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Healthcare Personnel Attire in Non-Operating-Room Settings

Published online by Cambridge University Press:  10 May 2016

Gonzalo Bearman*
Virginia Commonwealth University, Richmond, Virginia
Kristina Bryant
University of Louisville, Louisville, Kentucky
Surbhi Leekha
Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
Jeanmarie Mayer
Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
L. Silvia Munoz-Price
Departments of Medicine and Public Health Sciences, University of Miami, Miami, Florida
Rekha Murthy
Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California
Tara Palmore
National Institutes of Health Clinical Center, Bethesda, Maryland
Mark E. Rupp
University of Nebraska Medical Center, Omaha, Nebraska
Joshua White
Virginia Commonwealth University, Richmond, Virginia
Virginia Commonwealth University, Internal Medicine, Richmond, VA 23298 (gbearman
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Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established, and until more definitive information exists priority should be placed on evidence-based measures to prevent healthcare-associated infections (HAIs). This article aims to provide general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the article has 3 major components: (1) a review and interpretation of the medical literature regarding (a) perceptions of HCP attire (from both HCP and patients) and (b) evidence for contamination of attire and its potential contribution to cross-transmission; (2) a review of hospital policies related to HCP attire, as submitted by members of the Society for Healthcare Epidemiology of America (SHEA) Guidelines Committee; and (3) a survey of SHEA and SHEA Research Network members that assessed both institutional HCP attire policies and perceptions of HCP attire in the cross-transmission of pathogens. Recommendations for HCP attire should attempt to balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens. Although the optimal choice of HCP attire for inpatient care remains undefined, we provide recommendations on the use of white coats, neckties, footwear, the bare-below-the-elbows strategy, and laundering. Institutions considering these optional measures should introduce them with a well-organized communication and education effort directed at both HCP and patients. Appropriately designed studies are needed to better define the relationship between HCP attire and HAIs.

SHEA Expert Guidance
Copyright © The Society for Healthcare Epidemiology of America 2014


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