Bare Below the Elbows: Professionalism vs Infection Risk

Abstract

In September 2007 the Department of Health (DH) published a document entitled Uniforms and workwear: An evidence base for developing local policy. This report tackled the issues of wearing and appropriately laundering workwear in an effort to advise employers when creating their local policy. It was based on two literature reviews carried out by Thames Valley University known as TVU1 and TVU2. These studies looked at the evidence surrounding the role of uniforms in the transmission of infection (TVU1), the efficacy of laundry practices in removing contamination (TVU1) and how public perception of both the individual and the organisation is altered by uniforms (TVU2).

Patient’s Preference on Neurosurgeon’s Attire and Appearance: A Single Center Study in Korea Cross-Sectional Study

“…However, many other studies have argued that work attire with respect to professionalism and cleanliness may challenge the patient-doctor relationship; many patients regard the long-sleeved shirt and tie as the most professional attire. There was no significant gap between working attire and professional attire in terms of risk of transmitting hospital acquired infection; thus they regarded long-sleeved shirt and tie as the ideal attire for a doctor [4]. Likewise, the patients in our study preferred formal attire with white coat; they did not have any negative view of doctors wearing accessories.…”

“…The Department of Health in UK published guidelines in 2007 that it is better for doctors to remove white coats, jackets, and ties and roll up their shirt sleeves (bare below the elbows, BBE) [3]. However, other studies have stated that compared to other formal attires, the ideal attire according to the BBE regulation is not well accepted by the public [4]. Thus, it might be somewhat difficult to establish a patient-doctor relationship when doctors wear the BBE attire.…”

Healthcare Personnel Attire in Non-Operating-Room Settings

“…Most (23/26) studies surveyed patient preference for different types of HCP attire 1-6,8-18,20-25 using either pictures of models in various dress styles 3,4,7-9,15-18,20,22-24 or descriptions of attire 1,5,11,14,21,25 . Four studies 6,10,12,13 asked patients to assess the attire of their actual physicians.…”

“…Neckties were specifically addressed in several studies from the UK 5,21,24 . In one study, patients reported that attire was important but that neckties were not expected 21 .…”

“…In another survey among 15 obstetricians/gynecologists, 8 preferred casual attire while 7 preferred formal attire 6 . Three studies assessed HCP alongside patient perception of infection risk or lack of hygiene associated with white coat, formal attire, or neckties 3,24,26 , with one finding that HCP were more likely than patients to consider white coats unhygienic 26 .…”