ECJ EUROPEAN Cleaning Journal

Products such as soaps, hand towels and air dryers all help to facilitate hand hygiene in the away-from-home washroom. But can the choice of system play a part in encouraging people to improve their hand washing habits, asks Ann Laffeaty?

EVERYONE KNOWS the importance of hand hygiene and the role it plays in reducing the risk of infections. So public washrooms need to be equipped with the products people require to facilitate proper hand washing. This means soaps, hand drying facilities and running water should all be routinely supplied.

But can the choice of soap, dispenser or hand drying system have an impact on how well hand hygiene is carried out? And can washroom hygiene companies actively encourage good habits by offering products and systems that make the process more pleasant, easier or speedier?

It is important to ensure the hand hygiene process is as effortless as possible, says Hagleitner’s senior product manager for disinfection Kerstin Heine. “People want hand hygiene to be quick and easy which means the soap, paper towel dispensers and warm water all need to be available where the hands are going to be washed,” she said. “And end-users will respond better to touchless dispensers because they won’t know who has used manual dispensers before them, and may feel disgusted by them.”

Washroom visitors will be keener to use mild soaps than more aggressive products, she says. “However, all soaps should be functional and in sectors such as the food industry they need to be able to dissolve protein soiling, whereas in healthcare settings the hands are more likely to be disinfected than washed,” says Heine.

The positioning of dispensers can have a key impact on the level of hand hygiene practised, according to Heine. “Hand sanitiser dispensers should be situated in plain sight – for example, at the entrance to kitchens in food environments,” she said.

“In the washroom, too, dispensers should be situated in clearly visible locations rather than hiding them behind closed doors. This is because people are more likely to practise hand hygiene if they feel as though they’re being watched. And where hand hygiene is both accessible and observable, it is more likely to be performed.”

All dispensers need to be visually recognisable in order to encourage good hand hygiene, she said. “For example, brightly coloured dispensers are often used in healthcare.”

Hagleitner dispensers can be placed in stands at different heights to draw the eye and may be inscribed with the words: “Protect yourself and your environment” to encourage good hand hygiene habits. And the Hagleitner senseManagement tool helps to track hand hygiene compliance, says Heine.

Opportunities to practise hand hygiene should be available when and where they are needed in order to influence hygienic behaviour, says GOJO’s UK and Ireland managing director Chris Wakefield. “In healthcare settings, for example, hand hygiene stations should be located within arm’s reach of where patient treatment is taking place whereas in leisure, retail and catering establishments they should be positioned at the entrances and exits to buildings,” he said.

“And offering one final chance to clean the hands before leaving a washroom can make all the difference in reducing the number of germs leaving the room.” According to Wakefield, positioning a sanitising dispenser between 36 and 46 inches above the floor on the handle side of the washroom exit is the optimum height to encourage its use.

A positive experience

All products provided should be kind to the skin and offer a positive experience, he says. “If solutions are too smelly, sticky or runny, users are likely to avoid them,” said Wakefield. “But if people actively like using the products, they will do so more consistently – and this will help to prevent infections from spreading.” GOJO’s Purell Advanced Hygienic Hand Rub is said to be gentle on the skin, even with frequent use.

End-users tend to prefer products that are easy to use and intuitively designed, says Hylab’s product and project manager Joshua Edwardes. “Functionality and design are both essential aspects of a hand hygiene system and the right balance between the two is crucial,” he said.

“Ease of use is also important because it enables users to access soap and paper effortlessly. And while providing clear instructions is beneficial, ensuring the product is user-friendly without relying on extensive directions is equally important.”

He says the supply of appropriate products can prove highly effective at motivating people to improve their hand hygiene habits. “Washroom hygiene products usually work best when they are completely customised to individual customer needs,” he adds.

Convenience, quality and aesthetics are all key motivators when it comes to promoting hand hygiene, he said. “Easy accessibility of dispensers in terms of position, placement and functionality is essential, while a high product quality will reinforce the desire to maintain hygiene,” said Edwardes.

“Appealing designs will enhance the overall experience and encourage usage while clear instructions and motivational messages will further drive the motivation to maintain good hygiene. And when it comes to children: make it fun.”

