands, the first thing you touched was the faucet, so sinks and faucets become heavily contaminated with terms. Some faucets have automatic shut-off valves so you don't have to touch them after washing hands. Otherwise, teach children to leave the water turned on until after they dry their hands. Then, use the paper towel to turn off the faucet before throwing the paper towel in the trash container.
Sometimes soap and running water is not available. In these cases, pre-moistened towelettes with an alcohol base can be used to remove visible dirt. Liquid hand sanitizers do not remove dirt, but they can kill some germs. This is not as effective as washing with soap and water. However, it may help remove some germs from hands.
How can we teach children to wash their hands?
Young children do not know or practice hygienic guidelines automatically. Adults must teach and model the importance of hand washing for young children. Childcare workers should not only model appropriate hand washing methods, but also should draw attention to the activity as they do it each time by saying, "I'm going to wash my hands before I sit down to eat my snack." It is never too early to teach children to wash their hands. For example, before eating and after diapering, wash infants' hands with a moistened towel containing a small amount of liquid soap, and rinse with running water. With your assistance and supervision, toddlers and preschoolers can learn to routinely wash their hands at a sink using soap and water.
Reminders about hand washing can include singing songs as a part of transition routines such as: "This is the way we stack the blocks,wipe the tablewash our hands, etc.so early in the morning." Adults can use wait time while everyone is getting their hands washed to remind children why it is important to wash hands.
Hand washing works! There is no substitute for washing hands with soap and water and with appropriate hand washing practices in the childcare setting, children and staff can be healthier.
By Bernadette Haschke, Ph. D., Associate Professor, Janelle Walter, Ph. D., Associate Professor, Department of Family and Consumer Sciences, Baylor University
Resources
The ABC's of Clean is a program for preschool children, teachers and parents on handwashing. The Soap and Detergent Association, 475 Park Ave. South, New York, NY 10016; 212-725-1262; www.sdahq.org.
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