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Inadequacy of water and sanitation in school environments is a major hindrance towards young people’s educational achievements and ultimately, life goals. On the same breath, hands play a major role in the transmission of infectious diseases, which leads to illnesses and absenteeism. Hand hygiene is, therefore, critical in the efforts to reduce illnesses and the related absenteeism (Lau et al., 2012). To address the issue of sanitation in public schools, this paper suggests a hand washing policy at Spruce Creek High School as well as other public schools in the same locality. The scope of the policy will be at the local level, and it will involve the School Board of Spruce Creek High School. As such, the designated legislator will be the Vice-Chairman of the Volusia County School Board, Mrs. Cuthbert.
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Interest in and Importance of the Policy
My interest in hand washing in public schools is a personal one. My daughter attends a public high school (Spruce Creek High School) where bathrooms and sanitation are not desirable. The toilets are clogged; dead bugs float in the toilet water; there are no tissue papers and liners for menstrual products in the stalls; also, there are neither soaps nor paper towels. It occurred to me that it is necessary to address this issue the soonest possible.
Ultimately, a hand washing policy will be critical in numerous ways. Specifically, the policy will reduce disease burden among children and staff, their families. It will also enable effective learning towards healthy children in a healthy learning environment. It will ensure deeper gender equity regarding access to education and meeting hygiene-related needs. It will also give school children a background of positive hygiene behaviors that they can continue to practice in their post-school lives. All these with foster a safe and healthy environment for the entire community (Adams et al., 2009). In other words, this policy is not only valuable to individuals (that is, students and staff members), but also the surrounding communities.
Specific Problem: A Focus on Norms and Regulations
Policies as well as supporting legislation are essential in providing a clear vision for the establishment of basic principles and objectives that guide sanitary improvements (Adams et al., 2009; WaterAid, 2010). At the federal, state and local levels, there exist a number of historic public health legislations that consider and seek to correct health risks associated with poor sanitation. These refer to national and local standards of hygiene, and they include minimum requirements for the microbial quality of water, treatment of drinking water as well as chemical and radiological quality of drinking water (Adams et al., 2009). Almost every country has these policies and legislations, and they include additional recommendations from key agencies such as the World Health Organization (WHO).
The problem, however, is that these policies and legislations often lack traction at the program level where programs fail to utilize health outcomes as indicators of success. On the other hand, health policies tend to focus more on the aspects of service delivery, often with less emphasis on and dedication of human and financial resources towards preventive measures including sanitation (WaterAid, 2010). This is the failure that is evident at the Spruce Creek High School and many other public schools for that matter. Therefore, the policy recommendation of this paper focuses more on regulations at the local and implementation levels. Indeed, there is a huge opportunity for the health sector to promote behavior change (that is, positive hygiene behavior), which will ultimately lead to better policies and programs (WaterAid, 2010). Besides, it is in the realm of monitoring and enforcement that Spruce Creek High School has largely failed. In this respect, this policy will focus on clean and well-maintained (including regular janitorial services) and well-stocked facilities, which will provide a model to the users of healthy practices to be implemented in school settings. With appropriate regulation, the administration of Spruce Creek High School can ensure that the health facilities are equipped adequately with functioning sanitation facilities. Regulation, through instruction and monitoring, will also ensure that students and staff comply with proper sanitation guidelines. Teachers, for example, will be required to lead by example and demonstrate, among others, the effective ways of washing and drying hands.
Review of Thoughts on Hand Washing Policy Issue
There are factors that significantly influence hand washing behavior in school settings. Chittleborough et al. (2012) conducted a study on these factors (among both students and staff), focusing on the opinions of pupils and teachers. They made a number of significant findings that can be valuable in the formulation of the policy in question. The important implication in the study is that hand washing does not merely happen because of the presence of water. Particularly, their respondents reported the lack of time as one of the reasons why pupils and teachers fail to wash their hands entirely or not properly. Related to this was the question of competing priorities (that is, having something better to do with that time). On facilities, the study found that attractive and clean facilities encourage hand washing in a way that unsanitary facilities do not. There is also the salient issue of accessibility such as the height of sinks. The availability of soaps and paper towels, among others, was also associated with hand washing tendencies. They also cited social norms, encouragement and reminders, education and information, awareness and knowledge as significant factors related to hand washing.
Where to Find Status of the Issue
There are a number of places that can help to uncover the status of hand washing. The best sources are those from the agencies that run hand washing projects. For example, WHO’s WASH project, for example, is a good source, although this mainly focuses on the developing world. There is also the Government Take Action project (supported by UNICEF, Water and Sanitation Program [WSP], Pan-American Health Organization [PAHO], and WASHPlus), which focus on improving positive hand washing behavior in various countries across the world.
Sri Lanka is a good case study for the success of legislation and policy, accompanied by monitoring and enforcement efforts. The health sector actively took steps to develop guidelines for the construction of latrines and safe disposal of excreta. Moreover, the health ministry went on to undertake education and awareness-raising campaigns to develop norms and regulations. These were critical in changing behavior. Ultimately, policies, public information campaigns as well as proper implementation on cleanliness and availability of the right facilities stimulated “demand among communities for improved sanitation facilities” (Water Aid, 2010, p. 13). This approach can be more effective and successful at a smaller scale such as Spruce Creek High School.
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Importance to Nursing
This policy would be important to nursing in general, especially by freeing nurses to deal with bigger and unavoidable problems. The U.S. has suffered a shortage of nurses for decades and the problem is expected increase partly owing to an increasingly aging population and the rise of incidences of chronic illnesses (Grant, 2016). While in the meantime the government works towards dealing with this problem, the general population can help by ensuring that they do their part in dealing with preventable diseases. This will free up nurses to deal with more serious health issues. Hand washing – and sanitation in general – is a significant way to avoid creating unnecessary pressure on the already resource-strained nursing sector. Simply, the public should do their part so that nurses can have time to do what they must do.
The paper suggests stringent hand washing policy. The policy focuses on regulation at the implementation level in this case Spruce Creek High School, whose sanitation facilities are unsafe and lack the necessary resources including paper towels. Indeed, evidence shows that despite legislations, there are often problems at the implementation level. This policy, therefore, places emphasis on monitoring and enforcement which include keeping sanitation facilities clean as well as providing the necessities such as clean water, soap, tissue and paper towels among others.
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- Adams, J., Bartram, J., Chartier, Y., & Sims, J. (Eds.) (2009).Water, sanitation and hygiene standards for schools in low-cost settings.World Health Organization
- Chittleborough, C. R., Nicholson, A. L., Basker, E., Bell, S., & Campbell, R. (2012). Factors influencing hand washing behavior in primary schools: Process evaluation within a randomized controlled trial. Health Education Research, 27(6): pp. 1055-1068
- Grant, R. (2016). The U.S. is running out of nurses, The Atlantic, Feb. 03. Retrieved 03 November 2017, https://www.theatlantic.com/health/archive/2016/02/nursing-shortage/459741/
- Lau, C. H., Springston, E. E., Sohn, M., Mason, I., Gadola, E., Damitz, M., & Gupta, R. S. (2012). Hand hygiene instruction decreases illness-related absenteeism in elementary schools: A prospective cohort study. BMC Pediatrics, 12: pp. 52-59
- Jasper, C., Le, T., & Bartram, J. (2012). Water and sanitation in schools: A systematic review of the health and educational outcomes. International Journal of Environmental Research and Public Health, 9: pp. 2772-787
- WaterAid (2010).The sanitation problem: What can and should the health sector do? Report