Effects of 'bare below the elbows' policy on hand contamination of 92 hospital doctors in a district general hospital.

Despite a lack of evidence the UK's Department of Health introduced a policy of 'bare below the elbows' attire in order to try to reduce the incidence of nosocomial infection. This study investigates the link between this state of dress and hand contamination. A prospective observational study of doctors working in a district general hospital was carried out. The fingertips of each hand were imprinted onto culture medium, and resultant growth assessed for number of colony-forming units and presence of clinically significant pathogens or multiply resistant organisms. These findings were correlated with attire, grade, sex and specialty. Ninety-two doctors were recruited of whom 49 were 'bare below the elbows' compliant and 43 were not. There was no statistically significant difference between those doctors who were 'bare below the elbows' and those that were not, either for the number of colony-forming units or for the presence of clinically significant organisms. No multiply resistant organisms were cultured from doctors' hands. 'Bare below the elbows' attire is not related to the degree of contamination on doctors' fingertips or the presence of clinically significant pathogens. Further studies are required to establish whether investment in doctors' uniforms and patient education campaigns are worthwhile.