Letter to the Editor
‘Bare below the elbows’ and quality of hand washing: a randomised comparison study

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Acknowledgements

The authors acknowledge the great help of the infection control department at the Royal Cornwall Hospital, and the epidemiological advice of Dr S. de Martin.

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There are more references available in the full text version of this article.

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    Second, the data did not show any significant difference in the transmission of bacteria based on sleeve length. Sleeve length and possible routes of transmission have been written about in the past.9 One can understand how long sleeves make contact with various objects and then the patient.

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

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    These differing methods have previously been shown to give similar results.9,14 Recently attention has also focused on contamination in the wrist area, and BBE policy has been shown to have a positive effect on washing in this area, though the clinical implications of this remain unclear.16 To address this area, an alternative sampling technique would be required.

  • Pants, policies and paranoia...

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    There was no significant difference in the overall percentage area missed after hand washing between the two groups, although the group wearing white coats did miss significantly more of the wrist area. As the author point out, however, being bare below the elbows does not make any difference to the quality of hand washing among doctors and medical students, at least in terms of the areas covered when using alcohol gel.15 Being bare below the elbows improves wrist washing, but there is no evidence to show that patients acquire hospital organisms from a doctor's unwashed wrists.

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