Ask any health professional or childcare provider what is the most important way to control the spread of disease, and they will unanimously tell you--handwashing! But keeping hands clean when outside the childcare center during field trips is often overlooked. Even without proper facilities, you can take some steps to keep hands as clean as possible.

One of the first steps to controlling the spread of illness in your childcare setting is knowing the appropriate standards for handwashing.

• Why Handwashing controls the spread of illness. Instill healthy behaviors in children by example and by incorporation of handwashing information in health education.
• When National guidelines recommend that all staff, volunteers, and children wash hands upon arrival in the childcare program and when moving between groups; before and after meals, giving medication, or playing in water; and after diapering, toilet use, playing in sand boxes, and handling bodily fluids, garbage, animals, and certain foods like uncooked meat.
• What You need sinks with running water (as opposed to water basins), liquid soap, warm water, and paper towels or single-use cloth towels.
• How Make sure hands are washed thoroughly with soapy lather for at least 10 seconds using comfortably warm, running water (no less than 60° Fahrenheit and no more than 120° Fahrenheit) to remove organisms from the skin and allow them to be rinsed away.
• Where Here is the dilemma! You probably have appropriate handwashing facilities at your childcare site with signs explaining your facility’s policies on when and how to wash. But what do you do when you are off the site?

Field trips pose many challenges for childcare providers, and adhering to appropriate handwashing regimens is one of them. Most state childcare guidelines address many issues related to field trips, but do not require adherence to any handwashing procedures. Adhering to proper handwashing guidelines may not be possible while away from your facility, but it is in everyone’s best interest to keep hands as clean as possible.

Here are some tips to make sure you do not bring infection-causing organisms--and the sniffles or diarrhea--back to your site along with your happy memories!

Many museums, zoos, and other sites you visit with the children will have sinks that can be used for handwashing, usually in restroom facilities. Call in advance to determine what sinks will be accessible and where. If your group is large, you may need to use multiple facilities, with each staff or parent volunteer taking a small group to a different sink.

Review your agenda--have you incorporated time for the children and staff to wash their hands after activities (such as petting animals or exploring outside) and before eating? This can be important if you are traveling with a large group or on a tight schedule.

Even if the site will have a sink and supplies, consider packing paper towels and liquid soap just in case your host runs out. Also, pack disposable moistened cloths and an alcohol-based hand sanitizer for use in an emergency or if the anticipated facilities are unavailable or broken.

Consider this scenario: You are visiting the local museum. It is 15 minutes before lunch, and you have identified the proper facilities, organized the children into groups, and started the handwashing. As you finish with the last child in your group, you turn to see the others playing with the interactive exhibits they enjoyed so much earlier that day.

All your efforts will be in vain if children cannot stay clean before eating, or even if they touch the door on their way out of the bathroom you are using! Consider strategies to keep hands clean as long as possible. Lead children directly to the eating area, use staff or parent volunteers to hold open doors, or make a game out of keeping children’s hands in the air, away from contact, after washing.

Remind children why you are going to such lengths to maintain “clean hands” while on the go--handwashing during field trips is an important health education opportunity.

If no water facilities will be available, you do have some options. Portable commercial sinks with foot or hand pumps are available to dispense water and may be a worthwhile investment if your program takes many field trips to sites without facilities, such as parks or nature preserves.

These sinks must be cleaned and disinfected daily when in use. Also, consider bringing jugs of water with you on your trip, specifically for handwashing. Due to the size and weight of such jugs--added to all the other materials you need for your trip such as lunches, first aid kits and other supplies--this may only be appropriate for small groups.

Barriers such as gloves or chemical substitutes for soap and water such as hand sanitizers are not as effective as running water, and every effort should be made to follow the above procedures when outside your facility. However, the Centers for Disease Control and Prevention (CDC) recommends using alcohol-based handwashing products in emergencies, when running water is not available. Alcohol is a natural antiseptic that has been used in the medical field for more than 100 years because it kills germs in seconds, without water, and evaporates quickly, leaving no residue on the skin.

Remove visible dirt with a moistened wipe, then sanitize. When using an alcohol-based hand rub, you should apply the product to palm of one hand and then rub hands together, covering all the surfaces of hands and fingers, until the hands are dry.

With a little attention to detail, you can make sure everyone on your trip avoids dirty hands as much as possible. And, of course, make sure to remember that everyone--staff included should wash their hands properly upon returning to the childcare center after the field trip!

Scott G. Allen, Executive Director, Illinois Chapter, American Academy of Pediatrics

Henry the Hand, www.henrythehand.com

Centers for Disease Control and Prevention (CDC), National Center for Infectious Diseases, An Ounce of Prevention: Keeps the Germs Away, handwashing section; www.cdc.gov/ncidod/op/handwashing.htm.

National Resource Center for Health and Safety in Child Care, Caring for Our Children, National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, Second Edition; 800-598-KIDS; http://nrc.uchsc.edu

Download a handwashing poster, in both English Hand Washing Poster, and Spanish Hand Washing Poster.