Dress / Uniform Policy Author(s) Charlie Sheldon, Chief Nurse & Director of Governance Version 3.1 Version Date 15.9.12 Implementation/approval Date November 2012 Review Date November 2015 Review Body Policy Reference Number Clinical Board Infection Control committee NMAC 178\tw\o\d\ 1
Contents Page Page number Summary 3 Scope 3 Roles and responsibilities 3 Principles 3 Identification 3 Compliance with standards for infection prevention and control 4 General presentation 4 Jewellery 5 Clothing 6 Headwear 8 Wearing of uniform outside of Trust premises 8 Changing and laundering of uniforms 8 Monitoring / audit 9 Equalities impact assessment 10 Policy submission form 12 2
1. Summary 2. Scope The Homerton University Hospital NHS FT wants all staff to feel positive about their appearance and this policy is not in place to prevent individual expression be that religious, cultural or individual preference. The policy is intended to cultivate a positive and professional image of staff that is consistent with expectations of patients, colleagues and the wider public whilst maintaining standards of healthcare compliance. Staff must at all times consider how their behaviour and appearance impacts upon patients and the health and safety of themselves, the public, patients and other staff members. 2.1. This policy applies to all Trust workers and employees including contracted staff, volunteers, pre and post registration students and work experience students. Temporary staff are expected to meet the same standards. A failure to follow the requirements of the policy may result in investigation and management action being taken as considered appropriate. This may include formal action in line with the Trust's disciplinary or capability procedures for Trust employees; and other action in relation to other workers, which may result in the termination of an assignment, placement, secondment or honorary arrangement. 3. Roles and Responsibilities 3.1. All staff have a duty to adhere to Trust policies and to present a professional image. 3.2. Managers are expected to apply a consistent but common sense approach in applying this policy. 4. Principles 4.1 In addition to cultivating a positive and professional image of staff, specific underlying principles are to: 4.1.1. Reduce the risk of cross infection 4.1.2. Avoid potential injury to patients 4.1.3. Avoid potential injury to staff including themselves 4.1.4. Avoid offence to others (unduly revealing clothing) 5. Identification 5.1 All staff must wear a valid identification (ID) badge whilst at work in a clearly visible position. 5.2 Trust ID badges must not be worn when travelling to and from work. 5.3 Nursing and midwifery staff are also required to wear their separate name and role badge on their uniform. 3
6. Compliance with standards for infection prevention and control 6.1. The instruction from Homerton Clinical Board is that all staff involved with direct patient care (e.g. within a ward or clinic setting where hands on care is provided) must comply with the bare below the elbows standard. If relevant, managers within diagnostic services may wish to consider in discussion with infection control an exception to this rule where staff are administering medication which comes under the Ionising Radiation Regulations 2000 e.g. x-rays, radiotherapy and exposing their forearms could put them at greater risk of harm]. Bare below the elbows requirements are: 6.1.1. Rolled up or short sleeves so that arms are exposed from below the elbow. 6.1.2. No white coats. 6.1.3. No ties (including bow ties). 6.1.4. No wristwatches. 6.1.5. Bracelets and wrist jewellery are not permitted except where these are for religious reasons and they can be pushed and secured out of the way for hand washing and direct patient care. Religious exceptions under this provision must be discussed with and agreed by the line manager and infection control nurse specialist. Disposable over sleeves may also be considered and can be discussed with the infection control team. 6.1.6. No rings with stones or other inserts. Only one plain band is acceptable. 7. General presentation and appearance 7.1 The following will apply: 8. Jewellery 7.1.1. Staff are to look clean, tidy and well presented 7.1.2 Clothes and uniform are to be in good condition and free from obvious dirt and stains and creases. 7.1.3 Staff are to maintain a high standard of personal hygiene. 7.1.4 Hair is to be clean and tidy. For staff in a clinical setting hair is to be off the face, above shoulder level or tied back neatly and securely. 7.1.5 Male staff are to be clean shaven or have tidy beards / moustaches. Partial beard growth (stubble) is not acceptable. Beards must be covered with an appropriate facial mask when the needs of infection control and/or health and safety require it. Staff must consult their line manager if they are unsure as to whether a facial mask is needed. 7.1.6 Make up is to be discreet. 7.1.7 Tattoos must be inoffensive and covered up where possible. 7.1.8 Nails are to be clean and neat. For staff in clinical areas nails are to be short and unvarnished. False nails or nail extensions are not permitted where the staff member undertakes or may undertake any duties in circumstances where they are directly involved in patient care including reception staff. 8.1 Staff in direct patient care: 4
