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Preview: handwashingforlife® - Reducing the Risk of Illness by Overcoming Underwashing™

Handwashing for Life


Handwashing for Life Olympics: Battle at Waterloo

Thu, 07 Dec 2017 16:50:28 +0000

Originally published in the 11-20-17 edition of Food Safety News. Republished with permission. Pathogens met their Waterloo as more than 400 culinary professionals staged a two day pursuit of the latest advances in nutrition and food safety. The annual campaign is sponsored by Martin Brothers, a regional distributor focused on the culinary needs of hospitals and nursing homes. The location was the Waterloo Convention Center, celebrating the famous five Sullivan Brother patriots who fought together and unfortunately died together in WWII. The two-day event opened Nov. 15 with an afternoon of competition to determine the best-of-the-best culinary handwashers. The Handwashing for Life Olympics continued the spirit of war, a war on healthcare acquired infections, the dreaded HAIs. Contestants pledged to do their part by stepping up their handwashing, the single greatest contributing factor to the 380,000 annual deaths attributed to infections acquired in long-term care residences across the United States. Participants learned by active engagement. The goal was to deliver the knowhow and support materials to conduct this unique behavior-changing training program back at their base facilities. The instructional design of the program is based on the power of personalized and visualized learning. Contestants discover for themselves that effective handwashing is a skill and must not be trivialized at any organizational level. Many were surprised to discover that their handwashing was less than perfect and in a few cases, far less. They learned how calloused skin is hard to clean and how important it is to keep hands hydrated. Scoring of the handwashing skills followed the Handwashing for Life ProGrade protocol. Brevis simulated germ UV-lotion is applied and washed off. Missed spots get a 1 point deduction and missed areas cost contestants 5 points. A perfect score of 100 was achieved by one person, Mark O’Connell, who is culinary services coordinator at Evergreen Senior Living in Chillicothe, IL. Administrators were reminded of their role of leadership in the pursuit of enhanced handwashing as they rolled up their sleeves and entered the competition. There was a common concern expressed in the chitchat surrounding the event. Implementing responses to the constant flow of new regulations is a “major competitor” to hand-washing training. Multi-topic training sessions and motivational presentations rounded out an the agenda. Roxanne Hassman, a Martin Brothers category manager, summed up the event: “Our culinary clients return every year hungry to learn and appreciate the environment created by our staff, a staff that truly cares and it shows.” [...]

Handwashing: Frequency vs. Quality

Mon, 04 Dec 2017 22:00:46 +0000

Collaborative handwashing assessment Sixty-two healthcare culinary professionals volunteered to share their opinion of handwashing at their establishment, a kitchen in either a hospital or nursing home in the Midwest. The objective of the qualitative research was to highlight the two primary dimensions of handwashing, the quality of the outcome and the handwash frequency. Each requires a very different solution. This exercise serves to raise awareness when assessing the risk of outbreaks and provides guidance for improving both the quality and frequency, using the standards of continuous improvement. Each participant was asked to align a dot on a chart representing the quality of the wash - the “percentage of safe” reached on average by all the kitchen staff. They were then asked to affix their dot to the chart where the quality line intersects their estimate of handwash frequency – the “percentage of safe” reached on average again by the total kitchen staff. Results displayed on the chart revealed first that handwashing was well below a safe level in both quality and frequency. Secondly, the quality fared better than the frequency. There is not even one dot in the quadrant representing high frequency and low quality. The patients and residents being served at the facilities identified in the lower left quadrant are clearly at risk. Their staffs are grossly failing on both measures. Even those served in the upper right are huddled far from safe. The far upper right, where the 10s meet, are the levels the participants considered safe. The nearly blank lower right quadrant suggests that those doing well on frequency also are doing quite well on quality. The upper left shows many of the people low on frequency are high on quality. "They don’t wash often but when they do, they are thorough” reported one of the participants in a moment of reflection. The call for standards The most impassioned comments came along with the ratings in low quality-low frequency area. Of those standing around the open voting, there was a feeling that these 10 people were the most honest. There was one pair of voters who approached the chart and after the senior of the two documented her view, the junior person returned her dot without voting. Resolving these issues starts with setting agreed standards. The Handwashing For Life’s ProGrade™ protocol is one simple but effective alternative for setting the quality expectation: A frequency standard is next but without a tracking system to verify, this is generally an ineffective exercise. Verification is a game changer when wanting to improve on the frequency dimension: Electronic handwash monitoring can be a major help in kitchens where observational protocols are proving ineffective. Handwashing For Life® proposes operators use this simple qualitative instrument in taking the pulse of their handwashing. The exercise increases the discussion, raises awareness of issues, guides training and shines a light on possible risk-based solutions. It is another helpful tool to initiate collaborative solutions. [Note: When this same exercise is conducted in non-healthcare foodservice, mainly restaurants, the clustering now seen in the upper right moves to the upper corner of the lower left. Might this reflect higher staff turnover in non-healthcare foodservice and/or might there be a higher level of concern and commitment due to the immune compromised residents and patients? Or is this too much of a stretch of participants’ approximations to draw such conclusions?]  File Attachment:  AttachmentSize ServeReady Frequency vs. Quality3.96 MB [...]

