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Child Care

Hand Hygiene and Respiratory Etiquette

Hand Hygiene 

Having clean hands is the best way to prevent yourself from getting sick.  Ensuring your hands are clean  before and after handling food, before eating or drinking, and before touching your face are all ways to  keep yourself healthy.  If you are already sick, you can help others stay healthy by cleaning your hands  after sneezing or coughing into your hands.

Respiratory Etiquette

Respiratory etiquette is taking care to properly cover your nose and mouth when you cough or sneeze.  Ensure to throw any disposable tissues in the trash. If you do not have a tissue, cough or sneeze into  your elbow, not your hands. Always ensure to conduct hand hygiene after coughing or sneezing. It is  essential to monitor children at the centre and ensure proper respiratory etiquette is taking place to   prevent transmission of illness.

  • When you arrive at the child care centre, before or immediately after entry into any room and before you go home
  • After using the washroom or after a diaper change
  • After coming in from outdoors
  • Before and after eating and before drinking
  • Before and after handling animals, pet cages or other pet objects
  • After covering a cough, sneeze or blowing your nose
  • Before and after sensory play activities
  • Before and after touching your eyes, nose or mouth
  • Whenever hands are visibly dirty
  • Before or after preparing, handling or serving food or bottles
  • Before and after giving medication or applying ointment or lotion
  • After changing diapers, assisting children to use the toilet or using the washroom
  • After contact with broken skin or body fluids (ie: runny nose, spit, vomit, blood, cut or open sore) even if gloves are worn
  • Before and after glove use
  • After cleaning, handing garbage or contact with contaminated surfaces
  • Whenever in doubt

Note: artificial nails, chipped nail polish and jewelry can harbour germs. For this reason, it is recommended that staff at child care centres keep their nails short, unpolished and clean. Your hands can be cleaned with either liquid soap and water or alcohol-based hand sanitizer.

Properly washing your hands with liquid soap and water is the most effective way to clean your hands especially when your hands are visibly dirty.  Children need to be taught how to properly wash their hands. The "Happy Birthday" song can be sung twice while scrubbing hands with soap to ensure hands are scrubbed long enough (at least 15 seconds). Be sure to cover the entire hands and wrist and don't forget under the nails!  Steps to washing your hands with soap and water can be found here.
Alcohol-based hand rub is the most effective when your hands look clean.  This will allow the sanitizer to kill any microorganisms that are on your hands but not visible. Steps to washing hands with ABHR can be found here. ABHR should have an alcohol content of 60-90% and not be past its expiration date.  Some children are too young to use ABHR.  All children must be supervised when using ABHR as it can be harmful if swallowed.  Before handling food, soap and water must be used, not ABHR.

Child care operators must provide education to staff and children regarding hand hygiene including:

  • Assisting and supervising children while using alcohol-based hand sanitizer
  • Ensuring hand washing is carried out when hands are visibly soiled
  • Ensuring staff, visitors and children practice hand hygiene upon arrival
  • Remind staff and children to avoid touching their face, nose and mouth with unwashed hands
  • Provide alcohol-based hand sanitizer (60-90%) stations (i.e: wall mounted hand sanitizer dispensers) near entrances, service counters and other high touch locations in supervised areas where children cannot access the ABHR independently.  Monitor and refill as needed.
  • Monitor supplies to ensure adequate amounts of liquid soap, paper towel, hand sanitizer, tissues and waste receptacles with line plastic bags. 
Gloves are useful personal protective equipment (PPE). However, it is important to remember gloves do not replace proper hand hygiene (i.e. using soap and water or ABHR). If gloves are used, hands hygiene should occur before and after glove use. When using gloves ensure to monitor changes. If a contaminated surface has been touched, gloves should be removed and hand hygiene should occur before any other surface is touched. 
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