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Appropriate shoes for female laboratorians.

Q Many of the female employees in our laboratory have started to wear shoes that I feel provide inadequate protection against the inherent dangers of a clinical laboratory. The problem is that there seems to be only a vague standard at best. The NCCLS document GP17-A, Clinical Laboratory Safety: Approved Guideline, provides one paragraph on shoes. To quote: "Shoes should be comfortable, rubber soled, and cover the entire foot." The interpretation of "covers the entire foot" is inconsistent with most shoe styles today.

A Our panelist, Terry Jo Gile, who is a nationally recognized expert in the area of lab safety, cites the NCCLS guidelines: Clinical Laboratory Safety Approved Guideline. NCCLS document GP17-A 1996; Volume 16, Number 6, (ISBN 1-56238- 300-0). (Available from NCCLS, 940 West Valley Road, Suite 1400, Wayne, PA 19087.) This guideline states, "Shoes should be comfortable, rubber soled, and cover the entire foot. Disposable, fluid-resistant shoe covers can be worn for jobs where splashing is expected. Because canvas shoes will absorb chemicals or infectious fluids, they are not recommended. Leather or a synthetic, fluid-impermeable material is suggested."

Ms. Gile adds, "Obviously, this eliminates sandals, clogs, and sling back shoes, but even the classic woman's pump does not cover the entire foot. Most laboratories I have visited require athletic shoes (jogging or running shoes) because they have a nonskid sole, are comfortable for the many hours of standing required in our profession, and they protect the whole foot. There has been some discussion about clogs at my institution because they are allowed in the operating rooms; however, we continue to follow the guidelines to provide the best protection for our employees against spilled chemicals and sharps, such as broken glass."

Marti Bailey says, "I believe you will be hard-pressed to make laboratory workers adhere to a strict footwear standard when other healthcare employees who are exposed to the same type of hazards do not. Even though there appears to be no hospital policy, I recommend that you double check with your safety department to find out definitively whether or not a standard exists. If there is a hospital standard and it's being ignored for the most part, you'll have to deal with it on a global basis. If no hospital-wide policy exists, then it would seem that you're reasonably free to create one for the lab if you feel it's necessary.

"Although footwear in the laboratory is usually considered a safety item, it obviously crosses over into the dress code realm. And I have real questions about the value of considering footwear as a safety item in today's laboratory. I've never been a supporter of any kind of written dress standards, because once you implement standards, you're faced with the unpleasant task of having to police them. My own preference would be to let your staff know that, in the case of attire, you expect them to use the same good judgment that they use in executing their technical responsibilities. This should not limit you, however, from intervening when you see something that you feel exceeds tolerance limits for appearance or safety."

Ms. Bailey adds, "I agree with you that the standard you quoted, although well intended from a safety standpoint, doesn't seem particularly logical. If the entire foot must be covered, then wouldn't you want arms and legs entirely covered as well? It seems to me that if you are concerned about spilled body fluids and chemicals, it is the front of the foot that is vulnerable and not the back. So open-toed shoes or sandals may truly not offer the safety protection they should, but clogs and sling back shoes probably don't affect risk at all. I am happy to report that our laboratory manager relaxed safety rules pertaining to footwear in the past year or so, and our laboratory now allows employees to wear clog-type shoes. Because this is the primary footwear worn by operating room personnel, there seems to be a well-grounded precedent for this action. Allowing lab staff to wear clogs has been a morale booster, plus they are about the most comfortable shoes I've ever worn."

According to Linda Blacklidge, "The key to the development of a policy for appropriate laboratory shoewear is a comprehensive assessment of the risk presented by working in the laboratory. Each lab discipline performs different testing and is, therefore, subjected to different chemicals, varying risks of pathogenic exposure, and varying potential for accidental injury caused by use of sharps or equipment. All of this has to be taken into consideration. Ideally, employees should wear leather shoes that cover the entire foot, as well as some type of leg covering or socks to prevent against accidental exposure of biohazard or chemical substances. We use the NCCLS recommendations."

Ms. Blacklidge adds, "Shoewear is also a part of our departmental dress code. We all know of individuals who wear sandals to work in the summertime. Often, these people are physicians or other workplace leaders on whom we depend to set an example. We need to evaluate if these are occasional or consistent lapses in adherence to policy. For infractions to our dress code policy, a verbal warning is followed by a written warning, followed by sending the employee home to change on his or her own time, followed by termination. Beyond the extremes of temperature and comfort, most employees will elect to conform to the policy for their own protection."

Bottom line. The NCCLS standard states that shoes should be comfortable, rubber soled, and cover the entire foot. Disposable, fluid-resistant shoe covers can be worn for jobs where splashing is expected. Because canvas shoes will absorb chemicals or infectious fluids, they are not recommended. Leather or a synthetic, fluid-impermeable material is suggested. Make certain that you are following the guidelines of any accrediting agency that inspects your facility. From a practical viewpoint, the clog shoes that are popular today provide as much protection from spills as most other shoes considered acceptable in a hospital environment.

Christopher S. Frings is an internationally known consultant and speaker on the topics of leadership, managing change, time management reaching goals, and stress management. His consulting firm, Chris Frings & Associates, is in Birmingham, AL.
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Author:Frings, Christopher S.
Publication:Medical Laboratory Observer
Article Type:Brief Article
Date:Nov 1, 2000
Words:1030
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