“Students are often in a rush to participate in outdoor activities or lunch breaks,

preventing them from washing their hands.”

Influencing change

Robert Kravitz reflects upon how to encourage better washroom hygiene in schools. Facilities

A study was completed a few years back involving six Local Authority schools in southwest England. The researchers were looking for ways to address the fact that about half of all the respiratory infections and intestinal diseases in these local communities were among school-aged children.

The researchers suspected that poor hand hygiene in schools was playing a role in this problem. They were also looking for ways to encourage students to wash their hands more frequently and thoroughly.

The study included actual observations of students using washroom facilities, interviews with teachers as well as students attending these schools, and focus groups with teachers and pupils. It was believed that with the focus groups, the researchers could explore the students’ views on handwashing, the handwashing facilities in the schools, and their thoughts on barriers to good hand washing.

Here are some of the results reported:

Time Many students indicated they did not wash their hands correctly or at all because they did not have enough time. One teacher reported that this was ‘the biggest barrier’. Students added that they are often in a rush to participate in outdoor activities or lunch breaks, preventing them from washing their hands.

One way this issue was addressed at lunchtime was to give the students five to 10 minutes to use the washrooms and wash their hands, before going to food areas.


The researchers reported that ‘having attractive and clean facilities was seen to encourage hand washing’. However, the restrooms were apparently not well maintained. One student in the focus group said the restrooms in one school were ‘dirty, dirty… they're dirty’, which is why she tried to avoid the toilets in general. She also mentioned they had malodours.

Further, it was noted that on a score of one to five, with five representing the most severe situation, the students scored the restrooms three or higher. This indicates most students felt the restrooms needed more adequate cleaning.


Some students said that when they walked into restrooms, there were no lights on. This made them uncomfortable, causing many students to not use the restroom. School authorities were encouraged to install movement sensors to detect when someone entered. Another issue was soap: while it was available in all restrooms, it was not always available at classroom sinks. It was suggested that soap be provided at all sinks, no matter where they were located, to facilitate improved hand hygiene.

Finally, water issues surfaced. Occasionally, some restrooms had no water; at other times, the sinks only dispensed cold water or only hot water. Further, some students complained about touching the faucet handles, preferring the faucets be sensor-controlled, as are the toilets in the schools.

Societal norms

What may have come as a bit of a surprise was that the focus groups revealed that some students did not wash their hands because they believed there was ‘disapproval of such behaviour’ by their peers. Many of us underestimate the power of societal norms, especially when we were in school. Apparently, it was so invasive, one pupil said: "some people pretend to turn the tap on but don't actually put their hands under."


The researchers suggested encouragement and reminders. Teachers were urged to ask the youngest students "have you washed your hands?" after using the restroom or before going to food service areas. Older students, as they approached food service areas, were asked, "aren't you going to wash your hands?" A gentle, yet direct, reminder.

Additionally, handwashing posters, encouraging students to wash their hands, were placed in strategic areas around the schools. One teacher commented: "I think posters around the schools help."

Overall, posters were seen as very helpful influencers, according to the participants in the study. Other studies have also found that posters placed around schools and

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