False Nails (Does it promote infection?) - page 2

I am curious to what people think about this subject. At the hospital where I work they are really emphasizing that no care giver direct patient care or indirect patient care are permitted to wear... Read More

  1. by   LauraRN0501
    okay, now I have a question. Kona2 and anyone else who discourages the use of nail polish, I am wondering why? I totally understand the artificial nail theory, but am curious as to the polish problem. I use clear sally hansen tuff as nails as my nails tend to crack and split. If the polish is kept up, not chipped, loose, etc, is there still a problem? I am very curious.

    On the artificial nail discussion, one of my good friends was scratched by a nurse's artificial nails while being checked during labor. Ouch!

    Laura
  2. by   Y2KRN
    I too think, artificial nails are not the way to go. I am surprised to read that the AORN does not have a problem with OR nurses having long or artificial nails. I can recall back in the 80's and early 90's when I worked as a surgical tech, being told that we could no longer have long nails, because of the bacteria that they harbor. I can also add that when I was a tech, I found when my nails were long the gloves would get holes in them easier, even if we double gloved. It also made it harder to hold retractors, and pick things up. Just my 0.02
    cents.

    My nails are still short and I do not wear nail polish. Many nurses I work with wear them, and we had instructors who would preach about not having long nails, then come to clinical with newly polished false nails??????????
  3. by   Genista
    Unless the AORN changed their 1999 policy, I think Kaknurse's certified OR nurse friend is misinformed about artificial nails being "okay." In fact, the AORN website states "artificial nails should not be worn" and that they recommend "only natural nails" in the OR.
    http://www.aorn.org/journal/1999/marchci.htm#artificial

    It seems the jury is out, though on whether nail polish itself promotes spread of infection. Many infection control articles (CDC and others) state that well kept, non chipped nail polish has not been proven as a significant spread of organisms. However, they do often recommend clear polish, as it is easier to visualize the nail & nailbed. Polish that is chipped, however, is not recommended, as it tends to harbor more bacteria. Some sources say that if you do chip your polish at work, you should remove all the polish from the nail.

    Check out this summary of a study on "The Effect of Fingernails on Gram Negative Bacteria." I am interested to hear more about this one! http://www.apic.org/monday.html

    [ June 01, 2001: Message edited by: kona2 ]
  4. by   ornurse217
    I am a Clinical Educator in the OR and done a lot of research on this subject. Aseptic technique has a lot of aspects and good technique is the most important. However, cultures have revealed fungal growth under artifical nails and rather than risk the transmission of any fungal contaminates we have made it a no-no. Artifical nails usually are very long as well and tears gloves, and can injure a patient. So, even if it is rather controversal, the risks are not worth it.
  5. by   ornurse2001
    I am also a member of AORN, and they definitly state that artificial nails should not be worn.The concern with nail polish is mostly due to chipping of the polish.AORN does not really condone it, but says that if worn, should be freshly applied and not cracked or chipping.I must say, in our OR dept., the consensus is that artificial nails should not be worn, however-the coordinator of our dept. whom does do pt. care does have acrylic nails which she has maintained and polished every 2 wks
  6. by   Calli
    originally posted by kaknurse
    ok i need to add my $0.02 here,

    i have artificial nails. i wash my hand religiously and wear gloves when i am supposed to and as far as i know have never gotten an infection. i know a nurse that is a certified or nurse and is a member of aorn and she told me that as far as aorn is concerned, that artificial nails are ok with them.

    really though they are not that expensive. i pay 13 dollars every two weeks to get them filed and polished.

    just my 2 cents

    kelly
    kelly- kaknurse- like you, i am a wearer. however, i have an eternally guilty conscience. i'm a first year student in the u.k. and have recently started to question my reasons behind wearing false nails, like many replies i have read on this page i agree it is pure vanity. i really needed a kick start to giving up the habit and came across this site purely by accident and registered this morning. before reading your piece, i was struck by how against this practice most people seem as i have not yet come across any opposition in my area to wearing false nails- polish yes but the nails themselves have never come into question. as much as i would love to a) back you up on this matter and b) to continue wearing what i choose, the element of possible risk to the patients i tend to has to be of paramount importance, hence i am about to rid them like the last packet of cigarettes went last month and consign them to the bin where they should have been before i took up this profession. calli.
  7. by   KC CHICK
    kaknurse, unfortunately in your friend's case, being certified in her specialty does not mean she is very well informed.
    On the AORN's website www.aorn.org, they recommend that "artificial nail should not be worn. Rationale: It has not been proven that artificial or acrylic nails on healthy hands increase the risk of surgical infection. Artificial nails, however, may harbor organisms and prevent effective handwashing. Higher numbers of gram-negative microorganisms have been cultured from the fingertips of personnel wearing artificial nails than from personnel with natural nails...." 'Whether it is the scrub person or circulator, AORN believes that artificial nails should not be worn.' Maybe the hospital where you're friend works does not follow this recommendation in their facility policy.

