Benefits of restroom automation: touchless technology keeps germs in their place.

Driven by the growing concern over germs on restroom surfaces, an increasing number of commercial, private, and public buildings are installing automatic faucets, flushers, soap and paper towel dispensers, cleaning systems, and other touch-free devices in their restrooms. In addition to sanitation issues, other factors are contributing to this trend that long-term care facility managers should consider.

Germ Concerns and Phobias 

Restrooms and wash stations used by nursing home residents and staff members can potentially communicate disease. Nurses and aides are aware of the risks and, whether they are working in facilities with or without restroom automation, they strive to be diligent about frequent and thorough handwashing and other precautions.

Aged and infirm residents, however, are not capable of the same level of personal hygiene. Despite the best efforts of nursing homes to assist residents and to ensure their rooms and bathrooms are clean and sanitary, a common perception among visitors is that germs are pervasive in the bathrooms. The facilities are not to blame. Rather, the general public's awareness of germs and how they are transmitted has increased, their fears fueled by widely publicized reports of new viruses, such as SARS and virulent strains of the flu. Increasingly, people are avoiding contact with anything in any bathroom away from home, including the most spotless restrooms. Their suspicions are likely to be greater in bathrooms used by people who are incontinent, sick, or incapable of proper hygiene.

Conversely, friends and relatives are naturally going to feel more comfortable visiting a long-term care facility with bathrooms that are sanitary and designed to promote cleanliness and accommodate easy maintenance. This preference is especially true of families searching for a permanent home for a parent or grandparent. Discovering that resident and guest bathrooms are fitted with touch-free faucets, automatic flushers, and possibly other automatic devices could contribute to their selection of a long-term care facility. Just knowing that a family member will have the convenience and luxury of automation will help make them satisfied with their decision.

Minimizing Visitors' "Contributions"

The public's assumptions about the sanitation benefits of automation are accurate. Evidence exits that touch-free faucets and flushers can effectively reduce possible cross-contamination, but proof is not essential when the absence of handles means no one has to touch the same water activators that other people have touched.

Visitors, or course, bring their own germs. They might see the wisdom in washing their hands when they arrive and when they leave a nursing home, but fail to do so. Even though the CDC's National Center for Infectious Diseases says frequent handwashing is one of the best ways to prevent the spread of infectious diseases, a survey conducted by Impulse Research Corporation found that 30% of Americans use bathrooms away from home only when they are desperate. The same survey discovered that among people who do use public restrooms, nearly 66% employ a variety of maneuvers to avoid touching anything: using elbows to open doors, feet to flush, and paper towels to touch faucets and the door on their way out. For some, it's easier to avoid handwashing altogether.

Logic dictates that people would be more willing to wash their hands if they didn't have to touch anything at the sink. The surfaces of automatic faucets and soap and towel dispensers won't be contaminated or transmit germs if no one needs to touch them. With automation, people can lather up, scrub down, rinse, and dry with only touching a fresh paper towel.

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Reduced Cost and Maintenance

Automatic faucets save water, which only flows when hands activate the fixture. Excess water use is no longer an issue solely for conservationists, but also for the budget-conscious. People who move slowly often allow faucets to flow longer than necessary, or forget to turn them off when they are done washing. If a washcloth or paper towel settles in the sink, a blocked plug can result in flood-like conditions if not detected quickly, causing a safety hazard, a maintenance problem, and possible damage to the floor and baseboards.

Water conservation was the impetus for a decision by the nursing home operated by Cape May County, New Jersey, to install automatic faucets in every bathroom in its 178-bed facility, including in the common areas.

"The faucets were a major investment, but they have paid for themselves in reduced water consumption and maintenance costs," says Jim Kronemeyer, manager of mechanical services for all county buildings.

He says he did not do a return on investment analysis because the savings were obvious. Before making the purchase, however, he was aware of a test at the Minneapolis-St. Paul International Airport that compared the metered use of the automatic faucet with the metered use of a push-down, self-closing faucet. After more than 500,000 cycles, the automatic faucet used an average of 0.20 gallons of water per use, compared with 0.65 gallons for the manual faucet. After factoring in the costs of energy, sewerage, and maintenance, the automatic faucet decreased water and energy usage by 70%.

