Dress Code. Approved. Date April Policy Number HR 17. Version number 2. Review Date March 2010 HR 17

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1 Dress Code This Policy should be read in conjunction with: Infection Prevention and Control Policies Patient Movement and Manual Handling Risk Management Strategy Nurse Uniform and Clothing Worn in the Delivery of Patient Care Disciplinary Policy Lead Director Chief Nurse Date April 2008 Policy Number HR 17 Version number 2 Approving Committee Trust Council Review Date March 2010 Page 1 of 9

2 Contents Page Number 1. General Statement of Purpose 3 2. Principles 3 3. Scope and Application 3 4. Identification 5 5. General Presentation and Appearance 5 6. Jewellery 5 7. Clothing 5 8. Footwear 7 9. Responsibilities Equality & Diversity 7 References 8 Summary 9 Page 2 of 9

3 1. General statement of purpose The clothing and personal appearance of staff can impact on the safety of the services we provide to patients and the public perception of the quality of those services. Our Dress Code is designed to: Promote patient safety and the prevention and control of infection by ensuring all staff wear clothing that is appropriate to their working environment. Ensure the personal appearance of our staff contributes to a positive, professional image and promotes confidence in what we do. We are committed to reducing the number of avoidable infections in our hospitals to give confidence to patients and their families by taking action that the public sees. The attitude and actions of every individual can make a difference and the objectives our Dress Code are to ensure that all staff: Understand what they should be doing and why. Contribute to good infection control practice. Lead by example. Reassure others that we provide a professional service and that patient safety and infection prevention and control are of the highest priority. Our Dress Code sets out what the Trust expects from all staff with regards to personal appearance and clothing. Compliance with it maximises the opportunities for good infection control practice and minimises risk with regard to health and safety. 2. Principles Any discussions with staff concerning appearance should be based on the following five principles: 2.1 To promote infection prevention and control. 2.2 To avoid unintentional injury to patients. 2.3 To reduce the likelihood of injury to staff. 2.4 To respect the cultural values or beliefs of our patients, visitors and staff. 2.5 To lead by example and promote public confidence. 3. Scope and Application 3.1 It is not possible or desirable to be prescriptive across the wide range of work situations within our hospitals. Distinctions are made between the application of the Dress Code in clinical and non-clinical areas. Page 3 of 9

4 For the purpose of the Dress Code a clinical area is defined as any area within the hospitals where patients receive treatment and care. This includes, for example, Wards, Outpatients, diagnostic areas and theatres. It is expected that everyone will use common sense in applying the Dress Code and in doing so will fully comply with the purpose and principles of the Code. 3.2 This Dress Code applies to all staff (with the exception of those that wear uniforms see C000159, Uniform Policy) including those on honorary contracts, agency and locum workers, volunteers and those on work experience placements. A summary of the application of the Dress Code in relation to general staff groups is set out in the table below. Staff Main Concern Dress Purpose 1 Doctors, nurses, midwives, health professionals and other healthcare workers visiting wards, giving patient care or in physical contact with patients in a clinical area. Infection prevention and control No jackets or ties, sleeves short or rolled up, no watches or wrist jewellery, no hand jewellery except plain wedding bands, no neck or ankle chains, no false nails, tidy hair. Scrubs to be worn on site only and not in hospital restaurant or refreshment areas. To allow effective hand hygiene and reduce the risk of cross infection. 2 Staff in contact with the patients/public but not giving clinical care (e.g. reception staff, admissions staff, medical secretaries.) Image and public confidence Smart, clean, tidy, of modest appearance and as above if in a clinical area. To promote public confidence and allow effective hand hygiene. and Staff not in contact with patients or members of the public (e.g. finance.) Page 4 of 9

