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General Orthopaedics

AN ASSESSMENT OF ‘BARE BELOW ELBOW’ POLICY OF THE HAND CONTAMINATION IN DISTRICT GENERAL HOSPITAL

Indian Orthopaedic Society UK (IOS)



Abstract

Despite a lack of evidence, the UK's Department of Health introduced a policy of ‘Bare below the elbows’ attire to try to reduce the incidence of nosocomial infection. This study investigates the link between attire and hand contamination. A prospective observational study of doctors working in a District General Hospital was performed. The fingertips were imprinted on culture medium, and the resulting growth assessed for number of colony forming units, presence of clinically significant pathogens and multiply resistant organisms. These findings were correlated with attire, grade, gender and specialty. 92 doctors were recruited of which 49 were ‘Bare below the elbows’ compliant and 43 were not. There was no statistically significant difference between those doctors who were ‘bare below the elbows’ and those that were not for either the number of colony forming units (p=1.0), or the presence of significant organisms (p=0.77). No multiply resistant organisms were cultured from doctors' hands. ‘Bare below the elbows’ attire is not related to the degree of contamination on doctors' fingertips or the presence of clinically significant pathogens. Further studies are required to establish whether investment in doctor's uniforms and patient education campaigns are worthwhile.