Thanksgiving’s Top 10 Tips For Healthy Hands & Wellness

Sat, 18 Nov 2017 14:00:00 +0000

Tags: Hand HygieneFood-borne illness Thanksgiving, the eater's favorite holiday. Ours always starts on Wednesday with a little pre-prep and gathering last minute supplies. As joyous the occasion, it’s also a special feast day for bacteria and virus, particularly for salmonella and norovirus – the poster children for holiday pain. Staying well can make the difference between a memory of magic or misery. Good hand hygiene can do more for protecting holiday health than an over-cooked Turkey.  Salmonella celebrates this one more than most. First with the turkey and then joined by the encampment of the rest of their family in the shell eggs. It’s easy to forget the family-unfriendly norovirus, the common cold and the flu. They too love the holidays. People are stressed and their army of defenses is weakened. Enter Jimmy with the runny nose and Jamie with the grumbling stomach. They can’t stay home without a babysitter. Everyone wants to see them. Their situation is a lot like an ocean cruise. “We’re committed. We are going!” And going and going until the ship is returned to port. Consider fortifying your defenses during this 5 day siege to follow the food and avoid the foodborne. On Wednesday: 10. Retire the reusable kitchen hand towels in favor of single-use paper. Convenient pop-up boxes are available at Office Depot and Staples.9. Get an accurate food thermometer. Check for accuracy with boiling water or inserting in ice water. Use it for heating, cooling and reheating.8. Train the resident family to wash their hands first thing on returning home.  They were out shopping for pasteurized eggs as we enforce a holiday ban on shell eggs other than pasteurized.7. Agree the rewards and punishments for complying with the temporary heightened standards. No turkey for anyone missing a handwash after using the bathroom. Extra handwashes earn extra servings or a glass of port. Thursday 6. Welcome guests with a hug or a fist bump.5. Introduce guests to your Holiday Wellness Habit of periodic use of Purell - especially if anyone has a cold or tells you how sick they were yesterday. Cruise liner Rules In Effect!4. Don't overcook the turkey. 160 - 165 F keeps the white meat moist. 170F is best for the dark meat. At 180F, everything is ruined. Remember to let stand for 5-10 minutes as the temperature will rise at least 5 degrees F. It’s part of the cooking process. Friday/Saturday/Sunday 3. Maintain the rhythm of wellness while reheating leftovers.2. Eat or freeze all the leftovers rather than sending granny home with a special assortment of salmonella sandwiches.1. Tighten the loosened belt if you can! Goodbye hugs all around. [...]

Soap Formulated For Frequent User

Wed, 20 Sep 2017 20:14:36 +0000

Chemical irritants removed

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Fast-paced foodservice work results in frequent hand contamination. Frequent handwashing is a must but most hand soaps are formulated for few handwashes per shift with a focus on quick foaming and grease cutting. Both criteria can result in damaged skin which is then even harder to clean.

Purell Healthy Soap was formulated as a corrective-action handwash for the frequent washer - without hazardous preservatives, antibacterials, parabens, phthalates, fragrance and dye. It out cleans regular soap by 30% but delivers a hypoallergenic standard for the skin-component of one’s healthy immune system.

