Dress Code Policy Version: V3.00 Ratifying Committee: Infection Prevention & Control Committee Date ratified: April 2012 Name of originator/author/job title: Name of responsible committee/individual: Jay Turner-Gardner, HON, Infection Prevention Mandy Bailey, Chief Nurse Infection Prevention Committee Date published on intranet: April 2012 Review date: February 2014 Target audience: Trust wide EQUALITY IMPACT University Hospital of South Manchester NHS Foundation Trust ( UHSM ) strives to ensure equality of opportunity for all service users, local people and the workforce. As an employer and a provider of health care UHSM aims to ensure that none are placed at a disadvantage as a result of its policies and procedures. This document has therefore been equality impact assessed by the Infection Prevention Committee to ensure fairness and consistency for all those covered by it regardless of their individuality. The results are shown in the Equality Impact Tool at Appendix C. 1/16 This Review Date FEB 2012
University Hospital of South Manchester NHS Foundation Trust VERSION CONTROL SCHEDULE Version Issue Date number V1.0 February 2009 V2.0 February 2010 V2.1 January 2011 Revisions from previous issue General update and review V3.00 April 2012 Incorporating new guidance from Uniforms and workwear DoH 2010 Date of Ratification by Committee 24 th February 2010 25 April 2012 Summary consultation process of DOCUMENT CONTROL All members of the infection Prevention and Control Team & Committee have been consulted. DIPC, Microbiology, Infection Prevention and Control Doctor, Head of Nursing, Infection Prevention and Control were part of the consultation process. Control arrangements This policy will be subject to review bi-annually or more frequently if legislation or authorities guidance changes. This Policy will be audited on an annual basis. The ICPT will review and evaluate the Infection Prevention and Control Annual Plan and performance in line with the Health and Social Care Act (2008) This process will be monitored by the IPCC and the Executive Team. Assurances will also be obtained by the completion of internal audits and external inspections by the Care Quality Commission and NHSLA Associated documentation references and H7 policy UHSM Infection Prevention & Control Policies. UHSM Health and Safety Policies. RCN uniform guidelines 2005 Uniforms and work wear DoH 2010 2/16 This Review Date FEB 2012
CONTENTS Paragraph Page 1 Introduction 5 2 Purpose 5 3 Duties & Responsibilities 5 4 Key Principles 6 5 Travelling to and from work 6 6 Additional Uniform Accessories 7 7 Footwear 7 8 Hair 7 9 Nails 7 10 Jewellery 8 11 Cosmetics/Toiletries 8 12 Clothing General 8 13 Maintenance of a Professional Image for n Uniform Wearing Staff 9 14 Replacements 10 15 Leaving the Trust 10 16 Alternative Uniforms 10 17 Culture/Religious Requests/beliefs 10 18 Washing uniforms and work wear 11 19 Bank and Agency staff 12 3/16 This Review Date FEB 2012
Paragraph Page 20 References and bibliography. 12 Appendix A: Uniforms 13 Appendix B: Plan for Dissemination of Policy or Procedural Document 14 Appendix C: Equality Impact Assessment Tool 15 4/16 This Review Date FEB 2012
1 Introduction 2 Purpose The Legislation affecting uniforms and work wear has two main areas of focus. a) A primary concern with health and safety, along with the requirement to prevent the spread of infections and b) employment equality for staff in terms of age, disability, gender, sexual orientation, race and ethnicity, religion or belief and human rights. It is the Policy of the Trust that all front line and support staff comply with the corporate identity, which along with their identity badges will ensure that all staff are easily recognisable by patients and members of the public. In Clinical areas this also promotes safe clinical practice and the uniform provided must be properly worn at all times whilst on duty. This policy applies to all Trust Staff including students and those from partner organisations. Uniforms must be worn in all designated areas (clinical environments) apart from those areas where specialist protective clothing is a necessity or where non-uniform clothes are approved. The wearing of clinical uniforms in public places is not recommended by the Trust and must therefore be covered when worn off site. Scrub style uniforms must not be worn out side of the work area due to the nature of the work undertaken in these areas. 3 Duties & Responsibilities The roles and responsibilities of named individuals within the organisation, with regard to their duty to comply with the Dress code policy and protect patients from the risks of acquiring healthcare associated infection, are identified in the Trust Prevention and Control of Healthcare Associated Infections H7 Policy which can be access via the following link, sub category Infection Control http://uhsm-intranet/policies/pages/default.aspx in accordance with The Health and Social Care Act 2008, Section 2. In addition to the key individuals responsibilities highlighted in the H7 Policy, all health care workers and clinicians including PFI partner staff and outside contractors (who come into contact with the clinical environment) have a responsibility to comply with all aspects of the Dress code Policy and demonstrate their commitment to this Policy by signing the UHSM Pledge. 5/16 This Review Date FEB 2012
