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Personal Appearance Standards

OBJECTIVE

To promote a neat, clean, professional, and business like appearance consistent with preserving and enhancing the image of the Detroit Medical Center, while assuring that attire is not hazardous, distracting or offensive to patients and employees.

SCOPE

All Detroit Medical Center, Children’s Hospital of Michigan, Detroit Receiving Hospital and University Health Center, DMC Surgery Hospital, Harper University Hospital, Hutzel Women’s Hospital, Huron Valley-Sinai Hospital, Rehabilitation Institute of Michigan, and Sinai-Grace Hospital personnel in patient care areas.  This policy applies to all DSG and other contracted (agency) staff working in with patients or in patient care areas of the DMC

POLICY

  1. All personnel maintain personal appearance standards that are consistent with the professional image of a health care institution, and all infection control, legal, and safety requirements.
  2. Professional business attire is required while on duty and when employees and contract employees represent the DMC at any outside conferences, community outreach functions and other professional and/or education events.
  3. The utilization of specialized safety equipment (e.g. steel-toed shoes, as determined by OSHA regulations is addressed in department guidelines or MODs.

See site, department or discipline specific guidelines for additional guidance.

PROVISIONS

Universal Personal Appearance Standards

  1. Clothing should be of appropriate size and fit permitting freedom of movement while maintaining coverage of body.  All personal clothing must be

     

  2. Clean, neat, and of appropriate length with finished hems. 
  3. In good repair and securely fastened (no holes, rips, tears, patches)
  4. Well fitting (i.e. neither too tight or too loose) and not excessively revealing nor transparent.
  5. Tucking pant legs into socks is not permitted.
  6. Lab coats when worn are clean and in good repair
  7. Articles of clothing (not limited to jackets and sweatshirts) should not be tied around the waist.
  8. Clothing with hoods are not permitted with the hood up.
  9. Undergarments must be worn at all times, and color and/or design must not be visible through or above clothing.

      Socks or hosiery must be worn.  Bare legs/feet and fishnet hosiery are not acceptable.

  10. Hair is to be neat and clean.  Long hair must be so styled and/or restrained so as not to interfere with work performance, safety and infection control.  Head coverings mandated by religious beliefs are acceptable unless heard coverings may pose an infection control risk.  Hair or head coverings may not obscure vision or come in contact with patient or other surfaces.  Styling combs/picks may not be work in the hair.

  11. Mustaches and beards must be clean and neatly trimmed.  Chest hair must be covered.
  12. Fingernails must be kept short (i.e., not to exceed 1/4 inch past the fingertip) and clean. Chipped nail polish or enhancements such as jewels may not be worn. Nail enhancements of any kind (e.g., wraps, acrylics, gels and stones) may not be worn in the Operating Rooms, Same Day Surgery, Intensive Care Units (for example, ICU, BMT, Burn unit, NICU, PICU, pheresis), step-down ICU units, or other areas where invasive procedures are routinely performed or when procedures require a surgical scrub. (CDC Guideline for Hand Hygiene in Health-Care Settings. MMWR 51[RR16]; 1-44: 2002).
  13. Jewelry must not create a hazard to self or others.  No visible ornamental piercing except for ears.  No bracelets are to be worn by care providers.  Latex jewelry (eg:  watchbands, wristbands) may not be worn.  Award, service and school pins are acceptable.  Use discretion when using other pins or stickers.
  14. Visible adornment with tattoos or body paint is not acceptable. 
  15. Hospital Identification (ID) badges must be worn in a clearly visible location on the upper chest or shoulder area at all times while on DMC property.  ID badges must be worn with the photo/name forward and must not be obscured or defaced. (1 EC 021 & 2 FEC 022)  Badge holders/lanyards must not interfere with patient care activities and must be worn above waist level.
  16. Shoes must be clean and appropriate.  Open toed shoes or sandals without heel straps may not be worn in patient care areas.
  17. Shoe covers, where required, must be removed when leaving the patient care area (2 POS 012).
  18. Makeup should be appropriate for office daytime wear. 
  19. Scented personal products (including but not limited to perfume, scented make-up and lotions, scented after-shave lotion, scented deodorant) must not be worn due to the health risk to others.
  20. Personal headphones and earphones are not to be used or worn during non-break times or in the presence of patients and/or visitors. 
  21. Personal electronic devices (e.g. cell phones, pagers, netbooks, iPads, Kindles™) must be on vibrating (non-audible) mode. They may not be visible or used during non-break times or in the presence of patients or visitors (1 HR 514).  
  22. Personal electronic devices may be used for hospital business purposes.  However, they may not be used in the presence of patients/visitors unless directly related to that patient's care.  When used in patient care areas staff must perform hand hygiene before and after use of personal electronic devices.
  23. No images may be taken with personal devices (e.g. cell phones, cameras, i-pads or tablets) in the work place.    
  24. Non-Direct Care Activities: Unless otherwise directed, casual business wear may be worn while in orientation, and/or at skills validation class, or other educational offerings.  This includes appropriate shoes/hose.  If a portion of the day is spent in the clinical area, uniforms, scrubs, or a lab coat must be worn. 
  25. Business casual or professional business attire must be worn while in the hospital including going to and from work site, orientation, and or skills validation class, or other educational offerings unless an exception is documented with Hospital Administration.  This includes shoes/hose.  If a portion of the day is spent in direct patient care, scrubs, or lab coat must be worn.
  26. Off-Site Functions: DMC Personal Appearance Standards must be adhered to when employees or contract employees represent the DMC at any outside conferences, community outreach functions, and other professional/educational events.
  27. Non-DMC (agency and contingent) staff must adhere to the universal personal appearance standards and those appropriate to their job category.
  28. The following types of clothing are not permitted:
    1. Jeans or clothing of denim-like material
    2. T-shirts (without hospital-approved design or logos)
    3. Sweatshirts, sweatpants, or jogging suits 

