Wristwatches in bare-below-the-elbows out-of-hospital policies: time for a review

Abstract

Background: Bare-below-the-elbows (BBE) policies are common in infection prevention and control strategies but the evidence relating to wristwatch prohibition is slim and varied in quality. No dispensation is considered for those working outside hospital, which poses unique infection prevention and control challenges. Blanket approaches may be putting patients at further risk of healthcare-acquired infections (HCAIs). Aims: This review aimed to collate evidence and bring clarity to the ongoing debate surrounding mandated BBE policy, specifically relating to wristwatches worn within the prehospital setting. Methods: Three searches were undertaken, and results refined against an inclusion criterion to ensure relevance. Findings: Wristwatches can be considered a vector for HCAI; however, most data on this are confounded by other known risk factors. No studies were conducted outside a hospital environment. Alternative time sources used by clinicians such as touchscreen phones are a significant pathogen vector. Conclusion: Four policy evidence-based recommendations are made in relation to this topic. The National Institute for Health and Care Excellence (NICE) should review this topic as the evidence base underpinning its guidance is inadequate. Abstract published with permission.