3 quarter uniform sleeves

Hi Margaret

My comments are based on working in many private facilities with different uniform options. To me, it all boils down to whether appropriate hand hygiene and PPE use can be easily performed with the uniform choices for those staff groups. I worked at one facility where nursing manager uniforms were all sleeve. Not a problem for most ward / department managers as their hand hygiene requirements were all wrist and below. The problem was for specialised nursing managers who performed ward based procedures requiring a surgical scrub – they had to change into surgical scrubs to perform a full surgical scrub for ward-based procedures, as they could not roll up the sleeves as the design was quite tight on the arms.

So in my opinion it is more about utility of the design in enabling required practices than anything else.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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Can anyone contribute to some feedback I received from a staff member regarding new uniforms being introduced at our facility? For the first time, we are giving staff the option of having a 3 quarter sleeve, both care staff and registered/enrolled nurses. One RN stated that she had been informed at an acute facility that 3 quarter sleeves are not permitted because of Infection Control issues. I have looked up the National Guidelines and in there it states:

Given that there is limited evidence available to support many routine practices intended to reduce infection risk, practice is based on decisions made on scientific principles. Some activities, such as performing hand hygiene between administering care to successive patients, have a credible history to support their routine application in preventing cross-infection. Others, such as some uniform and clothing requirements, have more to do with the ethos of quality care and workplace culture than with a proven reduction of cross-infection.

From that I came to the conclusion that there is no evidence against having a variance in uniform style. Also given the work carried out in residential care vs acute care, my thoughts were that there is limited cross infection risk.

If anyone has any other thoughts, responses welcome

Regards

Margaret Byrne RN BN

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Hi Margaret,

In my home state of Tasmania this issue was considered at a state level for nursing staff during a recent state hospitals uniform review. A decision was taken to make the clinical nursing staff uniform have mandatory short sleeves, this was not based on advice from our state infection control service, and from my perspective very interesting that the focus was on nursing uniform rather than all healthcare workers! The advice from infection prevention and control staff was that rather than stipulating short sleeves for nursing staff that the key advice related to the relative impediment that long sleeves may cause to performing hand hygiene.

I have copied and include some of the wording from my own hospitals Uniform Policy and our Tasmanian Hand Hygiene Policy FYI.

RHH Dress Code Protocol “Infection Control” (extract):

* Long sleeves must be rolled above the elbows when providing direct patient care.

* All items such as neck-chains, neck ties, scarfs, lanyards, glasses on chains etc must be secured to prevent cross infection.

* Items that are not laundered daily (i.e. cardigans/jumpers) shall not be worn whilst delivering direct patient care/services

* Protective barrier uniforms should be removed before leaving the workplace ie aprons, shoe covers etc.

DHHS Hand Hygiene Policy (extract)
All Care Staff/Healthcare Workers are to be ‘bare below the elbows’ when providing clinical care/performing hand hygiene to meet their infection control and hand hygiene obligations. This means:

* Bracelets, wrist watches and rings with stones or ridges must not be worn when providing clinical care. A single flat ring/band may be worn but must not interfere with effective hand hygiene practice.

* Long ties, lanyards and long sleeved shirts must not interfere with effective hand hygiene practice. Retractable (or similar) ID card holders are recommended in place of lanyards and should be cleaned regularly.

* Nails should be kept short and clean and nail polish should not be worn. Artificial nails (gel or acrylic) must not be worn by any Care Staff/Health Care Workers with direct patient contact.

* Any breached skin (cuts, dermatitis or abrasion) must be covered with a waterproof film dressing. Staff with dermatitis should report for evaluation as per local protocols.

Hope this is of some help. Good luck!!

Kind regards
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Can anyone contribute to some feedback I received from a staff member regarding new uniforms being introduced at our facility? For the first time, we are giving staff the option of having a 3 quarter sleeve, both care staff and registered/enrolled nurses. One RN stated that she had been informed at an acute facility that 3 quarter sleeves are not permitted because of Infection Control issues. I have looked up the National Guidelines and in there it states:

Given that there is limited evidence available to support many routine practices intended to reduce infection risk, practice is based on decisions made on scientific principles. Some activities, such as performing hand hygiene between administering care to successive patients, have a credible history to support their routine application in preventing cross-infection. Others, such as some uniform and clothing requirements, have more to do with the ethos of quality care and workplace culture than with a proven reduction of cross-infection.

From that I came to the conclusion that there is no evidence against having a variance in uniform style. Also given the work carried out in residential care vs acute care, my thoughts were that there is limited cross infection risk.

If anyone has any other thoughts, responses welcome

Regards

Margaret Byrne RN BN

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