    The AORN also has a recommendation regarding the use of nail polish. 'Available data suggest that nail polish that is obviously chipped or worn longer than 4 days has a tendency to harbor greater numbers of bacteria. Surgical conscience, therefore, must be a foremost behavior in individuals who choose to wear nail polish in the surgical setting. "If the nail polish is in good repair and not more than 4 days old it may be worn in the OR, however, this may be very hard to monitor. Allowing personnel to wear nail polish requires relying on the individuals' sterile conscience regarding changing the nail polish frequently and strictly adhering to policies regarding hand scrubs."

    Personally, I don't believe in wearing artificail nails or nail polish. COMMON SENSE dictates that if there is a larger surface area and spaces to clean, there is a larger possibility that microorganisms will be missed during hand washing, etc. Not only is it a danger to the patient, it is a danger to the healthcare worker and healthcare workers' loved ones at home. In addition, a fungal infection under an acryllic nail can be a VERY nasty animal....yuk, yuk, icky. The amount of time that nurses spend hand washing, and having hands in gloves, promotes a moist, warm growth environment for these critters. Are our hands ever really dry for very long????

    I'd rather save myself the money and possible huge headache....no falsies for me, thanks.
    Last edit by KC CHICK on Sep 8, '01
  8. by   Cindy_A
    I'm like fergus. In nursing school, it is emphasized that we can wear no polish and our nails can't be longer than the end of our fingers, just like she'd said. So why the change in attitude when a person becomes staff? Isn't the nail issue just as important then? Doesn't make much sense to me!
  9. by   dewp_63
    I used to wear artificial nails, and believed all the hype/misinformation provided by the nail industry. But, I really didn't like how they left my natural nails (messed up for 6-8 months after I quit having them done), and use "press on" nails with super glue for special occasions - which I can remove once need to return to work. Our hospital system just issued a policy re: artificial nails, and reported that the CDC will be coming out with a position statement this year. I do wear nail polish, though, as my natural nails are very weak and tend to break off below the quick, leaving me with an open wound and painful finger. The nail polish does protect my natural nails from chipping and tearing...
  10. by   kennedyj
    Originally posted by LauraRN0501

    On the artificial nail discussion, one of my good friends was scratched by a nurse's artificial nails while being checked during labor. Ouch!

    Laura
    I could see artificial nails as being a big problem atleast in the OB setting. During a pelvic or cervical exam it would be very easy to err because you would not be able to accurately feel the dilitation or effacement of the cervix. Palpating the ovaries would also be difficult as other assessments. Not to mention the increased risk of breaking a glove or causing more patient discomfort to an already uncomfortable situation.

    At my facility earrings and excessive perfumes are also not allowed in most settings.

    Jared
  11. by   Shanners_SPN
    I worked under a Director @ a long term care facility who had VERY long fake nails painted almost BLACK! I just thought that looked so unprofessional.
    I don't even understand WHY there is a question about long/fake nails. I have always heard under the nails is so contaminated, I mean it catches everything! Seems to me it would be best to exercise common sense and also put your self in the pt.s position.
    Shannon
  12. by   April0121
    At the hospital where I work they have just recently come out with a policy to ban wearing fake nails. The reason that they did this was because there was an outbreak of seratia in the NICU that took a long time to contain. Many of the babies got very sick.
  13. by   nursenat1
    I'm a second year nursing student and we have a very strict policy on wearing artificial nails also. At first I thought what's the big deal but I soon learned why this is such an important issue.
    Over the summer I took Microbiology and we watched a documentry on nursing w/ artificial nails, the results were horrifying! Some of the nurses were harboring microbes like MRSA underneath their nails. I think even if you wear gloves you can still "pick-up" diseases, because a nurse does not constantly wear gloves while inside the hospital. Nurses could also pick-up microbes from other medical workers careless mistakes (not wearing gloves, hand washing, etc.). These reasons helped me conclude that wearing artificial nails is not a good idea.

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