What, no tie Dr Brown?

This is a picture of me in my consulting room:

I don't have a tie on because it helps to reduce the spread of infections and keeps patients safe? Can you spot anything else in the picture that helps reduce the spread of infections - I can see at least seven things!

Healthcare associated infections (HCAI) can occur from contacts with patients in general practice. They are caused by a variety of 'bugs' and can have a large impact on patients. It is estimated that 300,000 patients a year in England acquire a HCAI as a result of care within the NHS. In 2007, meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile infections were recorded as the underlying cause of, or a contributory factor in, approximately 9000 deaths in hospital and primary care in England. So, preventing HCAI is an important way to promote patient safety.

In my surgery consulting room picture the things that are helping reduce HACI are:

1. 'Bare below the elbows' - this allows me to wash and decontaminate my hands between direct patient contact
2. No wrist watch - this allows me to thoroughly decontaminate my hands
3. No jewellery or rings on
4. No tie - this is part of the 'Bare below the elbows' policy
5. Bottle of Alcohol Gel on my desk between me and patient to remind me to use it before patient contact
6. Hard floor surface in consulting rooms - our new premises were designed and built to reduce the risk of patients getting HCAIs. There are hard surfaces in consulting rooms that can be easily washed and decontaminated, we use couches that are free standing with no dirt traps and sinks with no plugs
7. Labelled bins to put correct waste in - clinical waste, paper towel waste, two sharps bins, confidential waste bin and then a normal rubbish bin!

So, the reason I have stopped wearing a tie in surgery is not because I have gone all casual but to help reduce healthcare acquired infections!