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Handwash Risk Assessment - Quality vs. Frequency

Two standards are required for handwashing, one for the quality and a second for the likely frequency to maintain hands CareReady. An assessment of current practices is a good place to involve management and all caregivers. 

The shared perceptions provide a better understanding of current risks and form a base for personal accountabilities. It's visual. It's personal. It urges action and followup. 

Written standards for a hand hygiene process are critical.

Written? Yes! In clear and compelling language, because so many people in so many different departments will be making decisions based on their understanding of these standards.

There are five categories of standards to address:

  1. Operational Identity: Review the mission statement of your operation. Here you should find a thoughtful expression of values, business goals and your desired culture. Does it include your position on insuring your specific level of patient safety?
  2. Legal: Do you have a written statement covering the understanding of the two legal principles, Strict Liability & Constructive Knowledge. Are all your managers aware of the legal, business and personal implications related to breakdowns in patient protection? They should understand the laws that apply to their accontibililities for hand and high-touch surface cleanliness.
  3. Facility & Equipment: Does your operation have a set minimum standard for the location, equipment and supplies for handwashing stations? Are these standards in writing? Convenience is an important criterion to include in your standard. Handwashing stations must be inviting to use - easily accessed, reliably equipped, easily supplied, well lit and easy to clean.

    Many older operations have barriers to hand hygiene. This is no excuse. There are things that can be done to improve on any existing situation. Put your improvement priorities in writing.

    Visit: Best Practices, Getting Started Visit TouchReady™ Surfaces early in the planning process to help define easy to clean surface choices.
  4. Process: Does your operation have clear guidelines for acceptable handwashing (frequency and technique)? Handwashing and gloving frequency will vary. Review your processes and complete the Handwashing For Life "MyQ" guide to help you develop handwashing frequency targets for your employees.

    Once these standards are established and reporting is in place, the ranges can be adjusted in a process of continuous improvement. Establishing good handwashing technique is difficult because everyone knows how to wash his/her hands. WRONG! Practices need to be properly learned and tested for optimum results. Consider it a MUST that every employee be certified in handwashing knowledge and skills.
  5. CareReady® Hands: Those hands, bare or gloved, that are not likely to transfer an infectious dose of pathogens that cause HAIs. They are hands that are continuously returned to safe levels of bacterial and viral contaminants through processes that insure proper handwashing, sanitizing and gloving (frequency, technique & materials).

    Bare hands will always have some level of bacteria, as resident bacteria are part of our immune system. Transient bacteria and viral contaminants are common. Neither hands nor gloves can be sterilized. Monitoring actual levels of pathogens is not technically practical. CareReady Hand are normally ones which have been recently washed. Additional interventions of sanitizing and gloving provide added levels of safety.

    Washing effectiveness should be periodically verified by washing off a tracer chemical using your standard process and checking for areas poorly cleaned via a UV light source. Achieving a CareReady standard requires an understanding of accountability and continuous effort by all those involved in resident and patient care. The information available at is designed to help you and your employees minimize the risk of HAIs.

ANSI is the American National Standards Institute, the North American partner to the International Standards organization (ISO), the UN standards development group. To have a standard certified as an ANSI standard is to say that ANSI has certified that the standard itself follows the appropriate documentation regimen, and has the appropriate checks and balances to assure its integrity. It provides for universal recognition in our global marketplace.

Leadership Company

NSF® International


NSF International, The Public Health and Safety Company, is an independent, not for profit organization providing food and water safety standards for over 55 years. For further perspectives on the importance of standards.

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