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Bare Below the Elbow (BBE) Policy

Uniforms and work wear must not impede effective hand hygiene, and should not come into

contact with patients during direct patient care activity. All staff will adopt the “bare below the

elbows‟ dress code whenever they are engaged in a direct patient care activity.

Key requirements for the Trust in relation to uniform and work wear:

A‟ bare below the elbows‟ approach will be adopted at all times by all staff in the clinical area.

This includes nurses, doctors, professionals allied to medicine and administration staff who work in

a clinical area.

Any staff who do not wear uniform but have patient contact must adhere to the „bare below the

elbows‟ initiative for the facilitation of hand decontamination.

Clothing worn by all staff must be clean and fit for purpose and hands decontamination before and

after each patient contact.

Coats etc. can either be left in ward „rest room‟ or carried with you as long as they are removed

whilst hand decontamination takes place.

Please see the Department of Health Guidance on uniform and work wear policies for NHS


The Trusts Dress Code Policy does not define clinical area. However this policy makes clear that

Bare below the elbow in “clinical areas” means that from the door that provides direct access to a

ward or department where patients are seen or treated or in any facility where personal care is

being provided all staff must comply with the following :-

  • Nails should be short and clean – no nail polish or extensions.
  • Wrist watches must not be worn.
  • No other jewellery should be worn around the wrist. Alert bracelets must be removed and

attached around lanyard or pinned to uniform.

  • No rings with stones should be worn – one plain band is permitted.
  • Sleeves must be short or rolled securely up to the elbow in order to allow access to the

wrist for good hand wash technique.

  • Ties should not be worn or, if worn, should be tucked in.

Where there is no facility for leaving coats, bags etc. outside the „clinical area‟ these should be

removed and secured immediately on entering the area where patients are treated or seen.

Although policies only exist for the clinical professions, Senior Management Team has endorsed

the proposal, that all staff including managers, social care staff, pharmacy and support staff

visiting clinical areas must also be compliant.

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