Therapeutic Use of Soap: 7 Tips for Improving Your OT Hygiene Routine

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TRUE STORY: Due to God’s wonderful sense of humor, on the same day I was writing this post I experienced a perfect example of just how fun (and by fun I mean ABSOLUTELY GROSS) it is to work with kids in any setting!

I knew when I chose this career that working in healthcare – especially as an occupational therapist – would put me in close proximity to many unsanitary situations. However, my academic and professional experiences in schools, SNFs, hospitals, and retirement communities have given me a new perspective on the importance of maintaining a hygienic therapeutic environment as an OT.

Earlier this year, a kindergartner at one of my schools had a bowel accident and came down to my room for help because the school nurse and social worker were gone. I asked him to go into the bathroom and get cleaned up while I found him some clean clothes to change into. When he was done, he opened the door and tried to hand me his heavily soiled underwear and pants. I quickly ushered him back into the bathroom, where I reminded him to flush the toilet (which he did with his hand) and helped him bag up his soiled clothes. When we were done, he tried to leave the bathroom without washing his hands. When I asked him to wash his hands, he got some soap, quickly rinsed it off, dried his hands and left. And for all I know, all the rest of my little friends are doing the exact same thing before they come to see me!

This was an extreme example of just how dirty a job as a school-based OT can be, but for many clinicians this sort of situation is a regular occurrence. And for many others, it may be an everyday occurrence that they’re just not aware of…So no matter where you work, hygiene for yourself and your clients is crucial.

Much of this information will probably come as second nature to OT practitioners working in hospital environments, as there are generally much stricter sanitation regulations than there are in other settings. But even if you work in settings where you aren’t regularly providing interventions related to toileting or other self-care tasks that might put you in direct contact with bodily fluids, good hygiene is still something you can promote in in your daily practice.

After the jump, read 6 tips that demonstrate how making changes to the person, environment, or occupation can help clean up bad hygiene habits and improve your therapy practice!

6 Practical Tips to Improve Your OT Hygiene Routine

  1. Make being clean a part of your routine. Whenever possible, start each session with sanitization. You can work with clients of all ages on developing healthy handwashing habits that they can generalize to other environments. It may be a challenge at first, but by focusing on making hand hygiene a habit, you can help decrease the spread of germs between clients and clinicians. In case you’re wondering how you’re supposed to get every client to a sink before your session starts, research shows that in many cases using an alcohol-based liquid hand sanitizer/gel (with 60% or more alcohol content) is equally or more effective at disinfecting hands than liquid soap and water.* Even if you don’t believe that sanitizer is as effective, it significantly reduces the amount of germs on hands immediately after use, which is better than nothing! NOTE: If hands are visibly soiled after a session, use soap and water to get them clean.

  2. Keep cleaning items close by. For example, keep hand sanitizer gel or wipes in your therapy bag or treatment area. Or keep Lysol wipes in your car or bag that you take with you between sites. Having cleaning items handy means they are more likely to be used! (NOTE: Client safety is paramount. Make sure you store potentially harmful products in areas that are locked or out of reach. This goes for clients of all ages; in addition to young children, any person with cognitive impairments, impulsive behaviors, etc. is at risk of handling or ingesting materials that could be harmful).

  3. Cue yourself to clean. Put up a brightly colored sign in your treatment area(s) or wear a bracelet to remind you – and your clients – to get clean before getting to work! This tip goes hand-in-hand with #2, so keep sanitary products close by your workspace to make them available to use when you see your signs.
  4. Sanitize your own stuff too! It’s easy to remember to sanitize all of the therapy equipment your clients touched, sneezed, drooled, or sweated on. And in many rehab settings there are staff members responsible for wiping down equipment between clients. But when was the last time you wiped down your keyboard, washed your work bag, cleaned your cell phone, or sprayed down your therapy table? Leave a sticky note on your desk or computer to remind yourself that keeping your personal items and workspace clean is important as well.
  5. Make a sanitization schedule. It may not be feasible for you to sanitize every item you use every day. However, try to find time every couple of weeks to sanitize your work surfaces, therapy equipment, and personal items, especially if you are a traveling therapist or if you have equipment you maintain personally. You can use a simple DIY bleach solution or store-bought products to soak and sanitize your stuff while clients are not around. Make sure you read carefully and follow directions for how various items should be cleaned and what products are safe to use.
  6. Avoid taking work germs home. When you get home from working at a hospital, SNF, or rehab facility, it can be tempting to walk in your front door and fall right onto your bed or couch. However, research shows that people who work in hospital settings can have dangerous microbes on their clothing even 48 hours after leaving the workplace! If you work in these settings, leave work shoes near or outside the entrance to your home and put your clothes/scrubs in the laundry hamper first thing upon getting home to help prevent the spread of harmful germs into your living environment.
  7. If it can’t be cleaned, it may need to be replaced. Things like theraputty, small manipulatives, Play-doh, and sensory bins full of beans/beads/etc. are not easily cleaned. And even if you and your clients make an effort to wash your hands or use hand sanitizer before using these items, they just tend to get gross over time! Write a date on containers for any item that cannot be cleaned (sensory bin, putty, etc.) and toss them after 1-2 months or when they become visibly soiled or dingy.