4 Key Principles The following principles apply to all staff employed by the Trust as well as students on placements or work experience. The maintenance of a professional image for uniformed staff - all provided uniform and clothing must be maintained in good condition and always laundered appropriately, see item 18 below. The Trust is a non smoking environment and therefore smoking in uniform or any clothing provided by the Trust on Trust premises may result in disciplinary action. Uniforms are manufactured and supplied to a required standard in sizes that comply with Health and Safety. If your provided uniform requires alteration then please contact the Sewing Room. Uniforms must allow unrestricted movement at the shoulder, waist and hips Postures like bending and reaching should be undertaken without compromising the dignity of the nurse or the patient. If a uniform dress is worn, then tights must be worn that are of a neutral colour or black. If a uniform of trousers and tunic is worn then socks must be discreet in navy or black with no bright logos. Only navy blue coloured cardigans or fleeces are permitted to be worn by nursing staff and these must be removed before any patient care is undertaken. Staff should look clean and smart at all times. 5 Travelling to and from work Staff wearing uniform outside of the Trust premises must cover up their uniform completely when travelling to and from work. Staff must not go shopping in uniform or engage in other activities outside of work whilst still in uniform. If staff are representing the Trust at events taking place in the community advice should be sought from their line manager as to if it is appropriate to wear uniform There is no evidence of an infection risk from travelling in uniform but many people perceive this to be unhygienic. Community staff should travel directly between locations 6/16 This Review Date FEB 2012
6 Additional Uniform Accessories Patients like to know the names and roles of staff that are caring for them. Trust identification badges must be worn at all times whilst on duty or when acting in an official capacity representing the Trust. The only badges apart from the Trust identity badge permissible are the Hospital qualification badge, fob watch and Cleanyourhands campaign badges Staff undertaking clinical duties should not wear lanyards but clip on Identity badge holder. If they do wear lanyards in clinical areas they should be tucked away. 7 Footwear 8 Hair 9 Nails Clinical staff who wear uniform must wear soft soled shoes, closed over the foot and toes. Closed shoes offer protection from spills and dropped objects. Open shoes risk injury or contamination to staff. Soft soles reduce noise on wards. Shoes should also be smart and in good condition. Clogs are only permitted in Theatre areas. Black trainers with no colour flashings may be worn. Crocks can be worn in the Theatre environment but should be full toed without holes and be of an appropriate colour. There are certain jobs that require staff to wear protective footwear. These staff must wear the correct footwear for doing their work and if staffs are uncertain they must check with their line manager Hair must be neat, clean and tidy. Staff in clinical areas must not have hair untied if it is below collar length, it should be tied up and not be touching the collar of their uniform. Extreme hair colours are not acceptable, and is at the discretion of the local manager. Hair ornaments such as beads, large hair slides and combs must be discreet and should only be worn to keep hair tidy and off the collar. Beard and moustaches must be trimmed and neat Nails must be short and clean and unvarnished. Nail jewellery, false nails including nail extensions must not be worn in clinical /care environments as these are a hazard, potentially harbouring bacteria and make effective hand hygiene more difficult 7/16 This Review Date FEB 2012
Nail varnish is not permitted for those staff working in direct patient care/clinical areas (please refer to hand Hygiene policy on the Trust intranet. 10 Jewellery In clinical care areas no jewellery is to be worn with exception of one plain ring, such as a wedding ring and one pair of plain stud earrings. Necklaces, long or hoop earrings and rings present possible hazards for patients and staff. Conspicuous jewellery can be a distraction and at odds with presenting a professional image. For many, particularly the older patients, facial piercings and tattoos can be unsettling and distracting.. In the interest of health and safety, for staff and patients alike, staff must not wear visible face or body piercings whilst on duty. Staff are advised against displaying tattoos whilst on duty, the issue is patient attitude and confidence in their care Team. However tattoos on the forearms and hands must be left uncovered for hand hygiene during direct patient activity Wristwatches must not be worn in clinical areas when undertaking clinical duties (Please refer to hand hygiene policy) as they potentially harbour bacteria and make hand hygiene more difficult. For some clinical staff working outdoors, particularly ambulance Teams a wrist watch may be essential. Where worn, these wrist watches must be washable and removed for hand washing. Staff members, who wear medical alert bracelets in the clinical environment and engaged in patient care, must ensure that the bracelet can be pushed up the arm and secured in place for hand washing and direct patient care activity or they must be removed. Medical alert necklaces must be secured in place and not dangle when the staff member bends down, this is to promote health and safety. 11 Cosmetics/Toiletries Discrete cosmetic makeup and perfume/aftershave are permitted. Staff are expected to keep their clothing fresh and free from odours. 12 Clothing in General All staff, both those who wear a uniform and those who do not must not dress untidily and in an unprofessional manner. Patients and visitors may equate untidy appearance with low professional competence and poor 8/16 This Review Date FEB 2012