8.1.1 One pair of discreet ear studs or earrings can be worn. Other discreet facial piercing can be worn. 8.1.2 No visible body piercing is permitted. 8.1.3 No rings are permitted except one plain band 8.1.4 Neck chains must be completely concealed beneath uniforms. 8.1.5 Bracelets and ankle chains are not permitted except where these are for religious reasons and they can be pushed and secured out of the way for hand washing and direct patient care. Religious exceptions under this provision must be discussed with and agreed by the line manager and infection control nurse specialist. 8.2 All other staff who are in contact with the patients and public but not involved with direct contact: 9. Clothing 8.2.1 One pair of earrings and one other discreet facial piercing can be worn 8.2.2 No visible body piercing is permitted. 9.1 The Trust recognises the religious and cultural requirements of some members of staff in relation to the uniform/clothes they wear. These requirements will be handled with sensitivity and wherever possible the Trust will try to accommodate such requirements, including the provision of an appropriate uniform for uniformed staff, subject always to infection control, public confidence and risk management considerations. Clothing must reflect the professional approach to service that the Trust aims to deliver. Therefore the following will apply: 9.1.1. In respect of uniformed staff: Staff who are required to wear a uniform will be provided with an adequate number of uniforms by the Trust Uniformed staff must wear the uniform provided without alteration except for size purposes For staff wearing dress uniforms tights are to be brown or black and in good condition. In particular hot weather staff may be excused from wearing tights. Uniformed staff must wear a clean uniform every working day/shift. No outer garments should be worn in clinical areas. 9.1.2. In respect of staff not required to wear a uniform: Dresses and skirts should be of an appropriate length, mini or micro lengths are not permitted. Dresses should cover the majority of the shoulders. Material is not to be see-through. Denim jeans must never be worn at work 5
Tops, shirts and blouses should cover the majority of the shoulders and should not be low cut. They should also be of sufficient length to avoid exposing the midriff and should not have unnecessary pictures or logos. Material is not to be see-through. In patient and public areas male staff are to wear a shirt with a collar and female staff are to wear an equivalent appropriately smart top or dress. Trousers should be tailored or smart and be fitted around the waist (i.e. not low cut). Shorts of knee length or longer are acceptable if smart (i.e tailored or chino) but as a general rule should be worn only in areas such as gyms or rehabilitation areas. Ski pants / leggings are permitted if worn under a skirt or dress. Neckties/lanyards must not be worn during direct patient care activity. 9.1.3. Footwear is to be: 9.1.3.1.1. For uniformed staff and those involved in direct care: Loose fitting, casual footwear such as flip flops are not permitted for any members of staff. Direct care staff are not permitted to wear fabric or suede shoes due to infection control requirements. Tights and shoes are to be appropriate to the uniform worn. Trainers are acceptable but should not be fabric or heavily branded. Nursing staff should wear black or navy blue shoes / trainers only Certain positions within the Trust will require staff to wear specialist footwear (theatre shoes) Community staff should wear shoe covers when visiting homes where patients do not want shoes worn in their homes. 9.1.3.1.2. For staff not required to wear a uniform Smart and in keeping with the outfit worn. Soft soled shoes, closed over the foot and toes, must be worn in clinical areas. Loose fitting, casual footwear such as flip flops are not permitted for any members of staff 6
Certain positions within the Trust will require staff to wear protective footwear (such as steel toecaps) 10. Headwear 9.1.4. Scrubs / blues are only worn by staff working in the following designated areas: Intensive care & neonatal intensive care Operating theatres Day stay unit and endoscopy Accident & emergency Delivery suite Fertility Podiatry 9.1.4.1 Staff working in these areas are permitted to wear scrubs when leaving these areas in the course of their work and for breaks however the following principles must be adhered to: Soiled scrubs are never to be worn in public areas (such as the canteen) except in an emergency situation. Staff must not wear theatre scrubs in the smoking shelters Theatre clogs / shoes must never be worn outside of the main hospital building or in the canteen or coffee shops Theatre caps, masks and gowns must be removed when leaving the theatre or day surgical area Staff in scrubs must adhere to the same principles of bare below the elbows as other clinical staff Scrubs must never been worn outside of the Hospital grounds 10.1 The Trust recognises the religious and cultural requirements of some members of staff in relation to the headwear they wear. These requirements will be handled with sensitivity and wherever possible the Trust will try to accommodate such requirements subject always, in accordance with Department of Health guidance, to patient safety and public confidence considerations. 10.2 Where headwear is worn, for religious reasons, this should be clean, neat and in keeping with the professional appearance that all staff are required to maintain. The face must be fully exposed at all times. Casual headwear, such as baseball caps, is not permitted. 10.3 For uniformed staff, headwear should match their uniform as closely as possible. 7
10.4 Where a headwear is worn, staff must ensure that the flow of the garment does not interfere with work practice or present an infection control and/or health and safety risk. 10.5 Where staff work in a clinical area, any headwear worn must be changed on a daily basis for infection control purposes. 11. Wearing of uniform outside Trust premises 11.1 It is the Trust s preference that staff do not wear their work uniform outside of Trust premises. However, it is accepted that some staff will travel to and from work in their uniform. On public transport and in public areas the uniform is to be covered at all times by a coat. 11.2 Scrubs are never to be worn to travel to and from work. 11.3 Community staff who wear uniform should cover uniform when travelling between home visits or clinics. 