Skip to content Skip to main menu Skip to utility menu

Heartbeat: Right to bare arms – Give hygiene a helping hand

February 16, 2021

‘Bare below the elbows’ has been one of the simplest and safest rules we have had at our Trust for a long time, and in its essence it mandates that colleagues must be bare below the elbows when in a clinical area – rolled up sleeves, no watches, stoned rings (wedding band only), bracelets or anything that could prevent you from effectively washing your hands.

Please follow these simple rules:

  • When you enter a clinical area you must be bare below the elbows so that you are able to properly wash your hands. This is a rule that applies to everyone.
  • Whilst you remain on the ward, you must remain bare below the elbows and follow the ‘5 moments of hand hygiene’ to wash your hands between patients and procedures.
  • Colleagues carrying out a single Aerosol Generated Procedure (AGP), for example intubation, extubation, insertion of tracheostomy, suctioning or those having prolonged close contact with a patient, should wear a single use gown with full sleeves with a plastic apron over the gown. Please remove the gown after the task is completed.
  • For sessional work within a VERY HIGH RISK area or an AGP area (for example D17), a sessional gown with rolled up sleeves (Bare Below the Elbows) should be worn. Colleagues should wear a disposable plastic apron over the sessional use gown and change this in between patients. Please wash your hands and arms in between patients

Sharing her thoughts on the ‘Bare below the elbows’ guidance, Julie Booth said, “The guidance is there to protect patients, visitors and staff to the ever present danger of hospital borne infections not just COVID. We mandate the bare below the elbows rules simply to ensure that every person that enters a clinical area where there is an increased risk is able to wash their hands effectively. This can’t be achieved if they’re wearing watches or large rings with stones.

“Ensuring that you wash your hands effectively is one of the basic tenets of infection control – washing for 20 seconds or more and ensuring that you clean all areas of your hands and doing so without any watches or rings on that might harbour bacteria.

“Secondly, an area that many of us will be used to is ensuring that we have the right personal protective equipment (PPE) for the environment, task or procedure we are undertaking. This doesn’t mean dressing for a disaster but taking a moment to thoughtfully risk assess the area and ensure you are suitably protected with gloves, gowns and respirators, for the task and your individual risk assessment.

“Remember, protecting yourself isn’t the only objective here – it’s preventing the spread of infection. So, colleagues who wear gloves inappropriately and in doing so aren’t able to wash their hands to prevent cross-contamination, are often adding to the problem rather than being part of the solution.

“Finally, it’s something we want to instil in all our colleagues, patients and visitors and that is that it’s ‘Ok to ask’. It’s ‘Ok to ask’ if the person who has come into your ward or department has washed their hands. It’s ‘OK to ask’ someone to give you a little room if they inadvertently stand too close and it’s ‘OK to ask’ any question you have, if there’s something you’re not sure of, it’s better to speak up, ask a question and know that you have done something proactive.

If you have a question about infection control, whether you’re not sure of your processes or practices, you can contact the infection control team on ext. 5900.