hygiene standards. For all clinical staff: if a cardigan, jacket or white coat is worn it must be removed prior to giving direct patient care. Long sleeves must be rolled up before giving direct patient care (Please refer to the Hand Hygiene policy). If a tie is worn this must be secured away (tucked inside your shirt) or removed when delivering any clinical contact/patient care. Personal protective clothing must be worn as per the Trust Infection prevention & Control and Health & Safety policies. Staff working in Theatres or equivalent areas where sterile procedures are performed who wear theatre scrub, must cover clothing and remove face masks and hair protection when moving around the Hospital complex unless in an emergency. Uniforms/clothing that are visibly soiled with blood or body fluids must be changed/cleaned as soon as possible These items of clothing must not be taken off site. They must be washed in the hospital laundry. Shoes that are visibly soiled with blood or body fluids must be changed/cleaned as soon as possible and must not be worn outside the Theatre environment when visibly contaminated. Plastic aprons, masks and gloves must not be worn outside of the clinical area. (Please see Trust PPE policy) 13 Maintenance of a Professional Image for n Uniform Wearing Staff Staff groups who are non-uniform wearers must dress in a manner which is presentable and smart in appearance to inspire patient and public confidence. People may use appearance as a proxy measure of professional competence. The following items of clothing are unacceptable, either on the grounds of Health and Safety or for the Trusts public image; Skin tight clothing, crop tops, frayed or torn clothing, Tee-shirts with written messages, excessively high heeled shoes( Stilettos) /Boots i.e.; above 10cm. Excessive jewellery and jeans should not be worn if staff members work in a frontline position or in clinical areas i.e come into contact with patients/public/clinical staff. Trainers may be worn if smart in appearance. Staff should maintain a degree of modesty by ensuring that tops are not low cut, underwear is not visible above trouser tops and that belly buttons are not on display. 9/16 This Review Date FEB 2012
14 Replacements Uniforms are designed to last approximately 3 years. If items need to be replaced within the timescale it must be clearly demonstrated that the replacement request is due to an accident or incident at work or fluctuation in stature, uniforms will then be replaced on a one for one basis. If the old uniform has been wilfully damaged or has been altered then the Trust may charge for the replacement uniform. 15 Leaving the Trust Staff members who leave the Trust must return their uniform, together with their identity badge. The Trust reserves the right to deduct a payment if the uniform is not returned. 16 Alternative Uniforms On occasions when staff members require an alternative uniform, such as during pregnancy, this must be organised and requested by their line manager. Should staffs uniform become contaminated whilst at work, for example splashed with bodily fluids and/or blood please see details below of who you should contact for an alternative/replacement uniform. Staff members who wear scrubs as a uniform out of the theatre environment should change into their scrubs on site and not travel to and from work in them. UHSM staff -Please contact the linen room to request a temporary scrub uniform Sodexo Please contact line manager Sodexo CSIFM (Formerly Atkins) Please contact the Operations Manager. 17 Cultural/Religious Requests/beliefs If a Staff member feels that on the grounds of Religious or cultural need they need a consideration regarding the uniform they are required to wear to be taken into account this must be raised with their line manager and Human Resource Manager. Where for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not in the clinical environment and engaged in patient care, they must ensure that sleeves or bracelets can be pushed up the arm and secured in place for hand washing and direct patient care activity. 10/16 This Review Date FEB 2012
If staff have expressed a preference for disposable over sleeveselasticated at the wrist and elbow- to cover forearms during patient care activity, disposable over sleeves can be worn where gloves are used, but strict adherence to washing hands and wrists must be observed before and after use. Over-sleeves must be discarded in exactly the same way as disposable gloves. Staff who wish to wear over sleeves must contact their manager regarding purchase arrangements and contact infection prevention regarding the method of use N.B The use of alcohol based hand gels containing synthetic alcohol does not fall within the Muslim prohibition against natural alcohol( from fermented fruit or Grain) 18 Washing uniforms and work wear Staff should have at least enough uniforms available to start each day with a clean uniform. There is little effective difference between domestic and commercial laundering in terms of removing micro-organisms from uniforms and work wear. Washing with detergents at 30 c will remove most gram positive