The Mark Twain Solution to Embarrassingly Low Handwashing Rates

Wed, 06 Sep 2017 14:49:28 +0000

Data-driven continuous improvement for restaurants and hospitals Hospitals have a great standard for handwashing as does FSMA. It’s Continuous Improvement. Mark Twain agrees, noting that “Continuous improvement is better than delayed perfection.” Healthcare Kitchens & The Joint Commission The Joint Commission, healthcare’s performance auditors, encourages a path of measured progress but results are often discouraging because handwash monitoring is limited to observation and no one can afford the luxury of enough observations to make the process mathematically significant. JCAHO does offer a great system to maximize the observational method known as The Targeted Solutions Tool®. Visual observation by caregivers has its advantages and its significance is multiplied when complimented with electronic monitoring. Observation-only facilities have drifted into a dangerous circumstance by self-reporting a 90% compliance level while the reality is often less than 30%. Electronic handwash monitoring systems expose the fiction perpetuated by observation-only operations.The FDA Handwashing Standard The FDA’s recommended standard for handwashing is in their Model Food Code and is not based on Continuous Improvement but rather a series of nine situations calling for a handwash with soap and water (Food Code 2-301.14 When to Wash). This presents a major hurdle for compliance as it is neither based on risk nor measured in any way. There is no weighting of the nine situations. Washing after adjusting your glasses is equivalent to after using toilet facilities. The Model Food Code's approach is more geared to perfection but their army of local health inspectors end up awarding passing grades to restaurants and healthcare kitchens where handwashing is commonly far less than the existing policies and guidelines. It is common to find handwashing about 30% of the operator's desired goal. The shortfall is so massive, widespread and enduring that a switch to reality is challenging but would clearly be a wise move for public health. This would open the gate to Continuous Improvement. Here Comes FSMA’s Continuous Improvement Handwashing FSMA is all about prevention. Continuous Improvement is a natural fit. What was previously considered advice becomes the law. Its view of handwashing represents a cultural shift for operators and their coaches, the cadre of health inspectors.  FSMA’s preventive controls, known by the acronym HARPC (Hazard Analysis and Risk-based Preventive Controls), manufacturers and processors must create and maintain a thorough hygiene discipline throughout their facilities. The new law says “management of covered facilities must ensure that all employees who manufacture, process, pack or hold food have the necessary education, training, and/or experience and ensure they receive training in the principles of food hygiene, food safety, and employee health and hygiene.”  This training includes having hand washing records available for FDA inspection. FSMA drives a Continuous Improvement culture and is in the best interest of the operator’s goals of public health and brand protection. Continuous Improvement demands data and advanced electronic systems are now available. “Continuous improvement is better than delayed perfection." - Mark Twain  [...]

Handwashing On The Balance Sheet

Thu, 31 Aug 2017 16:06:42 +0000

New concept positions handwashing as a brand-builder

Crushed Red’s founder, Chris LaRocca, understood just how important handwashing was in preparing a ready-to-eat menu. He identified a new technology company that worked along side him as his new concept developed. The goal was an effective system to motivate and verify staff handwashing. Now with 10 locations, Chris has control of their handwashing system and can even monitor staff handwashing in the restrooms, thanks to Clean Hands LLC, the supplier of Crushed Red's voice recognition technology.

Clean Hands LLC certified the hand-cleanliness system, followed by Crushed Red earning Handwashing For Life’s coveted 5 Star Hand Hygiene Award and Certification.

This restaurant banner joyfully attests to Crushed Red’s confidence and commitment to their clients.

File Attachment: 
(image) Crushed Red Banner22.52 MB

Handwashing Monitoring: An Owner’s Perspective

Wed, 02 Aug 2017 11:58:43 +0000

Verified handwashing reinforces message of healthy salads.

This interview with the owner of a 10 unit chain is a compelling challenge to the industry and an opportunity to see handwashing as a business-building asset. Verified handwashing is mission critical and a highly valued factor in choosing where to eat. Check out the banner facing the waiting customers. This is handwashing for what it truly is - a baseline for a satisfying dining experience.

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International Clean Hands Week

Thu, 13 Jul 2017 15:44:54 +0000

Please join this annual campaign, sponsored by the CDC facilitated Clean Hands Coalition.  Raise awareness of the dangers of poor hand hygiene. Check out a variety of ideas to improve the away-from-home wellness factor in everyone's life.

