Bare below the elbow

The NHS has set out in the ‘Bare below the elbow’ supplementary policy for hand hygiene (2014) a requirement for healthcare professionals to be bare below the elbow due to the potential risks associated with activities within a healthcare environment. Being bare below the elbow creates more effective hand hygiene and reduces the risk of cross infection.

The ‘Bare below the elbow’ Supplementary Policy for Hand Hygiene (from 2014, but still stands today) highlights that infection is more likely to occur directly via hands or indirectly via an environmental source.

Hand-mediated transmission is one of the major contributors to the acquisition and spread of infection across hospitals. Ensuring hands are decontaminated effectively using the correct techniques around the hands and wrists is important.

The ‘Bare below the elbow supplementary policy’ requirements:

The ‘Bare below the elbow’ approach requires that at all times, all trust staff within a clinical area will have a uniform policy. This includes professionals allied to medicine, nurses, doctors and any administration staff who work in clinical areas.

The directive to the policy is as follows;

• Hands and arms up to the elbow bare/mid forearm are exposed and free from clothing/jewellery.

• Any staff who do not wear uniform but have patient contact must adhere to the ‘bare below the elbow’ initiative for the facilitation of hand decontamination.

• Clothing worn by all staff must be clean and fit for purpose and hands decontaminated before and after each patient contact.

Alexandra endeavours to support best practice and policy within medical and clinical environments. Therefore, we have taken the decision at this time not to provide tunics that will fall below the elbows as part of our healthcare product range.

Alexandra nurses tunics adhere to the bare below the elbow nhs standards and will help your staff to meet the hand hygiene audit. Our range of healthcare tunics uk and our nurses tunics uk allow your staff to feel confident and comfortable whilst partaking in their daily tasks. If you are looking for a white nurse tunic top for a women, a white male nurse tunic or lilac healthcare tunic, we have what you need.


The 'bare below the elbow' policy is part of a wider policy of dress code and behavioural standards adhered to by the NHS and private medical trusts to ensure hand hygiene and infection protection.

In clinical areas (which means from the door providing 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

However, in some circumstances being ‘bare below the elbows’ may cause difficulties to staff due to disability or religion.

If this problem occurs, they may gain guidance from infection prevention staff. Where possible, they will aim to accommodate individual requirements.

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