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Bare below the elbows

Gonzalo Bearman, Salma Abbas, Nadia Masroor, Kakotan Sanogo, Ginger Vanhoozer, Kaila Cooper, Michelle Doll, Michael P Stevens, Michael B Edmond
OBJECTIVETo investigate the impact of discontinuing contact precautions among patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) on rates of healthcare-associated infection (HAI). DESIGN: Single-center, quasi-experimental study conducted between 2011 and 2016.METHODSWe employed an interrupted time series design to evaluate the impact of 7 horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at an 865-bed urban, academic medical center...
March 27, 2018: Infection Control and Hospital Epidemiology
Mireille Dekker, Martine G Caris, Anne M van Gunsteren, Rosa van Mansfeld, Cees Lucas, Christina M J E Vandenbroucke-Grauls
BACKGROUND The VU University Medical Center, a tertiary-care hospital in the Netherlands, has adopted a dress code based on national guidelines. It includes uniforms provided by the hospital and a 'bare-below-the-elbow' policy for all healthcare workers (HCWs) in direct patient care. Because compliance was poor, we sought to improve adherence by interventions targeted at the main causes of noncompliance. OBJECTIVE To measure compliance with the dress code, to assess causes of noncompliance and to assess whether a behavioral approach (combing a nominal group technique with participatory action) is effective in improving compliance METHODS Between March 2014 and June 2016, a total of 1,920 HCWs were observed in hospital hallways for adherence to the policy, at baseline, and at follow-up measurements...
December 2017: Infection Control and Hospital Epidemiology
Nadia Masroor, Michelle Doll, Kakotan Sanogo, Kaila Cooper, Michael P Stevens, Michael B Edmond, Gonzalo Bearman
No abstract text is available yet for this article.
January 30, 2017: Infection Control and Hospital Epidemiology
M Lenski, M A Scherer
BACKGROUND: The hands of medical stuff are the most important vectors for the transmission of pathogens in the hospital. Furthermore a "bare below the elbows dress code" has been introduced in Great Britain. OBJECTIVES: Aim of this study was to investigate whether workwear contamination of the medical stuff by pathogens is similar to the contamination of their hands and whether wearing workwear is associated with increased transmission risk. MATERIAL AND METHODS: In total 54 swabs were collected from nursing stuff, medical doctors, patients and hospital work material...
March 2016: Der Orthop├Ąde
E J W Spierings, P T J Spierings, M Nabuurs-Franssen, J Hopman, E Perencevich, A Voss
BACKGROUND: Attempts to increase compliance with infection control practices are complex and are - in part - based on attempts to change behaviour. In particular, the behaviour of significant peers (role models) has been shown to be a strong motivator. While role models within the working environment are obviously the most important, some experts suggest that media and public display cannot be ignored. The aim of this present study was to examine the display of technique recommended by current infection control guidelines including the "bare below the elbow" principle, which is considered a basic requirement for good infection control in many countries, in sets of professional stock photos...
2015: Antimicrobial Resistance and Infection Control
G Tse, S Withey, J M Yeo, C Chang, A Burd
No abstract text is available yet for this article.
December 2015: Journal of Hospital Infection
Babak Meshkat, Gary Allan Bass, Melania Matcovici, Zarah Farnes, Claire Buckley, Omar Al Saffar, Peter Gillen
BACKGROUND: A doctor's competence and professionalism is often judged on the basis of attire. Our Lady of Lourdes (OLOL) is a leading Irish hospital in the implementation of Bare Below the Elbows (BBTE) policy, however surgical attire is not standardised and there is great variability in attire worn on wards. We aimed to evaluate patients attitude towards surgeons attire in OLOL. METHODS: A prospective survey of adult surgical in-patients was conducted from October 2013 to February 2014...
April 2015: International Journal of Health Policy and Management
S G Dancer, B I Duerden
The introduction of 'bare below the elbows' policies to facilitate handwashing led to the disappearance of the white coat from medical and surgical wards. While rates of key healthcare acquired infections in hospitals, e.g. Clostridium difficile and methicillin-resistant Staphylococcus aureus bacteraemia, have fallen, argument continues around the contribution of hand hygiene and dress codes to these changes. Conversely, the number of complaints against clinicians continues to rise, and respect for medical staff is falling...
2014: Journal of the Royal College of Physicians of Edinburgh
Mary Mcgoldrick
No abstract text is available yet for this article.
July 2014: Home Healthcare Nurse
James Pellerin, Gonzalo Bearman, Jonathan Sorah, Kakotan Sanogo, Michael Stevens, Michael B Edmond
No abstract text is available yet for this article.
