Hands-free sinks make hand hygiene compliance easier, but they aren’t required

By: February 10th, 2010 Email This Post Print This Post

Q: Are hands-free sinks required by OSHA? Are they recommended by the CDC?

A: This is a relatively unregulated subject of healthcare, which may be surprising considering the endless effort put into hand hygiene compliance.

OSHA does not have any standard or regulation that makes hands-free sinks a requirement, most likely because hand hygiene has more to do with patient safety and infection control, which goes beyond the employee safety scope of OSHA oversight.

The CDC Guideline for Hand Hygiene in Health-Care Settings also does not mention hands-free sinks. However, APIC’s Infection Control in Ambulatory Care says: “Ideally, sinks should be equipped with foot- or elbow-operated controls…many local or state public health codes regulate sink location and type.”

Essentially this comes down to your facility’s policies. Some medical facilities may require hands free sinks in certain high-risk areas such as the ICU, transplant unit, ED, or OR areas.

This is usually an issue during remodeling and construction. I have helped open up three different new facilities and have requested all patient care sinks to be hands-free, but when budgets have to be met, usually we have to prioritize by installing these sinks in the previously mentioned areas. If you’re lucky, you might have the money to get all of them.

In ASCs that often have even tighter budgets, I usually see hands-free sinks in the OR settings where staff members scrub their hands, but usually it’s not worth the money to install them in some of the other low-risk areas.

When it comes down to it, deciding where to put hands-free sinks comes down to what area has the highest level of 1) bioburden or 2) compromised patients.

Also keep in mind, when healthcare workers wash their hands at a regular sink, they should turn off the faucet without contaminating their hands, according to the Institute for Healthcare Improvement’s “How-to Guide: Improving Hand Hygiene.” (p. 22).

“Turn off water without recontaminating hands: If the faucet is hand-operated, use paper towel to turn off the faucet; if the faucet is automatic, credit for compliance is given for correct performance. Dry hands with fresh paper towel.”

For more hand hygiene compliance tips on surviellence, policies, and procedures, visit the Tools section, or check out the Infection Prevention Handbook, a beginners guide to all things IC.


By Susan E. Fisher on February 11th, 2010 at 3:53 pm

I just completed a hand-washing competency for 86% of the entire staff at our facility, a 33 bed nursing, 20 bed Personal Care facility. One of the most often neglected steps was that second dry paper towel to turn off the water. The other item that was done incorrectly was water temperature. Staff wanted to use water that was too hot.


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