1378. Bare Below the Elbows (BBE): Perception of Patients and Providers on the Impact on Patient Care in an Adult Oncology Setting
Session: Poster Abstract Session: HAI: Hand Hygiene
Friday, October 28, 2016
Room: Poster Hall
  • Bischoff_BBE_Poster_REV.pdf (52.9 kB)
  • Background: BBE (omission of long sleeves, wristwatches, jewelry, and neckties) has raised concerns regarding potential impact on patient care and satisfaction due to patient/provider perception of changes in traditional professional attire.

    Methods: In a case-control design, weekly surveys were given to 179 individual patients in the intervention unit and monthly surveys to 97 patients (control unit), 115 nurses, and 56 physicians over a three month period. Questions focused on the perceived impact of BBE on threat of infection, professional appearance, identification of and confidence in care provider, and willingness to adopt change without strong evidence (providers only).

    Results: No differences were detected in patient age, gender, race, isolation precautions or care satisfaction between units. Length of stay was longer in the BBE unit (8.0 vs 4.5 days; p<.05). Both patient groups rated the impact of BBE equally positive (p>.10). Over 90% of patients perceived an unchanged/decreased threat of infection due to BBE, and an unchanged/improved confidence in and professional appearance of physicians using BBE. Identification of physicians in BBE was unchanged/easier for >70%. Younger patients were less concerned about providers wearing a white coat/scrub jacket (p<.05). Patients educated in BBE could identify physicians easier, and had more confidence in providers practicing BBE (p<.05). Monthly or less laundering of white coats/scrub jackets was reported by 3.5% of nurses and 39% of physicians. Threat of infection, professional appearance, and confidence in providers were rated lower by nurses (74% - 84%) and physicians (52% - 73%) as compared to patients (93% - 96%; p<.0001). Over the course of the survey nurses felt less confident that patients are comfortable with BBE (p<.05), while patients did not. Willingness to adopt change ranged from 73% (physicians) to 80% (nurses) and was higher in those with BBE education (physicians: p<.10; nurses: p<.05) and physicians serving longer in their role (p<.10).

    Conclusion: The majority of patients in both units positively viewed BBE. Provider perceptions of patient views of BBE were significantly less favorable. Education efforts improved patient and provider perception.

    Werner Bischoff, MD, PhD, FSHEA1, Sylvia Pegg, RN CIC2, Sharon Henderson, RN CIC2, Linda Roach, BSMT CIC2, Deborah Jacob Brooks, BSMT (ASCP) RN2, Amy Braden, MS2, Shannon Flanner, CMA2, Debra Weston, CMA2, Elizabeth Floyd, .2, Andrea Anderson, MS3, James Viviano, MS2 and John Stehle Jr., PhD4, (1)Department of Internal Medicine, Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC, (2)Infection Prevention, Wake Forest Baptist Medical Center, Winston Salem, NC, (3)Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston Salem, NC, (4)Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC


    W. Bischoff, None

    S. Pegg, None

    S. Henderson, None

    L. Roach, None

    D. J. Brooks, None

    A. Braden, None

    S. Flanner, None

    D. Weston, None

    E. Floyd, None

    A. Anderson, None

    J. Viviano, None

    J. Stehle Jr., None

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