Handwashing for Life

Overcoming Underwashing
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Kindling a Culture of Cleanliness

Come Compete in the Handwashing For Life Olympics

Handwashing For Life® overcomes underwashing of hands and high-touch surfaces by integrating a series of best practices. At the Food Safety Consortium, being staged at the Schaumburg Conference Center, on December 4th & 5th, attendees will learn how to assess their hand hygiene related risks and assemble a sustainable solution. The program is a driver to establish a culture of cleanliness, one handwash at a time.

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What Constitutes a Handwash?

Blending available resources into an effective protocol.

From a Food Code perspective there is but one handwash. We like to think of it as a minimum and one of perhaps many. Handwashing For Life designates a soap-water 15 second hand wash, with a 2.0 gpm flow of warm water and paper towel drying, as its Core Hand Wash. Depending on risk, adjustments are made at the operator level to exceed the minimum where required.

Technically, a handwash is blend of four factors, four resource categories:

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Training Handwashing: A Sisyphean Task

Sometimes training handwashing feels futile and frustrating. For the professional who daily works through this repetitive task, we found a parallel image from back in Greek mythology. Sisyphus, the king of Corinth, was charged with rolling a stone uphill for eternity.

Luckily for our dedicated handwash trainers, their toil has a more rewarding outcome, especially when they introduce performance standards and incorporate success into staff rewards.

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The Case For Added Hand Wash/Cleanse/Sanitize Protocols

Light duty hand cleaning may increase frequency

The Model Food Code serves as a minimum standard, providing a foundation on which operators can build solutions tailored to their operation and their assessment of risk.

There is an unresolved handwashing dilemma in the Model Food Code in that it prescribes the same wash whether the hands are very lightly contaminated (visibly unsoiled) or are heavily soiled. The identical 15 second scrub time is specified for both.

Intuitively this doesn't make sense to the kitchen staff. Some, perhaps many, compensate by not washing at all when hands are seen as unsoiled. This likely accounts for over half of the 8.6 hand washes per employee hour identified in a CDC observational study as the number required to conform to the Model Food Code. (J Food Prot. 2006 Oct;69(10):2417-23)

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Patents, Proprietary Resources & The Model Food Code

How should innovation be treated in a regulated environment?

SaniTwice® as an alternative protocol for soap/water handwashing was rejected by at least one of the Conference for Food Protection (CFP) Council III delegates because SaniTwice works best with patented Purell VF-481. This is based on its unique effectiveness on norovirus, the leading pathogen in foodborne outbreaks.

In reality, the SaniTwice protocol potentiates all alcohol hand sanitizers as it simply adds a cleaning step.

There are three shortcomings in the Model Food Code that are exposed in this 7 year pursuit of a protocol immediately accepted by the US military, for whom it was originally developed:

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Restroom Research Drives Integrated Solution

Toilet Paper RollFDA's Captain Wendy Fanaselle took attendees of the Food Safety Summit on a research guided graphical trip of the restroom to emphasize the importance of killing the fecal-pathogens before they escape into public areas.

Toilet paper, designed by those more concerned about flushability than its barrier properties, doesn't do the job. Single or double ply, soft or strong, research indicates pathogens still escape the basic maneuver and often proceed beyond the restroom doors.

Toilet paper is an advance over at least three of its earlier substitutes:

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Hand Hygiene Outbreak Factor Established for Foodservice

The Southwest Environmental Health Association, during their 2013 annual meeting, volunteered to help establish a reference number for restaurant outbreaks due to poor hand hygiene. The group, largely local, state and national regulators, was asked What percentage of foodborne outbreaks are attributable to poor hand hygiene? They were given these choices: 20%, 40%, 60% or 80%.

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Norovirus-Focused Handwashing in Restaurants (Part one)

Defining a safe level for handwashing frequency

Norovirus outbreaks commonly raise this question: What is a safe level for handwashing frequency?

If we look to the FDA for answers, the Model Food Code wisely avoids getting over prescriptive, considering all the variables.

The CDC conducted a valuable observational study using the Model Food Code as its benchmark. They concluded 8.6 Handwashes/Employee Hour (HW/EH) were required to be code-compliant, a total of 69 Handwashes per 8 hour shift

This led to other questions: Is the Model Food Code already over-prescriptive or truly risk-based? Would this level of handwashing be in conflict with customer service? In general, a level of 8.6 HW/EH is seen as too much to ask of employees. Regulators generally agree.

More effective use of tongs and wraps can lower the need for handwashing but the basic issue remains. Some situations, like following restroom use, clearly demand a good handwash. A casual touch of the face or hair is a lot less risky yet the Code specifies the same handwash for both. Is that risk-based or inspection based?

A frequency rate target of 8.6 HW/EH discourages reasonable, attainable compliance improvement. It protects the status quo. "Don't let perfect be the enemy of good."

We believe the Food Code in this case should prioritize the risks by establishing categories of High, Moderate and Low. Operators then set up a controllable process based on risk, a process to which they are committed. We will be discussing this at CFP 2014 and will likely propose this change at CFP 2016. Read more about Norovirus-Focused Handwashing in Restaurants (Part one)

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2014 The Year of the … Norovirus?

Last year's fast start on the Norovirus season caused concern from the CDC, FDA and all food safety savvy operators. This year two of the largest cruise liner outbreaks ever sent two ships back to port early with over 900 vomiting passengers. Once again the focus is on guest handwashing and the cleaning of shared surfaces, now recognized as a major guest-to-guest hazard.

Norovirus or Winter Vomiting Disease. Vomitus or Diarrhea. Fecal or Faecal. Contaminated Hands or Surfaces. Foodborne or Person-to-Person. We hear a lot of conflicting distractions. The six simple truths about norovirus are these: Read more about 2014 The Year of the … Norovirus?

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HandsOn™ System

HandsOn<sup>™</sup> System

5 steps to convert underwashing to under control. Set and track your risk-based ServeReady® Hands and TouchReady® Surface standards.

SaniTwice® for Catered Events

SaniTwice<sup>®</sup> for Catered Events

Uncompromized hand cleanliness for those serving food at venues without running water.

Teaching Videos

Teaching Videos

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