Are banning wrist watches and providing hooks for white coats realistic solutions for reducing infections?


A new guideline released from the Society for Healthcare Epidemiology of America (SHEA) provides recommendations on reducing transmission of healthcare-associated infections (HAIs) through guidance of healthcare personnel (HCP) attire in non-operating room settings.

The recommendations, published in Infection Control and Hospital Epidemiology, are based on limited evidence, theoretical rationale, and practical considerations.

Acknowledging that more appropriately designed studies should be funded and performed to better define the relationship between HCP attire and HAIs, the following are based on evidence-based measures to prevent HAIs:

1)      “Bare below the elbows”: HCPs should wear short sleeves, no wristwatches or jewelry, and no ties during clinical practice. Even though the prevention impact is unknown, the recommendations rationalize that it is supported by “biological plausibility” and is unlikely to cause harm.

2)      White coats: Facilities that mandate or strongly recommend the use of white coats should require that HCPs possess 2 or more white coats in addition to institution-provided on-site laundering at no or low cost.  Institutions should also provide coat hooks so that HCPs can remove and hang their white coat before patient contact.

3)      Other HCP apparel: Use of other specific apparel items can’t be limited because transmission of pathogens remains undetermined. However, neckties, for example, should be secured.

4)      Laundering: Any apparel worn that comes in direct contact with patients or the patient environment should be laundered after daily use, no less frequently than once a week.

5)      HCP footwear: All footwear should have closed toes, low heels, and non-skid soles.

The article also delves into perceptions of HCP attire (from both HCP and patients).

Physician’s Weekly wants to knowAre banning wrist watches and providing hooks for white coats a realistic solution to reduce infections?

Read guest blogger Skeptical Scalpel’s related blog posts, Should Doctors and Nurses Wear Scrubs in Public? and Why I Wear a White Coat.