12. Changing and laundering of uniforms/clothes 12.1 The Trust does not have facilities for uniform/clothes laundering other than scrubs. Staff are therefore required to wash their own uniform/clothes. The following guidance should be followed when handling and decontaminating uniforms/clothes: 12.1.1 Wash separately from other items in a washing machine at the hottest temperature permitted by the manufacturer s instructions, preferably at 65º- 71º centigrade if possible 12.1.2 Wash in laundry detergent in the quantities recommended by the manufacturer (type, for example, biological etc, is not important). 12.1.3 Dry quickly, or tumble dry and iron. 12.1.4 Hand washing is ineffective and therefore not acceptable. 12.1.5 For infection control purposes direct care staff must change their uniforms/clothes every day and immediately if contaminated with blood or bodily fluids. Staff should therefore have spare uniform/clothes to change into if required. If no spare uniform is available then uniformed staff may wear a scrub suit as an emergency measure. 8
13. Monitoring/Audit Measurable Policy Objective Monitoring/Audit Frequency of monitoring Responsibility for performing the monitoring Monitoring reported to which groups/committees, inc responsibility for reviewing action plans Smart professional image of all staff. Through spot checks, rounding. Ad-hoc All managers 9
Equalities Impact Assessment This checklist should be completed for all new Corporate Policies and procedures to understand their potential impact on equalities and assure equality in service delivery and employment. Policy/Service Name: Author: Role: Directorate: Dress / Uniform Policy Charlie Sheldon, Chief Nurse & Director of Governance Chief Nurse Corporate Date Sept. 2012 Equalities Impact Assessment Question 1. How does the attached policy/service fit into the trusts overall aims? Yes No Comment Corporate image, professional image, safety, infection control, code of behaviour, reputation. 2. How will the policy/service be implemented? 3. What outcomes are intended by implementing the policy/delivering the service? 4. How will the above outcomes be measured? Dissemination to all staff. Professional public image and reputation whilst maintaining public confidence and patient safety. Patient feedback, complaints and PALS enquiries. 5. Who are they key stakeholders in respect of this policy/service and how have they been involved? 6. Does this policy/service impact on other policies or services and is that impact understood? 7. Does this policy/service impact on other agencies and is that impact understood? Professional leads & managers. Consulted as part of policy development. Infection control and single equalities policies have been referenced and considered. Temporary and contracted staff. 8. Is there any data on the policy or service that will help inform the EqIA? Not currently but potentially if an audit undertaken. 10
9. Are there are information gaps, and how will they be addressed/what additional information is required? Equalities Impact Assessment Question 10. Does the policy or service development have an adverse impact on any particular group? 11. Could the way the policy is carried out have an adverse impact on equality of opportunity or good relations between different groups? 12. Where an adverse impact has been identified can changes be made to minimise it? 13. Is the policy directly or indirectly discriminatory, and can the latter be justified? 14. Is the policy intended to increase equality of opportunity by permitting Positive Action or Reasonable Adjustment? If so is this lawful? Yes No Comment Policy states consideration of religious and cultural implications is required. EQUALITIES IMPACT ASSESSMENT FOR POLICIES AND PROCEDURES 2. If any of the questions are answered yes then the proposed policy is likely to be relevant to the Trust s responsibilities under the equalities duties. Please provide the ratifying committee with information on why yes answers were given and whether or not this is justifiable for clinical reasons. The author should consult with the Director of HR & Environment to develop a more detailed assessment of the Policy s impact and, where appropriate, design monitoring and reporting systems if there is any uncertainty. 3. A copy of the completed form should be submitted to the ratifying committee when submitting the document for ratification. The Committee will inform you if they perceive the Impact to be sufficient that a more detailed assessment is required. In this instance, the result of this impact assessment and any further work should be summarised in the body of the Policy and support will be given to ensure that the policy promotes equality. 11
Policy Submission Form Policy Submission Form To be completed and attached to any policy or procedure submitted to the Trust Policy Group 1 Details of policy 1.1 Title of Policy: Dress / Uniform Policy 1.2 Lead Executive Director Charlie Sheldon, Chief Nurse & Director of Governance 1.3 Author/Title Charlie Sheldon, Chief Nurse & Director of Governance 1.4 Lead Sub Committee Clinical Board 1.5 Reason for Policy Professional public image is fundamental to quality of care. 1.6 Who does policy affect? All staff 1.7 Are national guidelines/codes of practice incorporated? 1.8 Has an Equality Impact Assessment been carried out? 2 Information Collation 2.1 Where was Policy information obtained from? 3 Policy Management 3.1 Is there a requirement for a new or revised management structure if the policy is implemented? Infection control and Single Equalities Scheme yes Previous dress code that undertook consultation and presented to Clinical Board September 2008, employment law. No 3.2 If YES attach a copy to this form 3.3 If NO explain why In place. 4 Consultation Process 4.1 Was there internal/external consultation? yes 4.2 List groups/persons involved Clinical Board, NMAC, Infection Control Committee 4.3 Have internal/external comments been duly considered? Yes 4.4 Date approved by relevant Subcommittee 4.5 Signature of Sub committee chair 5 Implementation 12
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