Bare below the elbows.

In a widely criticised move, a new dress code is about to be introduced in British hospitals that includes not wearing a wrist watch. The new dress code is part of efforts to prevent the spread of infection in hospitals. But in a letter to the British Medical Journal, James Henderson and Sarah McCracken say that lack of a wristwatch leads to clinical errors and consistently late arrival on ward rounds. They assessed the ability of 20 health care staff to carry out clinical observations, such as respiratory rate and pulse, without the use of the second hand or LCD display available on a wristwatch. Participants instead used clocks in the wards, which were often difficult to see. They found that all participants took longer than 1 minute to make their observations and all would have failed an OSCE. The brief trial showed that the range of observations was so wide that it would be difficult to distinguish normal from abnormal without the use of a second hand or display. There is apparently little evidence to suggest that wrist watches carry infection, so the authors cannot see the point behind the ban. Perhaps frequent handwashing would be a better idea?

BMJ 2008; 336: 10.