5 4. Identification 4.1 A visible photo identity name badge should be worn with photo and personal details clearly displayed at all times. For staff in direct patient contact the clip-on style should be worn to reduce contamination. It is good infection control practice to clean ID badges daily to remove contaminants not removed during hand washing (as with phones and pens). 4.2 Other staff may wear the snap release neck chain or ribbon (Trust or recognised union ribbons only). 5. General presentation and appearance 5.1 Staff should look clean and tidy have a good standard of personal hygiene. Clothes should be free from obvious dirt and stains. 5.2 Hair should be clean and tidy. For staff performing clinical work, hair that falls below the collar should be secured away from the face in a style that does not need constant re-adjusting. Facial hair must be kept short, neatly trimmed or tidily secured. 5.3 Make up should be discreet. 5.4 Only discreet tattoos should be visible. If offence could occur due to the design or wording tattoos should be covered up. 5.5 Nails should be clean and well manicured. For clinical staff nails must be short and unvarnished. False nails are not permitted as they support fungal growth. 6. Jewellery For staff working in clinical areas: 6.1 No rings except plain wedding band 6.2 No wristwatches or bracelets 6.3 No visible neck chains 6.4 No visible ankle chains 6.5 No visible body piercing 6.6 No more than one pair of plain, discreet ear studs. 6.7 No more than one discreet nose stud 6.8 No tongue studs permitted Aims: a) ensure effective hand washing and prevention of cross infection b) avoid personal injury and injury to people being cared for maintains a professional image Exception will be made for medical alert bracelets. Staff working in non-clinical areas should maintain a professional image (therefore consider 6.5, 6.7 and 6.8). 7. Clothing Staff working in clinical areas: 7.1 Should consider the patient/client group they work with when dressing to promote patient safety and public confidence. The Trust respects the right of staff to adhere to religious and cultural observances or adaptations necessary Page 5 of 9

6 due to disability. However, for clinical and laboratory staff consideration should be given to infection control, the operation of machinery, clear identification and communication with patients and staff. 7.2 Dresses/skirts should be of a reasonable length (e.g. no mini or micro skirts). 7.3 Tops/shirts or blouses must not transparent, low cut or show a bare midriff. Vest style or strap tops are not permitted. 7.4 Shirts/tops or blouses should be smart, short-sleeved or worn with the sleeves rolled up to facilitate effective hand hygiene. Shirts should be worn tucked in. 7.5 Polo shirts are permitted to be worn by some health professions groups. 7.6 T-shirts and clothing with visible slogans are not permitted. 7.7 Ties (excluding bow ties) and other superfluous clothing (e.g. scarves and wraps) should not be worn as they are infrequently laundered and are often handled by the wearer unconsciously without washing their hands. 7.8 White coats should not be worn unless it is lab wear or part of personal protective equipment (e.g. dental tunics) as they do not provide adequate protection from contaminants and do not facilitate effective hand hygiene. 7.9 Jackets should not be worn in clinical areas to ensure effective hand hygiene Trousers should be tailored and smart. Jeans, ski pants, leggings or combatstyle trousers are not permitted; neither are low-waisted or unduly flared trousers. Track suit bottoms will only be worn by specific health professionals as part of an approved local departmental policy Shorts may be worn in summer months only (May to September) and should be smart and professional e.g. no patch pockets and just above the knee. Swimming shorts are not acceptable Maternity wear. The same general principles stated above apply Scrubs may only be worn by authorised staff groups. For infection control and to promote public confidence they must not be worn outside the hospital premises or in hospital restaurants and refreshment areas Personal protective clothing should be worn as provided to ensure compliance with Health and Safety Regulations and infection control policies. This includes all staff adopting Universal Precautions and the single use of gloves and plastic aprons, where indicated for use Staff using stethoscopes should ensure they are cleaned daily and between patients including both the bell and ear pieces Changes to this policy for individual staff who do not work publicly, or need adapted clothing due to the working environment e.g. engineering, IT etc. will be made via a written protocol agreed with staff side. However, the principles in this policy should be followed. Staff working in non-clinical areas should always look smart and professional. Points 7.2, 7.3, 7.6, 7.10, 7.11 and 7.12 are applicable. 8. Footwear Footwear for staff who work in clinical areas should: 8.1 Be clean and in good repair. 8.2 Enclose the whole foot and be plain to facilitate cleaning. Open toe shoes or sandals are not permitted as they provide no protection from injury. Page 6 of 9

