How to Improve Infection Control and Handwashing in School Restrooms

Planning and implementing coronavirus mitigation measures throughout schools has been a central focus for educators since spring. But school restrooms – shared spaces that are especially known for being high-use, high-traffic and frequently touched – have drawn a significant amount of infection control consideration.

Students themselves have identified school restrooms as a place that gives them trepidation about coronavirus germs. According to a recent survey, nearly four-out-of-five high schoolers say they’ve become more germ conscious since the pandemic and 58% are nervous about returning to school because of coronavirus. Within the school building, the top three places students are most concerned about coming into contact with germs are: school restrooms (63%); classrooms (50%); and the cafeteria (42%).

Complicating the matter is that many students barely give their school restrooms a passing grade. 50% rate their facilities as poor or fair while only 6% describe them as excellent, according to the handwashing survey conducted August 20-21 with 1,050 high school students ages 14 to 18. What’s more is that 42% of students believe unclean restrooms reflect poorly on school management and 41% take a more apathetic view, believing there’s nothing they can do about it anyway.

How do you create a hygienic and safe environment equipped to handle everyday usage and what’s sure to be increased handwashing activity by students, faculty, administration and staff? And, how do you improve the restroom experience to make it more appealing to its users?

Student washing hands with touchless faucet.

If you ask the students, their top suggestions for improvement circle back to the need for increased hygiene. Their number one request is cleaner restrooms that are stocked more frequently with soap, paper towels and toilet paper, and secondly, restrooms in which everything is touchless — with reliable technology.

From an administrative standpoint, it’s important to look at the holistic design of the school washroom, including traffic flow, as well as product design and materials. Schools are unique as they have peak times — in between classes — when bathrooms experience high usage and other times when they go virtually unused. There can be a lot of congestion, so it is key that facilities and equipment are clean, stocked and ready to expedite the traffic flow through the restroom.

To address both student and administrative restroom concerns, there are a number of actions and enhanced protocols that can be implemented to enhance cleanliness and maintenance, regulate traffic flow, upgrade technology and aesthetics, and support hand hygiene in restrooms.

Install touchless fixtures

Cross contamination of germs in restrooms can be reduced by using touch-free fixtures for everything from soap, faucets, hand dryers/towels, doors and flushers. Today’s touchless hand washing models incorporate advanced sensing technology for continuous and reliable washing. Automatic door openers typically seen to support accessible design are now also being implemented in locations to prevent hand-surface contact.

Research shows that students — as well as American adults — are highly in favor of using touch-free fixtures. 76% of high school students believe it’s extremely or very important that school restrooms have touchless fixtures, while 91% of adults echo that sentiment for access to touchless fixtures in all public restrooms.

Likewise, school facility guidelines like the ones issued by the Wisconsin Department of Public Instruction recommend the installation of all touch-free fixtures for infection control.

“Under any circumstance, using touchless fixtures helps to inhibit the spread of germs in restrooms and buildings,” says medical microbiologist Michael P. McCann, Ph.D., professor of biology, Saint Joseph's University. “The more we avoid restroom touchpoints, the healthier and easier our operations will be.”

Post signage outside and inside restrooms

Reinforce cleanliness with reminders about washing hands for 20 seconds per Centers for Disease Control (CDC) guidelines, maintaining safe distances, throwing away paper towels, etc. The Healthy Handwashing Survey found that signage is effective since 57% of students say they increase their handwashing when signs are posted.

Experts such as CDC believe that thorough handwashing with soap and water for at least 20 seconds, and drying them thoroughly with a hand dryer or paper towel, is among best ways to reduce the spread of disease-causing microorganisms like coronavirus. Proper handwashing will help reduce the spread of COVID-19 as well as flu and other illnesses in the home and workplace.

Schools can also deliver reminders during daily announcements, through video and email messages, on web sites and social media and at the beginning and end of each class about the importance of increased hand washing and other ways to reduce COVID-19.

To reduce groups of students converging on restrooms all at once and ensure there’s space for social distancing, schools can implement a bathroom schedule based on last names or a system that limits the number using the facility at a time.

Floor markings that designate six feet can be used to distance those waiting to use a restroom, sink or dry their hands. 

Increase cleaning, sanitization and restocking

Proper and frequent cleaning and disinfection is key for restrooms, especially for high-touch surfaces, such as doorknobs, faucets, sinks, toilets, stall door openers and paper towel dispensers. According to the CDC, daily cleaning with soap and water reduces germs, dirt, and impurities on the surface, and should be done frequently, especially if there is high traffic.

Avoid wet floors

Water dripping from hands onto floors can cause slips and falls, and breed bacteria. To avoid wet floors, place soap and drying options close to sinks so people needn’t move from the sink with wet hands. All-in-one hand washing fixtures that have the soap, faucet and dryer all in one unit can help to contain water.

Choose hygienic sink materials and designs

For sinks, using smooth and nonporous materials with seamless construction like solid surface and natural quartz helps prevent bacteria, mold and delamination accumulation. For multi-user restrooms, new washbasin designs with increased space between the hand washing areas allow for social distancing while washing hands.

Rethink layouts

Design elements like eliminating doors, adding S-curved and automated doors and widening doorways have been gaining traction in recent years and may also play a part in addressing COVID-19 concerns. Designs that help facilitate one-way traffic and minimize cross-traffic —like the European model of stalls forming a perimeter around communal washing stations with open circulation — may also be a layout that grows in popularity in schools.

Improve ventilation

Ensure the use of robust HVAC systems throughout facilities but especially in shared spaces such as in restrooms. Ventilating with outdoor air is vital to diluting airborne contaminants.

According to CDC, the coronavirus appears to spread indoors through close personal contact and via poor circulation of building ventilation systems. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) advises that ventilation and filtration provided by heating, ventilating, and air conditioning systems can reduce the airborne concentration of SARS-CoV-2 and thus the risk of transmission through air.

While there are a number of infection control measures on the horizon for school restrooms, in the short-term it’s still important to keep six feet of distance between people, wash hands with soap and water, dry hands completely, wear masks and limit crowding in restroom areas.

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