June 2014: Infection Control and Hospital Epidemiology
Gonzalo Bearman, Kristina Bryant, Surbhi Leekha, Jeanmarie Mayer, L Silvia Munoz-Price, Rekha Murthy, Tara Palmore, Mark E Rupp, Joshua White
Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established, and until more definitive information exists priority should be placed on evidence-based measures to prevent healthcare-associated infections (HAIs). This article aims to provide general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the article has 3 major components: (1) a review and interpretation of the medical literature regarding (a) perceptions of HCP attire (from both HCP and patients) and (b) evidence for contamination of attire and its potential contribution to cross-transmission; (2) a review of hospital policies related to HCP attire, as submitted by members of the Society for Healthcare Epidemiology of America (SHEA) Guidelines Committee; and (3) a survey of SHEA and SHEA Research Network members that assessed both institutional HCP attire policies and perceptions of HCP attire in the cross-transmission of pathogens...
February 2014: Infection Control and Hospital Epidemiology
A M Collins, J Connaughton, P F Ridgway
A 'Bare Below the Elbows' (BBTE) dress code policy has been introduced by the majority of NHS trusts in the UK. The aim of this Irish study was to evaluate the impact of an educational intervention on perception of medical attire. The study was carried out in two centres: a tertiary referral centre (Beaumont Hospital) and a district hospital (MRH, Portlaoise). Two questionnaires, incorporating photographic evaluation of appropriate attire for consultants and junior doctors, were completed pre and post BBTE education...
October 2013: Irish Medical Journal
Miles Landry, Adriana C Dornelles, Genevieve Hayek, Richard E Deichmann
BACKGROUND: The white coat's place in the medical profession is a heavily debated topic. Five years after the bare-below-the-elbow policy took effect in England, we reexamined the evidence about coats' potential to transmit infection, reviewed previous studies, and explored our patients' opinions on doctor attire. METHODS: We administered a survey at 3 locations in the Ochsner Health System (hospital clinic, satellite clinic, and inpatient ward) in 2013. The survey assessed patient preference for doctors to wear white coats and included 4 images of the same doctor in different attire: traditional white coat, bare-below-the-elbow attire, a white coat with scrubs, and scrubs alone...
2013: Ochsner Journal
Stuart A Aitken, Craig G Tinning, Sanjay Gupta, Gareth Medlock, Alexander M Wood, Margaret A Aitken
OBJECTIVES: Critics of the Department of Health 'bare below the elbow' guidelines have raised concerns over the impact of these dress regulations on the portrayed image and professionalism of doctors. However, the importance of the doctor's appearance in relation to other professional attributes is largely unknown. The purpose of this study was to determine the opinion of patients on the importance of appearance and the style of clothing worn by doctors. DESIGN: Patient questionnaire survey, administered across four Scottish regions...
February 2014: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
June Jones, Andrew Shanks
The decision by the Department of Health to introduce amendments to the uniform and workwear policy for the NHS in response to increasing problems with infection control seemed uncontroversial. There was, however, some difficulty with implementing the policy, which arose largely because of the conflict this caused for staff who wished to keep their arms covered for reasons which stemmed from religious beliefs. This paper uses textual analysis to examine how those reasons and challenges were discussed in online commentary within a medical and nursing journal...
September 2013: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
R A Greatorex
No abstract text is available yet for this article.
May 2011: Annals of the Royal College of Surgeons of England
A Burger, C Wijewardena, S Clayson, R A Greatorex
INTRODUCTION: UK Department of Health guidelines recommend that clinical staff are 'bare below the elbows'. There is a paucity of evidence to support this policy. One may hypothesise that absence of clothing around wrists facilitates more effective handwashing: this study aims to establish whether dress code affects bacterial colonisation before and after handwashing. SUBJECTS AND METHODS: Sixty-six clinical staff volunteered to take part in the study, noting whether they were bare below the elbows (BBE) or not bare (NB)...
January 2011: Annals of the Royal College of Surgeons of England
L Bond, P J Clamp, K Gray, V Van Dam
INTRODUCTION: In September 2007, the Department of Health published Uniforms and Workwear: an Evidence Base for Guiding Local Policy. Following this, most National Health Service trusts imposed a 'bare below the elbow' dress code policy, with clinical staff asked to remove ties, wristwatches and hand jewellery and to wear short-sleeved tops. There is currently no evidence linking dress code to the transmission of hospital-acquired infection. We designed the current survey to assess patients' perceptions of doctors' appearance, with specific reference to the 'bare below the elbow' policy...
September 2010: Journal of Laryngology and Otology
C A Willis-Owen, P Subramanian, P Kumari, D Houlihan-Burne
Despite a lack of evidence the UK's Department of Health introduced a policy of 'bare below the elbows' attire in order to try to reduce the incidence of nosocomial infection. This study investigates the link between this state of dress and hand contamination. A prospective observational study of doctors working in a district general hospital was carried out. The fingertips of each hand were imprinted onto culture medium, and resultant growth assessed for number of colony-forming units and presence of clinically significant pathogens or multiply resistant organisms...
June 2010: Journal of Hospital Infection
Maxim D Horwitz, Elliot D Sorene
No abstract text is available yet for this article.
March 2010: British Journal of Hospital Medicine
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