Kronemeyer says the staff members in the county's nursing home are pleased with the faucets since they save time and reduce the threat of cross-contamination. Also, the faucets are on a control loop that delivers a constant water temperature as soon as the flow is activated by the user's hands.

The county nursing home is now adding automatic flushing devices, prompted by requirements of the Americans With Disabilities Act (ADA). The facility is equipped with tankless toilets, but ADA inspectors declared that some of the handles are too difficult to reach and create problems for wheelchair users. The toilets' position in relation to walls and support bars was also a problem, so they needed to be moved to the other side of the pipe. To avoid a costly retrofitting, the county purchased automatic flushing units that slide over the existing handles and are clamped on with two simple screws.

"We not only complied with the ADA," says Kronemeyer, "but also solved the unpleasant problem of toilets that sometimes didn't get flushed."

Automatic faucets and flushers exceed ADA guidelines requiring restroom fixtures to be operated with "one hand and with a force to activate 5 lb or less." People weak with illnesses or infirmities have no handles to push or pull at the sink or difficult-to-reach handles in bathroom stalls. Self-activating fixtures simplify the process for everyone.

New Technology Improves Acceptance

Skepticism has prevented some facilities from converting to automation because some earlier generations of touch-free fixtures proved to be unreliable, but Kronemeyer says that the failure rate of the automated products he has installed is "next to nothing." Fortunately, technological advances have made touch-free products significantly more dependable and durable. Newer products are smaller, use fewer parts, are easier to install, and are more aesthetically pleasing. In general, they last longer, are cheaper to operate, and require less maintenance.

Among the new components found in some touch-free fixtures are cam gears that replace solenoid valves. Cam gears in faucets, flushers, and soap dispensers keep all electronics away from water, unlike solenoid valves that are sensitive to moisture and can corrode and fail.

The newest automatic faucets use capacitive sensors that are more responsive than infrared sensors. They surround the fixture with a force field. Water flows as soon as hands approach the top, the bottom, or any side of the faucet, an advancement that should appeal to seniors and convalescents who might be slower moving, physically impaired, or easily confused. Also new on the market are automatic flushing devices that can be installed on existing tank toilets.

Installations in existing buildings are easier and less costly with faucets, flushers, and soap dispensers that use standard alkaline batteries as their power source instead of low-voltage hardwiring. The batteries last up to three years, partly because cam gears only draw power when the units are in use. Solenoid valves require continuous electrical draw, using more energy.

Other Products and Benefits

Automation also eliminates or reduces the puddles and pools of soap around sinks that are viewed as breeding grounds for germs. A mess is less likely with a touch-free faucet and an over-the-bowl automatic soap dispenser because users don't have to raise their wet hands to turn a faucet handle or pump out more soap.

The bad smells and sights that convey the perception of germs can also be eliminated through automation. Automatic air fresheners, neutralizers, and cleaners are never touched by visitors to a bathroom. Clean air not only gives the impression that restrooms are free of germs and bacteria, it also makes restroom visits more pleasant.

Savings are generated from automatic soap dispensers with portion control. One shot of condensed soap from an automated dispenser is sufficient to prevent users from pumping an excessive amount of soap that takes longer to rinse off. Automatic paper towel dispensers control the amount of paper needed for a thorough hand drying.

The cost benefits of automatic bowl and urinal cleaning devices should not be overlooked. Around-the-clock cleaning and deodorizing--in addition to improving appearance, sanitation, and air freshness--eliminates the laborious task of scrubbing stains off toilets and urinals. Routine maintenance requires only washing a fixture's exterior surface.

With advancements in touch-free restroom devices, nursing homes can cost-effectively improve sanitation and health conditions, and meet the growing expectations of residents, families, and visitors.

Mark Lewis is the Outbound Marketing Director for Technical Concepts in Mundelein, Illinois, a manufacturer of touch-free restroom fixtures, air neutralizers, and aerosol fragrances and dispensers. For more information, call [phone], ext. 144, or visit www.technicalconcepts.com. To send comments to the author and editors, e-mail [e-mail]. To order reprints in quantities of 100 or more, call [phone].