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How to Handle Hand Hygiene in Long-term Care Facilities

Patrick Boshell
October 30, 2018



No one likes getting the flu, but the elderly are especially vulnerable to more serious flu-related complications. Any excess buildup in the respiratory tract often leads to other illnesses like pneumonia. Elderly people also have weakened immune systems that have trouble fighting off the flu on their own. It’s estimated that in the U.S., between about 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older and between 54 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in that age group[1]. As of January 2018, in Canada, there were 54 reported flu deaths people over 65 years of age[2].


While getting the influenza vaccination is the best way to prevent contracting the illness, it’s crucial that long-term care facilities implement an effective hand hygiene program as 80 percent of all infections are transmitted by hands.



While washing hands with soap and water is the best way to ensure hands are properly washed and rid of germs, it isn’t always a viable option. However, there is a simple solution: hand sanitizer. According to the World Health Organization (WHO) and the CDC, hand sanitizer is one of the best tools available to avoid getting sick and spreading germs. By placing hand sanitizer in strategic locations throughout the facility, and other high traffic areas, you can encourage patients, guests and staff to improve their hand hygiene and create a healthier living environment for patients.



Key Locations for Hand Sanitizer


The best way to remind people to use hand sanitizer is by making it easily accessible and always within sight. It’s important to place hand sanitizer near and around high-touch surfaces and communal areas, including:


  • A 2015 survey found that while 92 percent of Americans believe it’s important to wash their hands after using a public restroom, only 66 percent of them follow through[3]. Over a third of survey respondents admitted to skipping soap and rinsing with water. This makes it extra important to provide hand sanitizer in the restroom. If people are in a rush and don’t think to stop and rinse with soap and water, providing a backup option near sinks and at the doors ensures germs don’t escape the restroom.


  • Patient rooms. Health care workers should wash their hands before and after caring for each patient. It’s also important to make hand sanitizer available. Install dispensers in the same position in each room and preferably near sinks and the entrance. Also consider positioning dispensers near patients to help make caregivers’ work more efficient and more hygienic through the entire interaction.


  • Entrances and exits. A single doorknob could potentially be the cause of a widespread illness in a facility. In fact, new research showed that a within two to four hours, a virus placed on a doorknob was picked up by 40 to 60 percent of workers and visitors within the facility[4]. In addition to frequently disinfecting doorknobs, light switches and other high-touch surfaces within the workplace, make sure to also provide a hand sanitizing station nearby to limit the spread of infection.


  • Between 2 and 10 million bacteria live between a person’s fingertip and elbow[5], and if food is consumed with germ-ridden hands, it’s easy to digest the germs and become infected with several diseases. Although hand sanitizer is not a replacement for anyone who prepares food, it can help eliminate certain germs.


  • Communal areas. Communal areas are often packed with visitors, patients and staff who exchange handshakes, hugs and other forms of physical contact, thus swapping germs. By providing visitors and patients with an easy-to-access hand sanitizing station, either near the door or on a table, allows them to safeguard their hands against germs before and after they leave the area.

Make sure to use an alcohol-based hand sanitizer that contains at least 70 percent alcohol. The higher alcohol percentage will usually translate into higher efficacy. Look for products with a 5-log minimum kill rate (99.999%) – which are 100 times more effective than  3-log (99.9%) sanitizers.


Consider using foam hand sanitizers, as 84 percent of adults prefer foam sanitizer over sticky gel[6]. It’s also best to use sanitizers that contain moisturizers to prevent skin dryness, and are perfume- and dye-free to reduce potential allergic reactions and skin irritations.


Download Hand Hygiene Posters


Encourage Hand Hygiene


Having wall-mounted hand sanitizing dispensers and bottles on surfaces in and near germ hotspots is only part of a complete hand hygiene program.


Display posters and information boards, and distribute leaflets near hand washing stations and dispensers with reminders to clean hands and offer quick, easy facts about hand hygiene. These materials should also include information on how to properly use and apply hand sanitizer according to the 6 Step Method recommended by the World Health Organization[7], to ensure the correct amount is used and spread to cover all surfaces of both hands.


In order to keep your long-term facility a healthy environment, it’s critical that staff take into account how susceptible seniors are to the flu. Including hand sanitizer in your hand hygiene program, and providing product in patient rooms and in communal areas, is essential to help everyone survive the cold and flu season.







[5] University of Florida – Hand Hygiene and Hand Sanitizers, 2011




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