Contributing to a Quality Patient Experience: Applying Evidence Based Practice to Support Changes in Nursing Dress Code Policies

Abstract

The public image of nurse professionalism is important. Attributes of a professional nurse, such as caring, attentive, empathetic, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of individual uniform and dress choices. This article describes an evidence based practice project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients view as important. A team approach included the voice of nurses at different levels in the process. Ultimately, this work informed a revision of the health system nursing dress code. The study team also reflects on challenges, next steps in the process, and offers recommendations based on their experiences.

An Integrative Review of Body Art in Nursing

“…11,18,[31][32][33] Other nonresearch articles included 2 case studies, 8,16 a legal commentary, 34 2 specific to nursing issues, 10,17 and an editorial. 35 Also included were 2 literature reviews, 13,15 a policy development piece, 14 an evidence-based practice (EBP) project, 36 and EBP recommendations. 37 Through independent analysis of the articles by 2 nurse researchers, followed by iterative team discussions, 3 broad themes and 8 subthemes emerged (see Supplemental Digital Content, Figure 2, available at: http://links.lww.com/NE/B83): (1) level of acceptability (subthemes of positive perception, stigmatizing, and personal meaning); (2) professional image (subthemes of appearance matters and policy); and (3) infection concern (subthemes of hygiene, contamination, and injury potential).…”

“…This process again supported shared governance in the development of dress code policies. 36 Nurses should balance self-awareness with acceptance of patients' life choices and guidance with prescribed dress code policies. 18 Many dress code policies prohibit the visibility of body art; however, the expression should be further understood from the nursing perspective as well as how body art impacts patient satisfaction.…”

“…Professional image was exemplified in the subthemes of appearance matters and policy through 7 of the 9 research articles [22][23][24][25][26][27][28] and 16 of the 21 nonresearch articles. 7,[9][10][11][12][13][14][15][16][17][18]32,[34][35][36] Nurses' appearance conveys professionalism, trustworthiness, confidence, and compassion. 27,28 Research linked nurses' professional image and patients' perceptions of competency in care and comfort with the care provided.…”

“…Multiple commentaries corroborated that appearance matters in the professional image. 7,[9][10][11][12][13][14][15]17,31,36 Literature reviews verified the relationship between external appearance of nurses and their professional image and the patients' perception of their skill and level of professionalism. 13,14 The public equated nurses with body art as less professional.…”

Chinese nurses' self‐expression media image during COVID‐19 pandemic: A qualitative media image analysis

“…The nurse public image is important. Caring, attentive, empathetic, efficient, knowledgeable, competent and approachable are considered as attributes of professional, nurses own or lack them may contribute positively or negatively to the patient experience (West et al., 2016 ). However, the nurse public image were not always comprehensive.…”