Clean hands are the cure to the spread of colds, the flu and those illnesses acquired in our schools, offices, restaurants, nursing homes and hospitals.

For those preparing or serving food, print and post the International Clean Hands Week poster attachment to this blog as a reminder to all.

For the back-to-schoolers consider taking The Pledge of Caring with your schoolmates and posting it in your classroom.

Let this year's celebration of International Clean Hands Week mark the start of having all in your household wash their hands each time they arrive home.

Clean hands. Save lives.

File Attachment: 
(image) International Clean Hands Week Poster3.9 MB

A New Potential Legal Risk For Poor Handwashing

Tue, 20 Jun 2017 19:32:01 +0000

The "Readily Available" principle Immersion into the topic of hand hygiene to reduce operational risk has surfaced yet another incentive to improve handwashing process control. Operators know their handwashing rates are low and now they may be open to a charge of negligence should an outbreak be identified. allowfullscreen="" src="" width="853" height="480" frameborder="0"> In Foodservice, including in the kitchens of healthcare facilities, adoption of handwash verification systems is far less than 1%.  In hospital's patient-care locations there is little dispute on the value of data and verified handwashing compliance but yet it is reported that only 3% are currently using this advancement. In nursing homes, where 380,000 residents die annually from a home-acquired infection, it is virtually nonexistent. The usual reasons of cost and manpower were frequently cited as well as the objections to another intrusion of technology and its lack of reliability. Some referenced all the advantages of the direct observation protocol but this group did tend to concede that electronics added the statistical significance advantage by multiplying the observation opportunities. One hospital reported their capability to monitor 100,000 hand washings per day, thanks to automation. Handwashing For Life interprets this low penetration to be a function of five factors: C-Suites are not convinced that more handwashing can make a difference in outbreaks. Having a number does not change behaviors. Quality Assurance and Infection Prevention are respected for their technical knowledge and passion but are less effective in convincing Operations and Risk Management to install an electronic solution. Keeping up with the flood of regulations consumes key resources. Inability to monetize the risk factor of the unwashed hand. The intense healthcare focus on hand hygiene in the patient room has left the kitchen largely outside the net of current monitoring systems. The kitchen is not seen as a major source of healthcare infections yet In a recent study published in AJIC (American Journal of Infection Control) norovirus, frequently associated with food preparation, was identified as the pathogen most often responsible for shutdown/closure of a hospital unit/department. The popular World Health’s 5 moments for hand hygiene, ignores the kitchen as a source. Infection prevention and caregivers are often left with the common practice of "Wash In. Wash Out.” This protocol, generally using hand sanitizer, has improved compliance rates and does provide a convenient framework to track a level of compliance. The intent of the 5 Moments is often replaced by the reality of 2 Moments - in and out. Honesty in reporting is often a theme at major events focused on reducing outbreaks. How could an operation be serious about a path of continuous improvement without a baseline founded on reality? Handwashing For Life's research indicates handwashing rates in healthcare kitchens, patient areas and in restaurants appear to be hovering around 30%. The FDA Food Code is apparently being meet by culinary as their permits are regularly renewed  The Joint Commission audits are known for their rigor but yet approve the operations with 30% compliance, urging their members to report reality rather than the 90% commonly proclaimed. It is definitely time for a reset in all these away-from-home dining situations. [...]

Engaging Culture to Change Handwashing Behavior

Tue, 06 Jun 2017 21:22:59 +0000

Behavior verification motivates compliance

The 5 steps of the HandsOn System are converted to action with a process that opens with collaborative Risk Assessment and closes with Decision Verification. 

Well designed handwash data collection provides much more than a number. It is the living report card on the commitments made by the restaurant's chain of command, starting in the C-Suites and finishing with all the food handlers. Handwashing reports communicate the pulse of the process and either confirm the decisions taken or expose variances. Corrective actions reset standards and process adjustments.

This graphic is provided to facilitate recruiting a cross-functional team to collaboratively assess the risk of current practices, set standards and agree the integrated handwashing process, complete with verification methods. This is a visualization to help set a course of brand protection and continuous improvement.

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File Attachment: 
(image) Change Handwash Behaviors4.07 MB