Why off-site uniform wear is back in the infection control spotlight

A renewed call from Vet Times is putting a familiar infection control question back in front of veterinary teams: should staff ever wear clinical uniforms beyond practice premises? In the article, Jane Davidson argues they shouldn’t, warning that if infection control problems emerge, few professionals would want to be identified as the person still wearing uniform in the supermarket, the pub, or a human hospital. Her argument is that uniform use should sit within a broader infection prevention strategy, not be treated as a matter of convenience or habit. That stance is consistent with existing veterinary and human healthcare guidance that favors work-only clothing, on-site changing, and tighter laundering controls. (knowledge.rcvs.org.uk)

The backdrop is a long-running concern in veterinary medicine that hygiene standards haven’t always kept pace with more intensive clinical practice. Vet Times’ earlier 2015 coverage on practice hygiene described a profession that, in some settings, still had only a superficial grasp of infection control despite higher patient throughput and greater microbiological risk. Since then, the conversation has broadened from cleaning protocols and isolation procedures to everyday staff behaviors, including what gets worn to work, where it’s worn, and how it’s washed. The COVID-19 period also sharpened attention on these routines, with veterinary organizations issuing more explicit advice on PPE, client contact, and clothing. (bvna.org.uk)

The available guidance is fairly consistent on the basics. RCVS guidance published during the pandemic said uniforms, or clothes worn only at work, are “highly recommended” on site, but “should only be worn on site and not when travelling to and from home.” It also said they should be laundered at work wherever possible, or otherwise transported home in a sealed bag and washed immediately. BVNA guidance took a similar line, advising that uniforms should only be worn at work and ideally laundered there, and explicitly telling staff not to wear uniform or scrubs to and from work. (knowledge.rcvs.org.uk)

Human healthcare policy offers part of the rationale Davidson points to. NHS England’s workwear guidance says there is no evidence that wearing uniforms outside work increases infection risk, but still describes it as good practice to change at work or fully cover uniforms while travelling, because public attitudes matter and appearance can influence confidence in professional competence. The same guidance lists shopping in uniform as poor practice. NHS Wales’ dress code, which Davidson references as a model, has long set boundaries around public wear of uniforms, and related NHS policies continue to state that staff should not travel to and from work in uniform or wear it in public when off duty. (england.nhs.uk)

There’s also a stronger infection control case than simple public perception. A peer-reviewed review on barrier precautions and personal hygiene in veterinary hospitals says protective outerwear should be changed before personnel leave the building and should not be worn out of the hospital setting, because doing so increases the risk of transmitting pathogens from hospital to household and from animals at home back to hospitalized animals. A 2025 review in Animal Health Research Reviews similarly recommends that commuting should always be done in street clothes, with hospital-only footwear, designated changing areas, and clear separation between clean and contaminated zones. Together, those recommendations suggest uniform policy is not a symbolic gesture, but one practical part of biosecurity design. (pmc.ncbi.nlm.nih.gov)

For veterinary professionals, the deeper issue is culture and consistency. Uniforms are highly visible, so they often become shorthand for whether a practice takes infection prevention seriously. A policy that asks staff to change on site, use dedicated footwear, and follow laundering rules can reinforce other controls, including hand hygiene, PPE use, isolation protocols, and environmental cleaning. It may also reduce reputational risk with pet parents, referral partners, and neighboring healthcare providers, especially if a practice later faces questions about hygiene lapses or healthcare-associated infections. NHS guidance makes clear that public confidence is part of the equation, even where evidence of direct infection risk is limited. (england.nhs.uk)

The practical challenge, of course, is implementation. Practices need enough changing space, reliable laundry arrangements, clear written rules, and managers willing to enforce them consistently across vets, nurses, students, and support staff. Without that infrastructure, uniform rules can become aspirational rather than operational. The more robust biosecurity literature suggests the most effective approach is systems-based: designated changing zones, hospital-only clothing and footwear, ready access to PPE, and protocols that make the right behavior the easy behavior. (cambridge.org)

What to watch: The next step is likely to be more explicit practice-level policy, with uniform wear, laundering, commuting clothes, and footwear folded into formal infection prevention and biosecurity SOPs rather than left to individual judgment. That would bring small animal and mixed practice workflows closer to the more structured standards now being described in veterinary hospital biosecurity literature. (cambridge.org)