Having appropriate and easy to follow hand hygiene guidelines in place is the first line of defense against infectious disease gaining entry into your shelter or veterinary clinic. It might be unsettling for you to hear that most diseases are obtained from the shelter rather than coming on from outside sources because of inadequate sanitation protocols. This can extend beyond hand washing into poor intake protocol, poor choices being made for where to house certain cats, no quarantine or isolation areas and so on which are articles I will write later. The number cause of disease spread within a shelter or rescue are the actual employees because they fail to sanitize their hands at all.
Hands are the biggest fomite that is present in the animal care world for spreading disease from animal to animal. A fomite is basically any non-living object that can hold and carry disease. Simply touching an infected animal followed by touching any healthy animal can spread most communicable diseases immediately. This can be detrimental to the animal shelter if someone was to touch a cat with calicivirus or herpes virus then touch a litter of healthy kittens. The time that most diseases are spread by hands is when staff get complacent with not washing their hands because every cat looks healthy when that could easily be an incubatory carrier which means they are brewing the virus inside of them but not showing clinical symptoms yet. Most cats incubate a disease for 7 to 14 days before showing symptoms at which time they are still spreading it.
Proper hand washing or hand sanitation between each animal will limit the spread of disease and go a long way toward maintaining a healthy population. It is vital that you sanitize between touching any new intake or foster animal that may come into the shelter or clinic after touching a current resident. There should be a specific area designated toward entering new intakes. I mean it when I say you must sanitize your hands between each and every animal because you have no way of knowing who is healthy and is truly not healthy during in the incubation stage. Some animals will also continue to spread the disease post treatment for a few weeks.
Proper Hand Washing Protocol
Hand washing is the greatest form of hand sanitation that you can do and it is the cheapest. Washing your hands with antibacterial hand soap between animals or after touching an infected animal will avoid the transfer of disease from animal to animal.
It is estimated that about 50% or more of animal care staff around the world fail in properly washing their hands which leads to an increase in sick animals after a shelter medicine team visited several animal shelters across the United States. Washing your hands is not hard or rocket science so I have posted the protocol below.
The proper protocol for washing your hands is:
- Wet hands with warm water
- Lather hands with soap
- Scrub hands and forearms for 30 seconds
- Rinse hands thoroughly
- Dry hands with a single paper towel each
- Use final paper towel to turn off sink
Basically you want to wash your hands and forearms vigorously for about 30 seconds under soap and water. Clean under every fingernail and remove every piece of jewelry prior to washing your hands. It is only beneficial to wash your hands if you use a single paper towel for each hand and forearm or you are just transferring germs from place to place. You want to use the final paper towel to turn off the water faucet.
The most common mistake that people make is that they use their bare hands to turn on and off the faucet which just reintroduces any bacteria that you had back to your hands. The second biggest mistake people make is that they only wash their hands for 10-15 seconds because bad habits die hard in my experience where that was acceptable at home. It takes 30 full seconds and physical scrubbing to kill the germs.
It is crazy how many people contaminate their hands after washing them because they touch the sink with their bare hands to turn the water off. The same problem can occur with hand sanitizer units if an insufficient amount of hand sanitizer is used to disinfect the hands after touching the same bottle you have touched countless times to sanitize your hands. This may seem small but glo-germ and disease pathogen detection products have proven that small mistakes like this can lead to an outbreak. Last year a cat shelter had an outbreak of upper respiratory infection because of a dust brush that had disease particles caught up in it.
Proper Use of Hand Sanitizer
Hand sanitizer units are cheap and effective which will make this product easy to incorporate into any animal shelter. It is advised that one hand sanitizer unit be allotted per room for staff, volunteers, and customers that way there is always a unit available for staff to utilize. Employees or volunteers will not want to use the product if it is not convenient for them even if they are very caring people because it will eventually make them tired of going back and forth.
The hand sanitizer units would ideally be attached to the wall by a hanger so that it does not get lost or dropped which could break the bottle. Avoid placing hand sanitizer units in front of heaters or other hot objects so they do not explode or melt and do not set any sanitizer units by open windows as they are light sensitive.
The reason that hand sanitizer is so effective is because it is convenient for staff and customers to use in comparison to hand washing if placed strategically across the building. It is often said that the use of hand sanitizer can be more effective than hand washing just for the fact that people prefer it over going to the sink each time and washing their hands over and over again.
While using hand sanitizer between animals for the role of spot cleaning is fine – hand washing is advocated when dealing with ill animals or animals that have not been physically examined yet. I will also wash my hands if I have touched more than 5 animals and have only used hand sanitizer between them. Too much dirt or grime on the hands can inhibit hand sanitizer so I wash my hands thoroughly after touching every sick animal.
