The debate continues regarding ''bare below the elbows'' for inpatient care. At VCU medical center, this is an infection prevention recommendation and not a mandate.
A recent paper published in the Journal of Hospital Medicine failed to find a difference in bacterial and MRSA colonization between the white coats and uniforms. An excellent commentary was recently posted by my colleague Mike Edmond.
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| Photo: Mike Edmond |
At the core of the ongoing argument is that garments can harbor pathogens. A bare below the elbows approach allows for hand hygiene to the forearms and limits the contact of colonized apparel (cuffs) with the patient. The intervention is simple, inexpensive (all you need is a short sleeve garment), biologically plausible and likely will not cause harm.
Larger studies are needed to definitively prove or refute this hypothesis.
It seems that the old guard is resistant to shedding their symbolic white coats with some claiming that the lack of a shirt, tie and lab coat renders an unprofessional appearance. Others claim that coat pockets are needed for their instruments, papers, pens, etc.
For this last group, perhaps they could resolve the insufficient pockets issue by carrying a man purse !
