From the Guardian 1pm GMT
David Batty and agencies guardian.co.uk, Friday January 4 2008 14.18 GMT
A new government dress code for NHS staff, meant to combat the spread of hospital superbugs, is potentially dangerous and unscientific, doctors said today. Under the "bare below the elbows" dress code, which comes into force across all acute trusts this month, staff should wear only short sleeves, no wristwatch, no jewellery, and no ties during clinical practice.
The measures, first outlined by the health secretary, Alan Johnson, in September, are intended to curb the spread of dangerous hospital bugs, including Clostridium difficile and MRSA. They will also ban doctors from wearing traditional white coats. But today, in a letter to the British Medical Journal (BMJ), two hospital doctors warned that banning wristwatches could hinder doctors from taking accurate pulse and respiratory rates. They wrote that doctors need a second hand to measure pulse and respiratory rates, particularly in emergency situations.
James Henderson, a specialist registrar in plastic surgery at the Norfolk and Norwich University Hospital NHS trust, and Sarah McCracken, a specialist registrar in geriatric medicine at Ipswich Hospital, cited a study that showed doctors were unable to safely estimate pulse and respiratory rates without wearing a watch. Only one of the 20 doctors tested was able to give values for each reading that "would not have been potentially dangerous in a clinical setting", they said. "Most beds and examination couches in hospitals do not currently allow sight of a clock," they said. "This study highlights the necessity for doctors to have sight of [a watch] when assessing patients, especially in emergency situations where a clock might not be present," the doctors wrote.
A spokesman for the Department of Health said: "A bare-below-the-elbows dress code for clinicians helps to support effective hand-washing and so reduces the risk of patients catching infections. "It does not prevent clinicians from doing their job. We would expect clinicians to use clocks to measure pulse rates as this is good clinical practice."
The British Medical Association said it backed the government's "bare below the elbows" dress code, including the ban on wristwatches. But its head of science and ethics, Dr Vivienne Nathanson, said: "Basic diagnostic procedures, such as taking someone's pulse or monitoring breathing, require a clock with a second hand. "The health service will have to make sure there is access to a suitable timepiece in all treatment areas, or it could cause more problems than it will solve."