New Tricks: Bare Below the Elbows
We're still trying to work out how nosocomial drug-resistant pathogens from the environment, including healthcare personnel (HCP), are transmitted to patients to become a source of healthcare-associated infections. HCP-driven interventions can mitigate risk for pathogen transmission, for example, through improved hand hygiene. Another strategy is bare below the elbows (BBE), in which HCPs wear only short sleeves, without wristwatches, bracelets, neckties, or white coats during inpatient clinical care.
But can a voluntary BBE approach work? Compliance with BBE was evaluated by Godbout and colleagues[1] at an 865-bed academic medical center that recommended but did not mandate the BBE approach as part of a bundled horizontal infection prevention platform. Transitioning to BBE was encouraged by conducting intensive staff education and adopting black nylon vests for HCP to wear while on inpatient services. Assessments and feedback were implemented via direct observation by two trained hand hygiene monitors. Monitors observed HCP entering patient rooms and recorded observations using a Web-based application on an electronic device. Observations occurred throughout the hospital on general, acute, and intensive care units (ICUs).
The authors summarized BBE compliance frequencies among HCP during the years 2016 and 2017. The monitors made 74,796 observations of patient encounters across various HCP over the 2-year study period.
