health and hygiene

preventive measures
for school re-opening
 Session 1: Effective Hand Hygiene using Hand Sanitiser

Hand-washing with soap is the best method for killing viruses

(particularly enveloped viruses such as Coronavirus). Alcohol-based
hand rub with 60-70% alcohol is almost as effective as hand
washing but obviously a lot more convenient. The organic hand
sanitisers are not effective against the coronavirus.

If hands are visibly dirty then they should always be washed with soap
and water. Rings and bracelets are particular hazards for trapping virus
particles and bacteria and it is recommended they be removed. There
are 7 steps for effective hand hygiene.

Resource for 7 Steps poster:

https://www.who.int/gpsc/clean_hands_protection/en/
 The 7 steps to Hand Hygiene
● Basic steps are similar for hand washing and hand sanitising.
● The entire process should take 20-30 secs (e.g. sing Happy Birthday song twice).
● Wet hands first if hand washing.

01 02 03 04

Apply a palmful of the Rub hands palm Rub the back of the hands Palm to palm
hand soap or hand to palm. (right palm over left back interlace the
sanitiser unto of hand and then left palm fingers.
cupped hands. of right back of hand).
 The 7 steps to Hand Hygiene

05 06 07 08

Backs of fingers Rotate palm of Point the tips of the ● For hand washing: rinse
and nails and right hand around fingers into the palm soap with water and dry
vice versa left thumb and and rotate to clear hands with towel
vice versa nails and finger tips ● For hand sanitising: allow
and vice versa hands to dry
Source: https://www.who.int/gpsc/clean_hands_protection/en/
 Session 2: Correct use of face mask

Wearing a face mask offers some protection – to yourself and others.

● While wearing a face mask:
○ You still need to adhere to as much social distancing as possible.
○ You still need to frequently wash or sanitise your hands, including
cleaning your hands before and after wearing your mask.
○ You still need to frequently wash or sanitise your hands, including
cleaning your hands before and after removing your mask.
● Know your mask (the coloured side should face other people; the top has a
metal strip).
● Have adequate supply of correct type of mask (3-ply) available readily at all
times to all staff and students.
● Once you have put on a face mask, make sure it remains in place at all times
but do change it when it is wet or soiled.
● Ensure adequate covered dustbins, preferably those which the covers open up
with a foot lever. Empty the dustbin regularly.
 How to wear face masks correctly

Ensure your nose, mouth and chin are

01 Hold the mask by the ear loops. 02 covered entirely by the mask.

Ensure there are no gaps at the sides

Shape the metal strip properly to the
03 between face and mask. Tighten the ear 04 shape of your nose.
loops or strings if necessary.
How to remove and dispose face masks properly

Dispose the used face

01 mask into a closed 03
dustbin immediately.

Remove by the ear Do not reuse

loops. Do not touch the 02 disposable face
mask piece. masks.
 Session 3: Assertive Communication

School teachers are our new front-liners. However, you cannot protect yourself, or
stop Covid-19 alone. The whole community must do their part!

Behaviour change is complex. It’s important that we help each other. We need to be
able to approach someone who is not doing it correctly, even if it’s your headmaster.
 Supporting change
requires:
● Modelling appropriate behaviour – you have to do it yourself before you can ask others to do the same.
Children are in their developmental phase and will likely do what we do, not what we tell them to do.

● Training of all students and staff (including the general workers and administrative staff).

● Frequent reminders because it takes time for people to make this part of their lifestyle.

● Assertive requests to seniors that are not doing it correctly and that includes your
headmaster.
 Assertive people:

● Are respectful.

● Are clear about what is needed.

● Communicate clearly, kindly and firmly.

