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Preventing Infection in Schools

 

Clean Hands Often

Hand hygiene, washing thoroughly with soap and water or cleaning with an alcohol-based hand rub, is the single most effective way to both prevent infection and stop spread once an infection is present. Unclean hands are the most common means of transmitting infections when we touch our eyes, nose and mouth.

Hand hygiene decreases the number of disease-causing organisms on the surface of the skin and can be achieved by either traditional hand washing (PDF) with soap and running water or by using an alcohol-based hand rub (PDF) on the hands.

Promoting hand hygiene

Promote hand hygiene in your school by:

  • ensuring that washrooms and kitchen areas are regularly stocked with liquid pump soap and paper towels;
  • posting instructional signage about hand hygiene in kitchens and washrooms;
  • educating staff/students/children about cleaning hands properly, thoroughly and frequently;
  • recommending students/children clean their hands prior to snacks and lunch and after outdoor activities;
  • promoting hand hygiene prior to any food preparation and handling by parents, volunteers, staff and children/students;
  • supervising and helping others learn good hand washing methods;
  • teaching children in a relaxed and fun manner such as singing the alphabet or a hand washing song;
  • advocating for/providing easily accessible hand washing sinks or hand hygiene products; and
  • advocating for/providing warm water in washrooms so children are not deterred from washing their hands.

Correct way to wash hands with soap and water - poster (PDF)

  • Clothing or items such as watches should pushed back so as not to interfere with handwashing
  • Turn on tap
  • Wet hands with warm water
  • Apply soap and lather
  • Rub all over hand surfaces (concentrating on fingertips, between fingers, nail beds, back of hands and base of thumbs) for at least 15 seconds
  • Rinse hands thoroughly under running water
  • Pat dry using paper towel
  • Turn off taps using paper towel and discard

It is important to wash hands for at least 15 seconds. Choose a song to sing such as "Happy Birthday" to help ensure hands are washed long enough.

Children, staff and volunteers whose hands are soiled with glue, paint or organic material, should always use soap and running water to clean hands. For hands that are not visibly soiled, alcohol-based hand rub is an effective alternative to soap and water.

Using alcohol-based hand rub

  • Alcohol-based hand rub is an acceptable method of hand hygiene except when hands are visibly soiled. If soap and water are not available, disposable hand wipes or towelettes may be used to remove dirt or soil prior to the use of alcohol based hand rubs.
  • Products may be liquid, gel, foam or lotion. The recommended concentration of alcohol is 60 to 90 per cent for general use.
  • Using an alcohol-based hand rub is safe for young children's hands, but its use should be supervised. Licking of the hands after the sanitizer is dry carries no chance of alcohol intoxication. Store it safely so that a child cannot accidentally ingest it. If it is ingested, please contact Ontario Poison Control
  • Be aware that alcohol may be flammable while wet

Correct way to clean hands with alcohol-based hand rub - poster (PDF)

  • Squirt a small amount (one to two full pumps or a "loonie" sized amount) onto the palm of one hand.
  • Swirl the fingertips of your other hand into the product on your palm.
  • Switch the product to the palm of your other hand.
  • Swirl the fingertips of your other hand to clean, them, too.
  • Scrub all surfaces of your hands - wrists, between fingers, backs of hands, thumbs - for at least 15 seconds until your hands are dry.

Cover Coughs and Sneezes

Colds, influenza and many other respiratory viruses and bacteria can spread by sneezing, coughing or talking. You can be exposed if you are within two metres of a person who is ill with an infectious respiratory illness.

You can also be exposed if you come into contact with a surface (e.g., keyboard, telephone, table) that an infected person has exposed. Respiratory viruses can live on objects and surfaces from several hours to a few days.

Covering a cough or sneeze can be an effective way to stop the spread of infections.

Stay Home When Ill: Exclusion Criteria

Schools can promote wellness by implementing a "stay home if you are ill" policy for staff, students and volunteers. Staying home when ill at the onset of illness will help protect others and may help speed recovery.

In general, encourage anyone who has the following symptoms to stay home:

  • Any new onset of respiratory symptoms such as fever, cough, nasal congestion, sore throat or hoarseness.
  • Vomiting and/or diarrhea.
    • Handle any clothing or items soiled with any body fluids, such as fecal matter, vomit or blood, carefully. Place soiled items in a plastic bag for laundering/cleaning.  Ensure hands are cleaned thoroughly after touching soiled items. Clean and disinfect the immediate environment and affected surfaces.
  • A new and undiagnosed rash
    • Seek medical attention as necessary
    • Encourage others to stay at home if they are ill
    • Send ill children home and provide a separate place/room for ill children while they are waiting to go home. Ensure this room is cleaned.

