Monday, June 1, 2009

AMA to weigh in on hospital dress codes

Mike has blogged about this, and has gone to great lengths to encourage a “bare below the elbows” approach to patient care at VCU—but so far I haven’t seen a major professional society or public health authority in the U.S. make any definitive statements. So I find it very interesting that the AMA will be considering a resolution later this month (at their House of Delegates meeting in Chicago on June 13-17) that squarely addresses the role of clothing and accessories (jewelry, wrist watches, etc.) in the spread of pathogens in hospitals. All the resolutions can be accessed here (this one is resolution 720)—since I can’t directly link to it I’ll copy the text below. As you can see, the AMA doesn’t get very prescriptive about what should be done, just advises that hospitals adopt dress codes that “minimize transmission of nosocomial infections, particularly in critical and intensive care units.” But they specifically refer to the UK “bare below the elbows” policy, so I think it leaves the door open for hospitals to begin changing policy in this area….I’ll let Mike weigh in on just how difficult that can be.

Resolution: 720 (A-09)
Introduced by: Medical Student Section
Subject: Hospital Dress Codes for the Reduction of Nosocomial Transmission of Disease
Referred to: Reference Committee G

Whereas, Nosocomial infection is a significant cause of morbidity and mortality in the US; and
Whereas, According to the Centers for Disease Control and Prevention, approximately 1.7 million hospital patients contracted nosocomial infections in 2002, resulting in nearly 100,000 deaths; and
Whereas, Patients in critical or intensive care units are most susceptible to nosocomial infection, accounting for nearly 25 percent of all cases; and
Whereas, Neckties, long sleeves, and other clothing items and accessories have been implicated in the spread of nosocomial infection; and
Whereas, In 2007, the British National Health System implemented a “bare below the elbow” hospital dress code, banning neckties, long sleeves, hand and wrist jewelry, and traditional physician white coats; therefore be it
RESOLVED, That our American Medical Association advocate for the adoption of hospital guidelines for dress codes that minimize transmission of nosocomial infections, particularly in critical and intensive care units. (Directive to Take Action)


  1. Perhaps you referred to this and I missed it - medical student article on infection control/scrubs in CMAJ. 2009 Apr 28;180(9):984. (open access)

    Scrubs: what you don't see is what you get. Jacob GP.

    Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont.

  2. No, I missed that one, Kathy. Thanks for pointing us to it, I'll check it out!

    Interestingly, it was the medical student section that submitted this AMA resolution. I would be really interested in the background, and the discussions that preceded the drafting of the resolution. I was not involved in the AMA as a medical student, so I am not very well versed in how the student section operates.

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