The use of alcohol-based had-rub products does not substitute for hand washing in the group care setting. Hand washing is required to remove visible soil. Alcohol-based hand rubs should be limited to instanes in which no sink is available. These products require an alcohol content of 60% or greater to be effective at killing germs. They are highly flammable.
? Limit use of alcohol-based hand rubs to areas of the child care facility that are inaccessible to children, e.g., in a kitchen that is off-limits to children or in the maintenance equipment area. These products should not be accessible to children.
? Discourage alcohol-based hand rubs for hand hygiene in child use areas. If used, it should be limited to situations where there is no visible soil on the hands, where sinks are not available, and where the use and control of containers of the chemical sanitizer can ensure that no child can have independent use of the container or dispenser.
? Be sure that hand hygiene using alcohol-based hand rubs conform to the manufacturer’s instructions. The procedure for using alcohol-based rubs should include:
— Applying the required volume of the product to the palm of one hand and rubbing hands together, covering all surfaces of the hands and fingers until the hands are dry. The required volume should keep the hand surfaces wet for at least 15 seconds or longer if so indicated by the manufacturer.
— Checking the dispenser systems for hand hygiene rubs on a regular schedule to be sure they deliver the required volume of the product and that they do not become clogged or malfunction in some other way.
— Storing supplies of alcohol-based hand rubs in cabinets or areas approved for flammable materials.
? Contact with Body Fluids: Follow Standard Precautions for Child Care whenever contact with body fluids occurs.
? Staff Training: Educate all personnel about hand hygiene and the importance of appropriate hand hygiene practices to their health and the health of the children.
? Monitoring and Evaluation: Monitor hand hygiene with unannounced and regular direct observation. When hand rubs are used, check how much of the product is being used to be sure the appropriate amounts get used up as a way to verify the staff who are authorized to use this method of hand hygiene are continuing to use the material as they should.