Improving your hygiene routine with these quick tips can have a positive impact on the health of your clients and yourself. Establishing healthy habits like washing or sanitizing hands prior to participating in therapy and cleaning equipment regularly means people are less likely to transfer harmful bacteria to you or others. And while it may be impossible to make your therapy equipment or treatment setting 100% sanitary, making small changes can have a big impact!

*This is true for many types of common germs, but certain types of viruses and other disease-carrying microorganisms are much less likely to be killed without the friction and hot water of the handwashing process.



  • Test your knowledge about hand hygiene with this quiz!
  • If you are interested in promoting hand hygiene in your school or workplace, check out these resources from the CDC “Clean Hands Count” campaign.
  • Recent research provides evidence for the efficacy of hand hygiene in reducing student and teacher absenteeism in schools. Still, the debate continues – other researchers report that hand hygiene has little impact on absenteeism. Either way, having clean hands can’t hurt!



  • Provide explicit instruction in the steps for and importance of handwashing. Young children may enjoy scrubbing hands long enough to remove a small mark or singing a familiar song to understand the length of time they should spend cleaning (15-20 seconds).
  • If you use visual schedules with your clients, add an image for “washing hands” to the list of activities and put it on the schedule first.
  • Make a squirt of hand sanitizer the “key” that unlocks the container with a child’s favorite toy or writing toy.
  • Create a sequencing activity with pictures of the steps for handwashing and have patients cut, color, and organize them into a card or poster they can keep.
  • Provide group instruction in hand hygiene. Then have group members create posters, booklets, or other materials to share with others.
  • Have participants watch a video or demonstration and correct “errors” made during hand hygiene routine (i.e. using cold water, washing too quickly, not washing between fingers, not using soap, etc.)
  • Implement “Clean Hands Count” campaign from the CDC to increase awareness. Train a few colleagues to help lead a system-wide education program to increase and improve handwashing behaviors in your workplace.


4 thoughts on “Therapeutic Use of Soap: 7 Tips for Improving Your OT Hygiene Routine

  1. heather m October 13, 2017 / 8:01 pm

    I’m really enjoying going through your blog. I had googled “how to observe an OTA or OT”(after being told “we can’t accommodate you” by a couple places) and your blog popped up. There’s lots of good info on here for a noob like me. I’m applying to an OTA program and this is all very helpful. Just wanted to say ‘thank you’.

    • lej1123 January 20, 2018 / 11:10 pm

      Thanks for commenting! I’m glad you’re finding the blog helpful, and although it can be hard to get your foot in the door, I want to encourage you to be patient and persistent and know that you WILL find a place! It took me driving to the hospital and speaking directly with the volunteer coordinator for me to get one volunteer position, so sometimes you’ll have to do a little more than call. 🙂 But stick with it!! Good luck, and please reach out to me if you need help finding somewhere to observe.

  2. Joel Desotelle December 6, 2017 / 12:53 pm

    This is great information. Do you have any suggestions occupational therapists to address motivational issues? So many of the kids we work with who have hygiene issues, it is often a matter of not recognizing or desiring to be clean. Many times it is too much effort or pulls them away from a preferred task. Anyhow, any suggestions would be helpful. Thanks!

    • lej1123 January 20, 2018 / 9:42 pm

      Glad you found this post to be helpful! Addressing motivation is challenging with any patient, but especially with children. Some things I have found to be effective in pediatrics have been breaking down a task so that undesirable components are included with “fun” parts (i.e. If writing is a non-preferred task, having a child write his name atop a piece of paper, then doing a fun craft/art activity, then “remembering” they need to write the date, then doing something else fun…). Some children also benefit from First/Then charts outlining activities or actions and the consequences/rewards (Ex. First handwashing, then snack; First bath, then video games). Additionally, if you can find ways to decrease efforts (using sanitizer/wipes instead of full on handwashwashing, a quick rinse instead of a long bath) can help. Finally, incorporating undesirable or unmotivating tasks as part of a routine can help take away the stress (eventually), as then the child will eventually understand that even if the task is undesirable, it is just something that HAS to be done in order to continue onward with enjoyable things! I hope this helps!

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