microorganisms, including meticillin resistant Staphylococcus aureus ( MRSA). A 10 minute wash at 60 C is sufficient to remove almost all microorganisms. The Trust recommends the use of the Hospital Laundry service for washing specific uniforms i.e. scrubs and white coats that require high temperatures e.g. theatres, Intensive care units, Cardiac catheter labs, Laboratories. Uniforms that are washed at home should not be transported in the same bag as clean uniforms. Do not overload the washing machine as this will reduce wash efficiency. Heavily soiled uniforms must be washed separately as this will eliminate any possible cross contamination from high levels of soiling and enable the uniform to be washed at the highest recommended temperature for the fabric. Uniforms should be dried quickly, tumble dried if possible and ironed, not only to improve the appearance of the fabric and portray a professional image but the extra heat encourages further thermal disinfection. Hand washing clothing items is ineffective and unacceptable 11/16 This Review Date FEB 2012
19 Bank and Agency staff Bank and agency staff must be aware of and comply with the specific local uniform policy in each location that they work within the Trust. 20 References and Bibliography Infection Prevention Policies. Health and Safety Policies. Guidance on uniforms and clothing worn in the delivery of care.rcn 2005 Uniforms and work wear: Guidance on uniform and work wear policies for NHS employers. DoH 2010 12/16 This Review Date FEB 2012
Appendix A UNIFORMS Hospital staff Nursing and Midwifery Staff Chief Nurse: Heads of Nursing: Matron: Ward/Unit Manager: Ward/Unit Sister: Ward/Unit Registered Nurses: Assistant Practitioners: Trainee Assistant Practitioners: Senior Health Care Support Workers: Health Care Support Workers: Night Managers: Bed Managers (inc Discharge Facilitators: Student Nurses: Midwives: Emergency Nurse Practitioner & Nurse Consultant (A&E) Uniform Navy Blue tunic with red block collar & cuffs. Navy Blue tunic with lilac block collar & cuffs. Navy Blue tunic/dress with red trim. Navy Blue tunic/dress. Light blue tunic/dress with navy trim. Light blue tunic/dress with light blue trim. Green tunics/dress with green trim. Green tunics/dress with white trim. Light blue tunic/dress lilac trim. Light blue tunic. Navy blue tunic/dress white trim. Light blue tunics/dress with navy blue trim. Relevant university uniform. Royal blue dress/tunic with white trim. Navy Blue Cortex. n Ward Based specialist nurses Research nurse/midwife Lead research nurse/midwife Senior research nurse/midwife Specialist Nurse/Midwife Sky blue dress/tunic with emerald trim Navy blue dress/tunic with aqua trim Navy blue dress/tunic with emerald trim Sky blue dress/tunic with daffodil trim 13/16 This Review Date FEB 2012
Senior specialist nurse /Midwife Lead specialist nurse / Midwife Consultant nurse Navy blue dress/tunic with daffodil trim Navy blue dress/tunic with sunflower trim Navy blue dress/tunic with sunflower block collar and cuffs UNIFORMS Community staff Clinical lead Team leader/sister Staff nurse Assistant practitioner Support worker Navy blue dress/tunic with white trim Navy blue dress/tunic with white trim Hospital blue dress/tunic with white trim Pale blue dress/tunic with purple trim Pale blue dress/tunic with white trim Junior support worker Pale blue dress /tunic with self colour trim All staff Trousers Fleece/cardigan Navy blue trousers are to be worn with all tunics. Navy blue - with trust logo left chest and twin hearts on right sleeve Areas where scrubs are worn CTCCU AICU Burns Acute Theatres Transplant Delivery suite F block Theatres Cardiothoracic Theatres ENT Theatres TDC Theatres A side x-ray. Neo-natal unit 14/16 This Review Date FEB 2012
Title of document: APPENDIX B PLAN FOR DISSEMINATION Dress Code Policy V3 Date finalised: February 2012 Dissemination lead: Print name and Previous Yes contact details document already being used? If yes, in what format and where? Proposed action to retrieve out-of-date copies of the document: On Trust intranet Jay Turner- Gardner HON, Infection Prevention Remove version 2.1 and replace with version 3 Describe the plans for dissemination of the document to specific people / groups in specified formats and if appropriate with relevant training This Policy will be accessed via the Trusts Policy site via the Intranet. The Policy will be disseminated via Directorate Management structures in conjunction with the dissemination of other key Human Resource Policies and Procedures. Team Brief Daily Bulletin Dissemination Record - to be used once document is ratified. Date put on register / library of policy or procedural documents Date due to be reviewed tes 15/16 This Review Date FEB 2012
APPENDIX C EQUALITY IMPACT ASSESSMENT Of Dress code policy Yes/ Comments 1. Does the policy/guidance affect one group less or more favourably than another on the basis of: Race Ethnic origins (including gypsies and travellers) Nationality Gender Culture Religion or belief Sexual orientation including lesbian, gay, bisexual and transgender people Age Disability Yes 2. Is there any evidence that some groups are affected differently? 3. If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? 4. Is the impact of the policy/guidance likely to be negative? 5. If so can the impact be avoided? N/A 6. What alternatives are there to achieving the policy/guidance without the impact? 7. Can we reduce the impact by taking different action? N/A N/A 16/16 This Review Date FEB 2012