The Truth About Crocs

Stories in major newspapers around the country have raised questions about the appropriateness of wearing rubber clogs in the OR and other clinical areas in the hospital. Because of safety issues surrounding these shoes, accreditation and regulatory standards support restricting their use.

Relevant Regulations

Regulations related to the use of Crocs fall into three categories:

1. Protection from injuries by sharps
2. Protection from blood and body fluids
3. General safety, including electrical safety

Arguments and Solutions

1. Protection from sharps is regulated under OSHA 1910.1030(d)(3)(i). Shoes that have holes on top do not protect the wearer from infectious materials and sharps. Solid shoes provide additional protection.
2. Protection from infectious materials is regulated under OSHA 1910.1030(d)(3)(i) and Joint Commission standard IC.4.10. Shoes that have holes on top do not protect the wearer from infectious materials. Solid shoes provide additional protection. Since the surface of solid shoes is easily cleaned, contamination can be easily removed.
3. Information coming from Sweden raises the issue of general safety. A Swedish hospital eliminated the use of rubber clogs following an incident when a ventilator shut off unexpectedly. It was concluded that the buildup of static electricity impacted the ventilator and lead to the incident. An article describing the incident indicates that these plastic shoes do not dissipate static electricity like other shoes.
4. Other questions come into play when rubber clogs are examined for general safety. Organizations should do a risk assessment to determine whether staff members can move easily and efficiently to evacuate patients in an emergency while wearing these shoes.

Recommendations from Compass Clinical Consulting

1. Conduct a safety assessment to determine whether limitations on wearing these shoes will be set in place in the organization. Restrictions may be limited to critical areas that reflect a higher risk, such as units with ventilators
2. Evaluate the use of Crocs in your organization to develop a policy. You may want to include one of the following:
   • Shoes with holes are not allowed
   • Crocs must be worn with the heel strap engaged when walking.