News | September 16, 2007

Doctors’ White Coats, Ties, Watches Banned in the U.K.

September 17, 2007 – The traditional long-sleeve, white smocks doctors wear have been banned under a new set of guidelines issued by the British Department of Health to combat healthcare-associated infections.

The package of rules not only includes guidance on clothing, but also new responsibilities for matrons, the isolation of patients who are infected, increased infection reporting, and asking all healthcare workers to wash their hands.

The new rules on clothing outlaw doctors' traditional white coats and requires hospitals to adopt a new “bare below the elbows” dress code. The rule calls for only short sleeve shirts, no wristwatches, no jewelry, and no neckties when carrying out clinical activity.

“I’m determined that patient safety, including cleanliness, should be the first priority of every National Health Service organization,” said Health Secretary Alan Johnson. “Across the NHS we continue to bring the number of MRSA (Methicillin-resistant Staphylococcus aureus) cases down and make progress on measures to reduce Clostridium difficile bacteria. Today’s package of measures will give more responsibility to matrons and set guidelines on clothing that will help ensure thorough hand washing and prevent the spread of infections. This is a clear signal to patients that doctors, nurses, and other clinical staff are taking their safety seriously.”

The new clinical guidelines call for isolating patients who are infected with Clostridium difficile, or MRSA - also called “the super bug.” The Department of Health said some hospitals already meet this standard, but the majority will have to start using more single-patient rooms.

The new rules require matrons - superintendents charged with the domestic arrangements of hospitals - and clinical directors to report quarterly directly to trust boards on infection control and cleanliness. These reports will focus on compliance with statutory obligations and will increase the ability of senior clinical staff to raise concerns over infection control.

In concert with the new guidelines to limit infection, the National Patient Safety Agency will extend its “Clean Your Hands” campaign to care settings outside hospitals. The campaign will be rolled out to primary care, ambulance, mental health and care trusts as well as to care homes and hospices.

A new legal requirement will also be placed on all chief executives of health facilities to report all MRSA and Clostridium difficile infections to the Health Protection Agency. It is backed up by fines for noncompliance.

“We support any initiative that promotes good hand hygiene in clinical practice,” said Dr. Peter Carter, general secretary of the Royal College of Nursing. “This guidance offers a positive step forward in introducing dress code standards across all health professions to help reduce healthcare associated infections. Nurses are at the forefront of initiatives to tackle healthcare associated infections, but in order to be successful we need commitment from the entire NHS team - from all staff, in all disciplines and in every healthcare setting.”

This package follows the announcement in July from the Health Department of an extra 50 million pounds (about $101 million in U.S. dollars) to tackle healthcare associated infections. The department also said it will doubled the size of its Infection Improvement Team. The cash is being spent on staff training, education, increased infection surveillance, more sinks for hand washing, upgrading isolation facilities, and new cleaning equipment.

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