NICU Standard 13: Handwashing

Every infant bed, whether in a single or multiple-bed room, shall be within 20 feet (6 meters) of a hands-free handwashing station.  Handwashing stations shall be no closer than 3 feet (0.9 meter) from an infant bed, clean supply storage, or counter/work surface unless a splashguard is provided.

Handwashing sinks shall be large enough to control splashing and designed to avoid standing or retained water. Minimum dimensions for a handwashing sink are 24 inches wide x 16 inches front to back x 10 inches deep (61 cm x 41 cm x 25 cm) from the bottom of the sink to the top of its rim. The faucet shall be offset from the drain. There shall be no aerator on the faucet.  Space for pictorial handwashing instructions shall be provided above all sinks. Space shall also be provided for soap and towel dispensers and for appropriate trash receptacles. Towel dispensers shall operate so that only the towel itself need be touched in the process of dispensing, and constructed in such a fashion as to control noise as per Standard 29. Walls adjacent to handwashing sinks shall be constructed of non-porous material.  

Handwashing facilities located at a level where they can be used by people in wheelchairs shall be available in the NICU.

Separate receptacles for biohazardous and non-biohazardous waste shall be available. 

Interpretation:  Proper hand hygiene is a key component in the prevention and reduction of spread of infection in health care settings.  Alcohol-based hand rubs (ABHR) have been shown to be more effective than soap-and-water handwashing in decontaminating hands that are not visibly soiled.  ABHR dispensers can be easily located at sites where hand hygiene is required. Handwashing sinks are also required in close proximity to infant spaces to be used when hands are soiled or contaminated with body fluids.

Sinks for handwashing should not be built into counters, and the rim should be either less than two inches wide or rounded to discourage placement of clean items on a contaminated surface. Sink location, construction material and related hardware (paper towel and soap dispensers) should be chosen with durability, ease of operation, ease of cleaning, and noise control in mind. Non-absorbent wall material should be used around sinks to prevent the growth of mold on cellulose material.

Local, state, and federal regulatory agencies dictate what healthcare-generated waste is biohazardous or non-biohazardous and appropriate disposal methods that are dependent on the type of waste. Depending upon the jurisdiction, biohazard signage may need to be affixed.

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