Hylab dispensers can feature bespoke pictures, logos and hand hygiene messaging to encourage good practices and all units are said to be ergonomic, intuitive, easy to use and quick to operate.
The positioning of the dispenser has a key impact on the level of hand hygiene practised, says Edwardes. “Ensuring that the dispenser is easily accessible and visible to everyone is crucial,” he said. “It should also be placed conveniently away from the sinks to allow ample space for people to use it while others are washing their hands.

“And the design of the dispenser can help to encourage usage and contribute to a positive user experience.”

The goal is not to speed up hand hygiene but to make it easier for people to participate in the process, says Kimberly-Clark Professional product technical leader Stephanie Martin. “The right products should be conveniently located at the point of use and there should be a sufficient supply to support the number of people in the facility,” she said. “It’s hard to wash your hands correctly when key items such as hand soap are out of stock. And having to wait for a sink or an air dryer may also discourage people from washing their hands if they have limited time.”

Washroom managers need to be vigilant about checking product levels while also ensuring all products and dispensers are clean and sanitary, she said. “Soap and hand sanitiser solutions should be non-irritating and any fragrances used should be mild to minimise the chance of skin reactions,” she added. “And hand sanitiser dispensers should be placed in easily accessible, common areas such as near lifts, offices, in hallways, in break rooms and near entrances and exits.

“Also, helping people to better understand the basics of good hand hygiene can help to encourage compliance.”

Common sense needs to be employed when choosing the location of hand hygiene dispensers, according to Martin. “Factors to consider include traffic, height convenience and the proximity to sinks when it comes to soap and towel dispensers,” she said. “For example, someone with wet hands could drip water on to the floor and create a slip hazard if they have to move any distance from the sink to the hand drying facilities.

Minimise barriers

“And locating hand sanitiser stands throughout a building will also encourage regular hand hygiene, even when people are not using the washroom.”

Any barriers to optimum hand hygiene practices need to be minimised, according to Essity’s communications director Jenny Turner. “To eliminate barriers to good hand hygiene we need to ensure all products are easy to use and refill and are accessible to everyone,” she said. “For example they should be mounted within reach of people of all heights and any communication they display should be readable and inclusive.”

Hygiene systems need to be designed with a clear understanding of the end-user’s needs, she says. “For example, it is not ideal if a parent has only one hand available when lifting a child to help them wash their hands – particularly if the dispenser itself is out of reach for the child,” she said. “And refilling some dispensers requires a degree of dexterity for the cleaner.

“In these types of scenarios, access to hygiene can prove troublesome or be slowed down - and this could have an impact on other users and their hygiene, comfort and experience of the facility.”

Good flow essential

A good washroom flow will encourage optimal hygiene practices, according to Turner. “Jet air dryers, for example, can service only one person at a time and they take 10 or more seconds per person,” she said. “As a result, some users may choose to walk away before their hands are completely dry while others may decide not to dry their hands at all because they feel the air dryers take too long. And this will increase the risk of cross-contamination.”

High quality, effective and user-friendly products will all help to support good hand hygiene practices, she said.  “Where frequent hand washing is required, soft paper hand towels and mild soaps with allergy-friendly formulas will help to encourage compliance. And specialist products can help to improve people’s practices in specific environments.”

As an example she cites Tork Odour Control Soap which is designed for use in professional kitchens. This is said to be kind to skin while also helping to remove pungent odours from the hands without adding any fragrance.

Tork dispensers for foam and liquid soaps have been certified by the Swedish Rheumatism Association as being easy to use for children, the elderly and people with limited hand function, while the Tork PeakServe Continuous Hand Towel dispenser requires a low pull force and allows a towel to be taken out in three seconds.

According to Turner, it is not sufficient to simply tell people hand hygiene is important in order to cause a behavioural change. “Significant change can only be produced with the aid of a deliberate programme combining several elements including the right tools for the task; education on the need for hand hygiene and visual reminders such as signage,” she said. “A new habit takes time to form, and it needs to be continually reinforced.”