 Tips for Assertive
communication:

● Keep it short.
● Always be respectful and non-judgemental.
● Monitor your voice and body language. Be cool, confident and calm.
● Maintain appropriate eye contact.
● Listen when the other person is talking and reflect back to show that you’ve heard him.
● Offer practical help if necessary.
 Session 4: Teaching a skill in healthcare
Skills in healthcare range from simple, such as putting on a mask, to extremely complex, such as
doing a surgical operation. Doing it right can be extremely important in healthcare so our teaching
aim is to ensure that the learner can do the skill correctly and understand why it is important to
use the correct technique:

● Obviously, a skill cannot be taught in a lecture. Lectures are for transferring knowledge and
we know they have limited ability to do even this and almost no ability to change practice.
● Likewise, it is unlikely a skill can be taught by just watching someone do it. They can
watch but until they have done the skill themselves, they don’t know whether they can do
it. (For example, you might watch how to cook a particular recipe on YouTube but you don’t
know whether you can do it until you have tried it).
● Can a skill be taught by doing it? Yes, but how will the participant know whether they have
done it right? (If you follow what your saw on YouTube and it doesn’t turn out right how will
you know what went wrong)?

So lecturing, watching or doing alone will not be enough but all of them together are and that’s
what the TELL, SHOW, DO and FEEDBACK method is.
TELL, SHOW, DO AND FEEDBACK teaching method
 Tell
You tell the learners what you are going to teach them. “I’m going to teach you to wear
a mask correctly. There are 7 steps.” This step might be used to give some introductory
information. For example, if we were teaching a group of healthcare students to wear a
mask, we might start with the theory behind why a mask is 3-ply and perhaps show some
research evidence on the effectiveness of masks in different situations such as in the
operating theatre or in a shopping mall. Asking questions here helps to get participation.
 SHOW
You run through the skill demonstrating it yourself and at the same time explaining
what you are doing and giving any necessary details. For example there are 7 steps to
wearing a mask:

1. Wash hands with soap, dry and take a mask. (Here I might say that a lot of people don’t realise that
their hands or not clear if the wash their hands without soap).
2. Take the mask and identify the side that faces outwards and the side that faces you.
(Here I might point out that this matters since the inside and outside materials are
different and that the coloured side is generally the outside).
3. Identify the top and the bottom. (Here you might explain that there is a metallic band
at the top and none at the bottom and the band is used to help ensure a close fit
around your nose).
4. Hook the mask over your ears.
5. Pinch the nose to shape the metallic band.
6. Pull the mask down under the chin.
7. Seal the edges (Here I might say that it is important to get a seal around the mask).
 DO
Each participant gets to do it. Sometimes you have to guide them through each step as
they do it and if so then it is a good idea to ask them to repeat it on their own or repeat it
while telling you the steps as they perform them.

FEEDBACK
Each participant is given effective feedback.
 How to give effective feedback using
the so-called ‘sandwich’ method (3 layers)
Top layer (BREAD)
Start with what the participant did well. (For
example, I liked the way you held the mask and you
applied it correctly).

Middle layer (filling)

Any areas that need improvement. But I noticed that you
touched the outer surface of the mask frequently. This is
worrying because when you touch the mask you are transferring
any droplets that may be on the surface of the mask onto your
hands. You could pass these to other people or transfer them to
another part of your face. Be careful that this is done in a
constructive way.

BOTTOM layer (Bread again)

But if you work on avoiding this and continue to use
the correct way of wearing the mask and manage to
avoid touching the mask or your face you are doing a
good job.
 Important Points that make this teaching method work better
01
Plan your session – write it out like
this (similar to a lesson plan).
04
Therefore, to allow for
participation the group size must
be small – 5-6 people.
07
To ensure that learning has
occurred an assessment should
be carried out at the end.
02 03
Keep it short 30 minutes. All the participants must participate.
There are no spectators.
05 06
To aid learning the session must be interactive – Feedback must be given in an
two-way – participants should contribute. effective way. Avoid destructive
feedback.
Encourage the quiet learners to contribute.
Don’t let the dominant learners dominate.
The content in this document are the notes for the virtual
training on ‘Health and Hygiene Preventive Measures for
School Re-opening’ held on 17 and 18 June 2020.

The virtual training was organised by Edvolution Enterprise

with the support of Pejabat Pendidikan Daerah Timur Laut.

We would like to thank four esteemed doctors from

Paediatric Department of RCSI & UCD Malaysia Campus
(RUMC), formerly known as Penang Medical College, for
delivering the training and providing the notes.