      Exception:  Staff may wear sweatshirts with hospital approved logo-site specific.  Personal Trainers at RIM wear RIM Logowear warm-up suits.

    4. Shorts, capris, bib overalls/coveralls
    5. Tank or tube tops or garments with spaghetti straps
    6. Low cut tops or bare midriffs
    7. Military fatigues or fatigue-like scrub wear
    8. Stretch pants, spandex, stirrup pants
    9. Body clinging, see-through or revealing clothing
    10. No garments that reveal undergarments
    11. Exercise apparel, including yoga pants
    12. Mini-skirts or mini-dresses (mid-thigh)
    13. No skirt slits, vents or kick pleat more than 3" above the knee
    14. Excessive or inappropriate jewelry
    15. Sunglasses
    16. Flip flops or rubber clogs with holes (ie Crocs®)

Direct Patient Care Providers

[Registered Nurse (RN), Licensed Practical Nurse (LPN), Patient Care Associate (PCA), Patient Service Associate (PSA)]

  1. The following attire is considered appropriate:
    1. Traditional nursing uniforms or scrub dress of mid-knee length or below.
    2. Scrub top and pants or skirt.  Scrub tops are to be long enough to tuck into pants or skirt, but may be worn either tucked in or not.
    3. In lieu of a scrub top, polo or other collared shirt may be worn or plain colored T-shirt (with hospital-approved design or logos)
    4. Turtleneck, mock turtleneck, plain tank top or T-shirt may be worn under a scrub top but must not be visible below the hemline.
    5. Scrub/warm-up jackets in a coordinating print may be worn with above uniforms or as designated by site. 
    6. Each facility may require the wearing of color and/or style of uniform specific to a job category or department.  See site-specific guidelines for color designation.  The wearing of white uniforms is limited to RNs and LPNs only.
  2. Shoes and Hosiery
    1. Shoes must be clean; white, black or colored shoes that coordinate with uniform pants or skirt may be worn.  
    2. No “high top” or athletic shoes that rise above the ankle are permitted.
    3. No open toe shoes are allowed by staff working in patient care areas.
    4. White or flesh tone hose must be worn with a skirt.
    5. Hose or socks must be worn with pants.

Specialty Areas

  1. Approved hospital provided and laundered scrubs are to be worn in designated areas only.  These include, but are not limited to, the Burn Center (DRH), Labor and Delivery, LDRP, Dialysis and Perioperative areas.
  2. In the operating room, clean scrubs are to be obtained in the department.  Hospital provided scrubs are not to be worn to or from work. Staff must change into hospital provided scrubs prior to having patient contact.
  3. Staff in departments that wear green scrubs must wear labs coats over their scrubs.  Shoe covers and masks must be removed
  4. Refer to site or department policy for staff assigned to the Rehabilitation Institute of Michigan and Psychiatric areas.

Indirect and Non-Patient Care Providers

(E.g., Patient Unit Clerks, Transporters, Clinic Staff, Ancillary/Support Staff, Sitters)

  1. Refer to site or department policies for specific uniform requirements for patient unit clerks and transporters.
  2. Non-patient care providers (e.g., clinic staff) must wear business attire and conservative shoes appropriate for business.
  3. Refer to site or department policies for specific uniform requirements for ancillary and support staff. 
  4. Patient Attendant Safety: may wear casual business wear, uniforms or scrubs while engaged in sitting.

Responsibility

  1. Each employee is responsible for maintaining an appearance consistent with this policy.  It is the responsibility of management to assure compliance with these guidelines.
  2. Managers are expected to counsel employees who wear inappropriate or unsafe clothing.
  3. Employees arriving at work in apparel deemed unacceptable or unprofessional will be sent home (without compensation) for more appropriate attire.
  4. If the employee does not respond to counseling, verbal and written warnings will be issued per the disciplinary policy (1 HR 506).
  5. Site managers may make exceptions to the above policy for specific purposes and events.

ADMINISTRATIVE RESPONSIBILITY

The Market Chief Nursing Officer has overall responsibility and authority for administration of policies, procedures and guidelines related to patient care.  The site CNO has day-to-day responsibility for administering of this policy.   

APPROVAL

This policy has been approved and is duly authorized by Detroit Medical Center, Children’s Hospital of Michigan, Detroit Receiving Hospital, Harper/Hutzel Hospital, Huron Valley-Sinai Hospital, Rehabilitation Institute of Michigan, and Sinai-Grace Hospital.  The posting of the policy on the DMC intranet signifies that it is in full force and effect.