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SHEA releases guidelines for HCW attire in clinical settings
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The Society for Healthcare Epidemiology of America has released guidelines for health care workers’ attire in non-operating room settings, meant to assist in the prevention of health care-associated infections.
“While studies have demonstrated the clothing of health care [workers] may have a role in transmission of pathogens, the role of clothing in passing pathogens to patients has not yet been established,” Gonzalo Bearman, MD, MPH, of Virginia Commonwealth University and a member of SHEA’s guidelines committee, said in a press release. “This document is an effort to analyze the available data, issue reasonable recommendations, define expert consensus and describe the need for future studies to close gaps in knowledge on infection prevention as it relates to [health care worker] attire.”
Gonzalo Bearman
Bearman and colleagues reviewed medical literature on health care workers’ (HCWs) attire, reviewed hospital policies on attire and conducted a survey of Society for Healthcare Epidemiology of America (SHEA) members about policies and perceptions of HCWs attire on pathogen transmission. Using this knowledge, they developed the guidelines, which are meant to balance professionalism, comfort and practicality with the potential for transmission of pathogens.
One key recommendation is “bare below the elbows,” defined as wearing short sleeves, with no wristwatch, jewelry or ties during clinical practice. The infection prevention effect of this approach is unknown, but studies support the biological plausibility of this practice.
Another recommendation is that facilities strongly recommend the use of white coats for direct patient care, making sure that all HCWs have at least two coats and access to laundry services for the coats. The guidelines committee said this practice will help maintain professional appearance and allow higher frequency of laundering white coats. The recommendations also suggest that coat hooks be provided for the HCWs to remove their coats.
The committee members also recommend that any clothing worn at bedside be laundered after daily use. Home laundering should be done in hot water, preferably with bleach, and followed by drying and/or ironing. Footwear should have closed toes, low heels and non-skid soles. Lastly, all shared equipment, including stethoscopes, should be cleaned before seeing the next patient.
No guidance is given regarding the use of lanyards, identification tags, cellphones, pagers and jewelry, but it is recommended that such items that come into direct contact with patients or environments be disinfected, replaced or eliminated.
Disclosure: Bearman and the other guideline authors report no relevant disclosures.
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