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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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FSMA Comment Time on Handwashing

Any operator with the time and patience to page through regulations will find a few references to handwashing at the farm level within the Food Safety Modernization Act. The window to comment on the proposed rules has been extended from its original May 16th deadline to mid September, 2013:

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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.

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Cleanliness: A Brand Builder with Seniors

Richard F. Ghiselli, Head of Purdue's School of Hospitality, is the lead researcher and author of a study which shows that senior diners value restaurant cleanliness above all else.

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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:

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Martha Misses

Martha Stewart, like so many celebrity “demonstration” chefs, likely missed a handwash and paid a price, “spending days in bed.” We hope she is luckier than some where the salmonella retreats to slowly work on a weakened joint and ends up as a later-in-life knee replacement: New York Post Article »

For those demonstration chefs working in environments full of lights but short on running water, try the hand sanitizer based SaniTwice® protocol.

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The 5 Handwashing Hurdles


Twelve years of formal and informal research have provided the Handwashing For Life Institute with a long list of reasons and excuses for low handwashing rates. Operators seldom know their specific frequency rate but generally feel it is well below what they would like.

This long list has been distilled into The 5 Handwashing Hurdles. An explanation of each is available here.

Please take a moment to share your opinion as to which hurdle or hurdles you think are most responsible for lower than desired foodservice handwashing rates.



Take Survey »



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Paper Towel Choices

Why poor hand washers need better paper

Single-use paper toweling is a critical component in professional handwashing, whether in restaurants, schools, the workplace or hospitals and nursing homes. The choice of drying method and materials is first driven by user habits and the risks resulting from potential failures in the hand cleansing process. Hand hygiene breakdowns are measured by some in illness outbreaks and by others in absenteeism rates.

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Badge-free Handwash Monitoring

An expandable system encourages getting started.

Vision Enabled Training has introduced a system that can both track handwashing frequency and provide an indication of handwash quality by tracking one's time at the handsink. It is a system that is easily implemented, especially in the badge-free Team Mode.

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Chef Specs Technology To Motivate Handwashing

First to Earn Handwashing For Life's 5 Star Hand Hygiene Award

The Atrio Restaurant's Chef Peter Fulgenzi had assessed his operation's risk if they were to experience a breakdown in their handwashing system. He set safe levels on both handwashing quality and frequency. His 12 handsink stations were optimized and he completed rigorous staff training along with a tightening of hiring policies. One gap persisted in his HandsOn process control system. Handwashing compliance monitoring remained compromised by observation only. 

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Hand Hygiene Survey - Recommendations

Executive Summary:

The 12 questions, delivered in three short survey segments, were designed to raise awareness of some unaddressed sub-issues remaining from the 2012 Conference For Food Protection's Hand Hygiene Committee, charged with identifying alternate handwashing protocols.  This qualitative study was independent of the CFP process but conducted in a timeframe to capture and maintain the momentum from the May, 2012 Indianapolis session and serve as a bridge to the 2014 Committee which will be formed later this month.

Respondents were all attendees of the 2012 CFP meeting and included industry, regulatory and academia. 

The overarching goal of this study is to seek the 2014 CFP Hand Hygiene Committee's consideration of each recommendation. No direct response is anticipated. The final committee report will be presented at the 2014 session.

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A Petting Zoo and State Fair Alert

Hey kids "Stop making my animals sick!"

SaniTwice® is a welcomed intervention at the University of Minnesota's National Center for Food Protection. So many times there is no convenient access to running water to facilitate good handwashing at petting zoos and state fairs. SaniTwice is a protocol that fills that void with effectiveness and convenience.

See what John Hoffman, Senior Research Fellow, has to say in the interest of overall safety for the kids and the animals.

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HandsOn™ System

HandsOn 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 for Catered Events

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

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