Thirty-eight percent of special nursing homes that responded to a survey admitted they failed to instruct their staff to wash and sterilize their hands every time they changed patients' diapers, a government survey showed Monday.

According to the survey conducted by the Health, Labor and Welfare Ministry's research team, 41 percent of the facilities also failed to instruct their staff to wear gloves when changing patients' diapers.

The survey was conducted in February and March by the ministry's research team in response to a recent spate of norovirus gastroenteritis outbreaks at nursing homes nationwide.

It sent questionnaires to all of Japan's roughly 5,400 special nursing homes for the elderly -- but only 35 percent responded.

The survey also found that of the 52 percent of the facilities that use carts to carry their used diapers, about a quarter do not disinfect the carts.

"We need to come up with measures to prevent infections (at nursing homes) and to deal with their outbreak," a ministry official said.

The elderly have low resistance to infections, and infections spread widely in communal living spaces.

Norovirus gastroenteritis, pneumonia and tuberculosis are among diseases common in such facilities. Feces are considered the source of infection for diseases such as norovirus.