As some countries reopen schools and as others fiercely debate whether to, hygiene practices at our schools are focal points of attention and anxiety. For a prescient professor and OPHARDT Hygiene, it was already front-of-mind before the pandemic.
As a dad of a school-age kid and as a professor specializing in medical microbiology and infection control at the University of Münster, Prof. Dr. Karsten Becker knew that schools had a problem. Children were not washing their hands often enough or for long enough, especially after going to the washroom. He had a hunch that this was an infrastructure problem as much as it was an education and motivation problem.
Prof. Dr. Becker, who leads a department at the University of Greifswald, started looking for a company to partner with to help him design and produce a kid-friendly soap dispenser. That led him to OPHARDT Hygiene and one of its lead researchers, Dr. Siegfried Steltenkamp. “OPHARDT is well recognized in the medical sector. So that’s how I got involved,” Dr. Steltenkamp recounts, “We met and had good chemistry. We were on the same page, so we said, okay, let’s go for it.”
Going for it meant starting a massive project that involved 13 elementary schools in the northwest of Germany. This study tested whether children’s hand hygiene would be positively-affected by the introduction of kid-focused soap dispensers and hygiene education.
No easy task
This project faced some real challenges that could have ended it before it even had a chance to start. In order to collect the necessary data, Prof. Becker needed to get permission from the school district, the school’s principal, the teachers, and the parents of the schoolchildren—13 times over. There were also technical issues in many of these elementary schools to be solved, which made the collection of data from smart dispensers challenging. And what could they change about a soap dispenser that would motivate and help kids wash their hands more often and more thoroughly?
The existing washroom infrastructure in the schools seemed indifferent to the needs of children. Here’s one photo that highlighted a typical, problematic design:
“Look at the soap dispenser, [the children] can put their heads underneath it. So it’s more like it’s for washing hair than washing hands… It’s totally misplaced and it’s not ergonomically optimized for kids―unfortunately, a typical situation in schools.” – Dr. Steltenkamp.
The height of the dispensers was only one of the design problems frequently found in school washrooms. Sometimes the dispensers were not placed close to the sinks. Usually, there was nothing to guide students through the proper steps and timing of handwashing. The most common issue by far, though, was that the dispensers were empty. “And let’s be honest,” Prof. Becker shared, “washing hands is not one of the favorite activities of children, thus, the dispenser is also needed a motivational design.”
A set of required features was coming into focus. The dispensers would contain smart monitoring for data-collection, some sort of visual guide and feedback, and they would be vandalism-safe to protect against the “over-enthusiasm” of schoolchildren.1 They would also need to be visually appealing to kids. To meet that last requirement, OPHARDT Hygiene engineers got feedback from colleagues of Prof. Becker, specialists in primary education at the University of Münster, who recommended designing the dispenser around the timeless simplicity of a smiling face.
The final, friendly and motivational design was a durable, smart dispenser that was able to simultaneously guide three students through the proper handwashing steps with the help of a series of flashing LEDs and colour-coded stickers.
To ensure good, scientific data, different test groups were set up to study the impact that three factors of (1) dispenser design, (2) hand hygiene lectures, and (3) practical instructions had on improving hand hygiene at schools. This way, the researchers could analyze the effect that each combination of these interventions had.
Before this project, kids would visit the school restroom, on average, three times per week, but only wash their hands once a week. After the project, visits to the washroom increased by one-third to a weekly average of 4.5 visits per student as preliminary data showed. Not only did children visit the washrooms more frequently, they also washed their hands twice as often. The combination of a motivational dispenser design, hygiene lectures, and practical, hands-on skill-building led to the greatest increase in handwashing.
Schools saw noticeable results:
“For our primary school children, the soap dispenser and the corresponding instructions for washing their hands were a real attraction. The pupils have now internalized these steps and are making an active contribution to infection protection”.Ingard Borgel, principal at the St.-Antonius-School Hörstel-Bevergern, one of the participating schools.
For schools that are reopening during the COVID-19 pandemic, this study offers some helpful lessons for how to engage students and drastically improve hand hygiene. Some of these interventions, like adding educational stickers by washroom sinks or teaching students about the theory and practice of good hand hygiene, can be done quickly. However, the more time-intensive work of redesigning washrooms around the needs of children is one that will have great and lasting health benefits for not just the school, but for the broader community.
The data collection for this study was handled by OHMS, OPHARDT’s connected monitoring system built for measuring and improving hand hygiene compliance at hospitals. This state-of-the-art product enabled schools to track when the washroom door opened and when soap was dispensed. The resulting data was then available around the clock through the OHMS web application.
This study combined OPHARDT Hygiene’s readiness to create custom solutions, our obsessive engineering and manufacturing, and our ability to collaborate with top researchers to help break the chain of infection.
1 The diplomatic wording of Dr. Steltenkamp.