Staff and artificial nails - page 2

More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy, but the risk of infection... Read More

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    There is no regulation that says "you must not wear artificial or long dangerous curved all around daggers on your fingers..." but the facility had an infection control policy against it, so guess what happened? quoted from previous post

    As a surveyor, there may not be a Federal regulation about fingernails, but CMS also states that facilities must follow state and/or local laws "whichever is more stringent". Go to the CDC website and follow their mandate on fake fingernails. Because tags can be written per the CDC guidelines.

    Also, as a general rule of thumb, facilties policy and procedures are more stringent than the CMS regs. If the facility has a policy and procedure prohibiting fake fingernails or finger nail length, polish, etc......time to enforce it.

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    Quote from txdon
    More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy, but the risk of infection increases, not to mention the lack of professionalism. Any suggestions on how to enforce this?
    I'd take a multi-step approach but set myself a 30 day deadline for compliance.

    Start by posting the policy prominently by the time clock with a notation that it is an existing policy that will be enforced and that compliance needs to be achieved by x date.

    Incorporate discussion of the policy and the deadline into staff meetings, have each employee sign a copy of the policy and an attached memo that includes a deadline for compliance and the progressive discipline). Track down every employee who dodges the meeting, inservice 1:1 and obtain their signature.

    This is a great opportunity to give everyone a brand new copy of the employee handbook (even better if it also includes the policy barring artificial nails on clinical staff) and have them sign an acknowledgment that they have received and read it.

    On day 30 start sending people home, failure to comply by their next scheduled shift is grounds for termination.

    Following a consistent and systematic process should establish progressive discipline.

    There is a certain crowd that you're going to be unpopular with but infection control policies aren't optional, if they want to quit over having to remove their nails so be it, wish them well in their future endeavors.

    Going forward include a seperate copy of the policy to be signed as part of every orientation packet (at least for the next year or so).
    Last edit by kids on Apr 7, '12
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    if you like you can use this story as a scary example of what can or does happen when caretakers (rns, lpns, and aides) wear artificial
    nails and do direct patient care.

    my type-1 diabetic husband went hiking in the woods and was either bitten or scratched, then developed open sores, then venous stasis ulcers on his ankle, lower leg, and foot. went to wound care rehab,nearly healed, sent home to be followed up by home health nurses and op pt. continued to heal and got op vanco.

    new nurse and new pta started the same week. both had dragon lady length fake lurid nails. one month later, he was diagnosed with
    osteomyelitis, a badly infected ankle and foot, and went back to woundcare rehab. much more vanco. he has suffered a hearing loss.
    he very nearly died and very narrowly escaped an above the knee amputation.

    home health and pt cultured the nails. both woman carried infections in/on those gross fake nails! they had been doing patient care all day!

    were those stupid fake nails really worth it?
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    You know, I have in the past worn fake nails because I have a tendency to bite my nails... but the thought of wearing them in a facility freaks me completely out. Right now my nails are suffering because we're not even allowed to wear clear polish in school (though a lot of people wear colored and nothing's been said to them... ) and frankly I think the ratty cuticles and splitting nails are more of an infection risk than if I wore some clear strengthening polish and kept it fresh.

    What has amazed me is the number of techs I've seen in the various hospitals I've been in wearing those fake dragon lady nails. I wouldn't have thought a hospital would stand for it. I've never seen nurses with anything but short apparently natural nails, but the techs are doing as much or more hands-on patient care than the nurses.

    I'd *love* to see cultures run on anyone who thinks it's ok to wear them.
    Last edit by theantichick on Apr 7, '12 : Reason: spelling
    sharpeimom likes this.
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    The CDC definitely has articles against artificial nails in the health care setting. I don't think there is any place for them and I would just let the staff know that effective immediately no one will be allowed to have patient contact while wearing them. I teach CNA's and if anyone shows up for class with them on, or even polish, they are sent to write a report for me as to why it is an infection control risk. And then they get to make up that clinical on another date.
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    They dont belong on a healthcare providers nails. It is an Infection control problem and hands should be well taken care of, not cracked, no open wounds and kept clean and decent. Nail polish/fake nails are for partying, not for the workplace. The nails themselves can harbor dangerous bacteria under them without the user knowing it. And I am sure most of them dont scrub under those nails after every patient. Doctors dont wash their hands as much as we would love them too also......another problem.!!!
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    along with sharpeamom(sorry about spelling) if that stoy doesn't get them, there was one about nurses wearing them in the NICU and bables almost dying. I know it is expensive, but if you culture under one set of nails oh what you will what if the person with the nails has to face the family member of the person they injured. " Sorry I gave your loved one staph, streph, e coli, c.diff (fill in the blank )
    sharpeimom likes this.
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    Getting a bit off topic, but what about people like me - without strengthening nail polish, my nails split and break and tear into the cuticles leaving me with ragged open sores? My nails and cuticles are a right mess now during school when we're not allowed to wear even clear polish. I think it's more of an infection issue than if I wear the strengthening polish and make sure the polish is replaced often enough that there aren't cracks and chips in it. Am I off base? I'm pretty sure I read a study somewhere that said that if the polish is in good repair, it's not a particular infection risk.

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