Exclusion criteria for specific diseases can be found on the Canadian Pediatric Society website

For general information about childhood illnesses and infections go to the Caring for Kids web site at: caringforkids.cps.ca/handouts/illnesses-index

Clean & Disinfect the Classroom and School Environment

Regular and thorough cleaning and disinfection are important to prevent and control the spread of infections in a classroom and school.

Cleaning involves manually/physically removing all visible dirt from a surface or object. Cleaning is accomplished with water, detergents and wiping of the surfaces.

Disinfection is a process that reduces the number of germs on a surface. Most disinfectants are designed for application to surfaces that have been pre-cleaned. Some products combine a cleaner with a disinfectant. Consult with your cleaning product supplier for the products best suited to the school environment.

Important cleaning tips

Clean using the following principles:

  • Surfaces that are frequently touched by hands are called high touch surfaces and will require more frequent cleaning. Examples of high touch surfaces include door knobs, light switches, desk tops, hand rails, shared computer keyboards and computer mice.
  • Cleaning should be done from the least soiled surfaces to the most soiled surfaces.
  • Feces, vomitus, blood and other large amounts of soiling should be removed with a disposable wipe and discarded in an appropriate container, such as a closed garbage bin.
  • Multiple clean cloths and buckets should be used when cleaning. Used cloths should not be dipped back into cleaning solution because it may contaminate the solution. Rinse cloths in clean water and wring out excess water before dipping cloths in cleaning solution
  • Wet mops should be laundered and thoroughly dried after use
  • Hands should be washed after performing any cleaning and after removing housekeeping gloves.

Using cleaning products

Use cleaning products according to the manufacturer's recommendations.

  • Ensure there is sufficient fresh cleaning solution for daily cleaning.
  • Dry cleaning containers before storage. ¬†This will help minimize the growth of microorganisms in standing water.
  • Maintain a supply of disinfectant specifically for disinfection of areas following clean-up of blood and body fluid spills.
  • Pre-mixed squirt bottles or wall mounted dispensing units for cleaning products are preferred. Spraying products that cause a misting effect are not recommended because of the potential for inhalation of the cleaning product.
  • Pre-mixed products are preferred over those that require mixing or dilution prior to use.
  • Store all chemicals in a locked storage compartment out of the reach of children and away from food.

Using disinfectants

  • Read the label for a description and the manufacturer's directions for use of the product.
  • Common disinfectants are:
    • Sodium hypochlorite
    • Quaternary ammonium compounds
    • Hydrogen peroxide
    • Accelerated hydrogen peroxide
  • Chose products based on the type of surface the product will disinfect.
  • Products for kitchen use must be safe for food-contact surfaces .
  • Determine how to use the product. Does it require pre-mixing or is it used directly from the container? Pre-mixed disinfectants are preferred.
  • Check for and read the cautionary statements and warnings on labels.

Cleaning up after a blood or body fluid spill

  • Secure the area to prevent people from walking through the spill area
  • Put on a pair of household rubber gloves.
  • If broken glass or other sharp objects are present remove them carefully with tongs or heavy-duty disposable gloves and dispose in a puncture resistant container.
  • Clean up the spill using paper towels, and then wash the area with detergent and water.
  • Wipe the surface with a fresh solution of bleach:
    • Major blood spill - dilute 1 part bleach to 10 parts tap water (5,000 ppm)
    • Minor blood spill - dilute 1 part bleach to 100 parts tap water (500 ppm)
  • Leave the solution in contact with the surface for at least 10 minutes. This will kill any germs left on the surface - Keep out of reach of children.
  • Dispose of used paper towel in a garbage bin, remove gloves and wash hands.

Cleaning toys and sports equipment (or other multi-use equipment)

  • Consider only using toys with hard surfaces so they can be easily cleaned.
  • Develop a schedule to wash/clean toys and sports equipment on a regular basis.
  • Steps for cleaning toys and sports equipment:
    • clean with soap and water;
    • rinse with clean, clear water; and
    • apply a disinfectant following the manufacturer's recommendations
  • Children should be encouraged not to share personal items such as sports helmets, clothing and hairbrushes

Cleaning in kitchens, lunchrooms and staff rooms

  • Clean multi-use equipment after each use.
  • Do not share cups, glasses, dishes or cutlery.
  • Wash kitchenware in a dishwasher or wash in soap and water, followed by sanitizer

Cleaning and maintaining heating, ventilation and air conditioning (HVAC) systems

  • Clean and inspect HVAC systems regularly - particularly prior to switching from heating to cooling (and vice versa).Maintenance staff should refer to the manufacturer and ASHRAE standards for maintenance recommendations for HVAC systems.

Disposal of sharps (i.e. needles)

  • Provide approved sharps containers for the disposal of sharps such as insulin needles.
  • Contact a private company to supply sharps containers and pick-up service.

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