Hand hygiene - a changing landscape

7th of January 2022
Hand hygiene - a changing landscape
Hand hygiene - a changing landscape

Chris Wakefield, managing director UK & Ireland for GOJO Industries-Europe, discusses the effects of the pandemic on the hand hygiene industry and how to maintain compliance in a sea of coronavirus fatigue.

We are emerging from the most tumultuous of times; a period which has particularly tested – and continues to challenge – the hand hygiene business. From facing huge demands in the early days of 2020, to today, where we find ourselves in an extraordinary situation. We are entering the winter germ season (with Covid still circulating); awareness of good hand hygiene is at an all-time high, yet ‘pandemic lethargy’ has set in and compliance has started to slip.

Facing the crisis

At the outset of the pandemic, there was an insatiable demand for hand sanitiser. This came with little warning and placed huge pressures on hand hygiene suppliers to fulfil all orders. Inevitably, in the early days, this unprecedented demand outpaced supply, which led to various scenarios.

Firstly, many turned to ‘bulk fill’ practices to help plug the gap. These ‘open refill’ dispensers are typically serviced by pouring product into them. They are usually ‘topped-off’ from gallons or drums of sanitiser that are not equipped with pumps for individual, portion-controlled product usage. Whilst it is understandable that businesses were seeking alternatives to protect people at the time, research we undertook showed that a large number of businesses had plans to continue this practice when supply chains return to normal, post-Covid.

However, this may not be the safest, or most effective solution, and could actually cause more harm than good. Problems associated with ‘open refill’ dispensing include branded hand sanitiser products being refilled with other formulas, products mixing into unknown chemical combinations, contamination or degradation, and product tampering. All of which can mean an uncompliant and potentially harmful end product.

Secondly, we saw an influx of new companies enter the market – some from companies with no experience producing these kinds of products. More often than not, products had been formulated purely with the aim of killing bacteria, without taking skin health into consideration. These sanitisers offered a poor user experience, often leaving hands feeling dry and tight, and with repeated use, potentially damaged skin. As one of the biggest barriers to hand hygiene, this was not good news for compliance.

In some cases, the sanitisers were not even fit for purpose. In fact, over the past year, we have seen several products pulled from European markets, due to compliance and safety issues.

A ticking time bomb

Before long, it became clear that the crisis was not a short-term problem and manufacturers invested in changes to increase production. However, after nearly two years of restrictions, coronavirus fatigue is setting in. Within the industry, there is a feeling that people are already neglecting the importance of hand hygiene and even within the NHS in the UK, compliance levels have started to fall.

This has led to a most unexpected problem. If, at the beginning of the pandemic, the issue was there was not enough supply, today we are faced with the opposite. There is simply too much – and it’s a ticking time bomb. Warehouses are full of product, which is fast approaching its expiry and not selling through, because businesses are already overstocked with potentially unsuitable product, and customer use is declining.

Further up the supply chain, distributors face a tough choice too. After purchasing stock (possibly at inflated prices, which was rife at the height of the pandemic), they must now either sell at rock bottom prices to clear the product or lose it completely.

Driving behaviour change

We must, therefore, work hard to drive positive behaviour change. This will not only help alleviate the burden of excess stock but more importantly, help protect health and prevent the spread of harmful germs.

Public awareness of the importance of hand hygiene has grown phenomenally and attitudes have changed. In fact, research reveals that eight in 10 people now expect to see hand sanitiser in public facilities  – but how many are actually stopping to use them? Recent US reports  have indicated that hand washing has fallen to pre-Covid levels and the fact that there is excess stock shows us compliance has dropped considerably.

At a time when borders are opening up and there is more opportunity for potential transmission – of Covid and a whole host of other seasonal viruses – it is crucial that hand hygiene momentum
is maintained.

It’s all too easy to slip back into old habits, so what measures can organisations put in place to improve compliance, now that people are becoming complacent about practising good hand hygiene?

Strategic positioning

The correct positioning of dispensers is key. In healthcare settings, these should be as close as possible, within arm’s reach of where patient care or treatment is taking place, without having to leave the area. Opportunities for hand hygiene should also be available at other prime germ hot-spots, such as waiting rooms.

As well as installing dispensers across the site, supplying hand rub in small form versions can help increase compliance. This enables time-poor staff to sanitise on the go, since, according to research  we undertook with healthcare trusts last year, many overburdened and stressed staff felt as if they didn’t have time to clean their hands as often as they should.

In other environments, such as leisure, retail and catering establishments, ensure dispensers are positioned at the entrances and exits to buildings – and any other high traffic areas, such as reception foyers. The sheer physical presence of having dispensers in the right places can help prompt hygienic behaviour.

When it comes to washrooms – in all settings regardless of industry – offering one final chance to clean hands can make all the difference in reducing the number of germs leaving the room. If people have not washed their hands properly, bacteria and viruses can be spread onto the door handle and other surfaces that they touch when they leave the room. Research shows that one single contaminated door handle can infect up to 60 per cent of the occupants of a building within just four hours!

Placing a sanitising dispenser at washroom exits provides an extra opportunity for hand hygiene, as well as offering an additional layer of protection. Positioning it between 36 and 46 inches above the floor, on the handle side, is the optimum height to trigger proper hand hygiene behaviour and prevent the transmission of bacteria from door handles.

Formulation matters

As well as ensuring dispensers are accessible, it is vital to equip them with high quality products. Of course, these must have proven antimicrobial efficacy, but formulation comes a close second in the order of importance.

After all, if the balance of ingredients is not right, hands can quickly become dry or irritated or result in a poor user experience. Products that are too runny, too smelly, or that irritate skin can put people off using the hand sanitisers provided, ultimately reducing compliance and increasing the risk of transmission of germs.

In fact, skin irritation is an increasingly common barrier to hand hygiene practice and is a growing issue within healthcare facilities. Recent reports have shown that 59 per cent of healthcare workers seen in occupational skin disease clinics, set up during the pandemic, were found to be affected by irritant contact dermatitis due to an increased use of personal protective equipment (PPE) and frequent hand washing.

It is clear then, that skin health is a key factor when choosing sanitising solutions, not only to care for hands, but to maximise compliance. Opt for products that are enriched with nourishing agents and have been proven to maintain skin health to offer that positive user experience.

While there is an understandable desire for ‘normality’ to return, we find ourselves in a precarious position this winter. According to Dr Jenny Harries, head of the UK Health Security Agency, the season is set to be ‘highly unpredictable’ with Covid, flu, and other serious respiratory viruses all circulating.

So take a look at the hand hygiene systems your organisation has in place. Do the formulations offer a pleasant experience or are hands left feeling dry and tight? Are there opportunities to
clean hands when you need them? Having the right products, in the right places, at the right time will go a long way in increasing adherence.

Now is not the time to let down our guard and become complacent. Rest assured, reputable hand hygiene companies are ready to play their part and will be with you every step of the way to help maximise compliance.



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