Hand sanitizer units need to be between 60% and 90% ethanol alcohol. Any lower or higher ration of alcohol in the sanitizer can actually facilitate the spread of disease. You want to avoid using a Triclosan or quaternary ammonium compound based sanitizer. Sanitizer that contain Triclosan or quats are ineffective against most diseases and are linked to toxicity in cats.
Follow the guideline for proper hand sanitizer usage below to ensure usage:
- Squirt olive sized glob of hand sanitizer
- Rub hands together vigorously for 30 seconds
- Allow the hands to dry completely
Latex gloves are great for when you are dealing with animals that are very sick but are never a substitute for hand washing or sanitation. You are to sanitize your hands before and after using gloves. Animals that are verified as being sick should not be handled without gloves if you want to be serious about preventing the spread of infectious disease. This is especially true with ringworm. Many shelter managers make the mistake of not buying gloves due to the cost of buying them in a store such as Walmart.
However, gloves do not have to be expensive or made of tough material for them to get the job done. You are only wanting the gloves to be strong enough to last for the animal that you are dealing with because they are single use gloves only and should not be used for multiple animals. Do not try to disinfect gloves as this leads to an increase in disease spread. The cheapest gloves you can buy are food service gloves which are available in bulk. You will find that you can buy about 5000 gloves per $30 which boils down to less than 10 cents per pair of gloves.
Food service gloves are affordable and made well enough to protect your hands from picking up deadly diseases that are contagious to other animals. Adding food service gloves to your shelter for staff use will decrease the amount of money you have to pour into treating sick animals as a result of not having them made available.
There are a few extra techniques that you can incorporate into your hand hygiene guidelines to promote proper sanitation protocol and to ensure that the staff are doing their job adequately. One of my first suggestions is to have official training sessions with each employee or a group of employees then have someone put up a how to clean your hands poster on the wall next to the sink.
Avoid The Following While Cleaning:
- Using mobile devices can serve as a fomite
- Eating or drinking is just not healthy
- Sitting or playing on the ground
- Holding animals too close to clothing
The first technique for determining how your employees are doing is to set one toy on each hand sanitation unit while they are cleaning. If the toy is not removed, then the hand sanitizer is not being used by staff and it is time for a staff meeting. You can draw a triangle shape in the sink with a dry erase marker to check that people are washing their hands. If people are washing their hands properly then the shape would be removed by the soap and water.
Glo-germ is an excellent choice for teaching people how to properly wash their hands after touching a shelter animal. You would throw this substance onto a stuffed animal then have staff touch the stuffed animal. You would have the staff wash their hands or sanitize them following the interaction with the stuffed animal. You will gauge how good their hand washing or sanitation was based on how much of the product remains on their hands.
You would use a fluorescent black light to check the hands over before and after to verify that the staff completely cleaned their hands of the glo-germ. If too much glo-germ remains, you will want to revisit the hand hygiene guidelines to make sure the staff understand them. One of the largest reasons that staff avoid sanitizing or washing their hands is because they are lazy or do not understand how it helps.
Someone once asked me if I make customers and guests sanitize their hands and my answer is absolutely or all of the hard work you did to keep your animals healthy will fall flat. The customer can leave if they do not want to abide by sanitation protocols. Hand washing is still a very good option for customers who are allergic to hand sanitizer – and you may carry a few brands that are not alcohol base for those people who do not want to wash their hands or use alcohol based sanitizers. They may not be as effective but at least you will have something on board to keep the cats healthy.
The second biggest leading cause is that employees are led to believe that upper respiratory is airborne and to an extent that is true since cats can sneeze up to 7 feet but beyond that 7 feet is the fault of the employee and bad management practices. Another common mistake I see in new shelters is that employees will not wash their hands after touching just the cage of a cat or their supplies. I once noticed an employee pick up the clipboard from a sick cat cage to review it and set it back on the cage but did not sanitize his hands before touching the cat next to him. It is important to realize that the bowls, clipboards and toys are just as likely to spread the disease through your hands as touching the animal is. There could be sneeze spots all over the box and bowls which will spread the disease potentially faster than touching the cat if you think about it.
A shelter manager from California that I talked to once said that since a cat can spread the upper respiratory infection from from the intake room to the isolation room through the air that it was a waste of time washing our hands. I have no idea who would actually believe a cat or a human for that matter can sneeze 30 feet and through a door but every single day I hear this excuse and I have to use all of my power not to tell them what I think. A cat is not going to sneeze and infect a cat one room away unless you have you air flow really messed up and we will talk about proper air flow management in a different article as that is a whole topic by itself.