7 8.3 Provide good support, have a non slip soft sole, ideally lace up to ensure they do not fall off in an emergency situation and have a heel no higher than 2.5 cm. 8.4 If trainers are worn they should be plain. 8.5 Suede shoes are not allowed as they can not be effectively cleaned. 8.6 Theatre-style clogs must not be worn outside of the critical care setting e.g. endoscopy or theatres. Footwear for staff who do not work in clinical areas should: 8.7 Be clean and in good repair. 8.8 For clerical staff or those who do not have access to laboratory or clinical setting open toed shoes or sandals with straps are permitted. Flip-flops or other beach-style footwear is not allowed. 9. Responsibilities 9.1 Delegated authority for this Policy is from the Trust Board and lies with the Trust Council. 9.2 Staff are individually responsible for complying with the Dress Code. 9.3 Local managers are accountable for ensuring staff are aware of the Dress Code and adhere to it. 9.4 Everyone has the responsibility and authority to challenge, in an appropriate manner, colleagues who do not adhere to the Dress Code. 9.5 Disregard for the Dress Code may result in disciplinary action. 10. Equality & Diversity The Trust recognises the diversity of cultures, religions, disabilities and beliefs of its employees and would always expect managers to adopt a sensitive approach, exercising discretion, when this affects dress and uniform requirements. However, priority will be given to health and safety, security and infection control considerations. For example, with respect to the Islamic faith, staff may roll their sleeves only four inches back from the wrist as that rule of necessity (they need to be able to wash hands thoroughly) takes precedent over the rule of law (Islam). This has been agreed with our local Imam. Advice may be sought from the Equality and Diversity Manager Page 7 of 9

8 References: Department of Health George, C et al Match, O Royal College of Nursing (2007) Uniforms and Workwear: An evidence base for developing local policy (2006) Healthcare associated infections: a guide for healthcare professionals BMA Science and Education Department and the Board of Science, British Medical Association. London. February (2005) Presenting a professional image University of Hertfordshire, London (2005) Guidance on uniforms and clothing worn in the delivery of patient care RCN, London Page 8 of 9

9 Summary In clinical areas it is good practice to Dress in a manner that promotes patient safety and inspires public confidence. Wear short-sleeved shirts/blouses or sleeves rolled up. Why? The clothing of staff can impact on the safety of the services we provide and people may use general appearance as a proxy measure. To facilitate effective hand hygiene and because cuffs become heavily contaminated and may come into contact with patients. Remove neck-ties (excluding bow-ties) and scarves. Ties are rarely laundered but worn daily. They perform no beneficial function in patient care, have been shown to be colonised by pathogens and are often handled unconsciously by the wearer. If bow ties are worn they must be free from visible dirt and regularly laundered. Change immediately if clothes become visibly soiled or contaminated. Keep fingernails short and clean. Not wear false nails for direct patient care. Remove wristwatches, hand or wrist jewellery (a plain wedding ring is acceptable). Remove necklaces, visible piercings and multiple earrings. Wear closed toe, soft-soled shoes. Visible soiling or contamination might be an infection risk, and is likely to affect patient confidence. Long and/or dirty nails can present a poor appearance and long nails are harder to keep clean. False nails harbour micro-organisms and can reduce compliance with hand hygiene. Hand/wrist jewellery can harbour micro-organisms and can reduce compliance with hand hygiene. Excessive jewellery looks unprofessional and may be hazardous (e.g. necklaces and hoop earrings can be inadvertently pulled or may be grabbed by confused patients). Closed toe shoes offer protection against spills. Soft soles reduce noise, which can disturb patients. Page 9 of 9

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