False Nails (Does it promote infection?)

SmilingBluEyes · Feb 3, 2003

it's a matter of vanity over patient safety, don really. those arguing FOR them have no leg to stand on when it comes to defending their safety in nursing practice, but will continue to fight for the right to such vanities as false nails, perfume and other things that have no place in patient care areas. It's food for debate which we all love, so it seems.

Katnip, RN · Feb 3, 2003

For hangnails, try a nighttime cuticle cream. Sally Hansen makes a couple of good ones. Can't think of their names, but one's an oil and one is a cream. The skin all around the nail bed stays soft enough that you shouldn't have a problem. I use it and haven't had a hangnail in years.

Gomer · Feb 3, 2003

I heard on our local (CALIF.) news this weekend that Kaiser hospitals are banning false fingernails on anyone doing direct patient care.

pickledpepperRN · Feb 3, 2003

Originally posted by RockiNbarbi
There has been some talk at the hospital that I work in about banning the artificial nails. My opinion is that I can't see them harbouring any more bacteria than a natural long nail. What I will disagree with is the inappropriate lengths some nurses come in with...ouch!

Fact Sheet

Hand Hygiene Guidelines Fact Sheet

Improved adherence to hand hygiene (i.e. hand washing or use of alcohol-based hand rubs) has been shown to terminate outbreaks in health care facilities, to reduce transmission of antimicrobial resistant organisms (e.g. methicillin resistant staphylococcus aureus) and reduce overall infection rates.

CDC is releasing guidelines to improve adherence to hand hygiene in health care settings. In addition to traditional handwashing with soap and water, CDC is recommending the use of alcohol-based handrubs by health care personnel for patient care because they address some of the obstacles that health care professionals face when taking care of patients.

Handwashing with soap and water remains a sensible strategy for hand hygiene in non-health care settings and is recommended by CDC and other experts.

When health care personnel's hands are visibly soiled, they should wash with soap and water.

The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Gloves reduce hand contamination by 70 percent to 80 percent, prevent cross-contamination and protect patients and health care personnel from infection. Handrubs should be used before and after each patient just as gloves should be changed before and after each patient.

When using an alcohol-based handrub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry. Note that the volume needed to reduce the number of bacteria on hands varies by product.

Alcohol-based handrubs significantly reduce the number of microorganisms on skin, are fast acting and cause less skin irritation.

Health care personnel should avoid wearing artificial nails and keep natural nails less than one quarter of an inch long if they care for patients at high risk of acquiring infections (e.g. Patients in intensive care units or in transplant units

When evaluating hand hygiene products for potential use in health care facilities, administrators or product selection committees should consider the relative efficacy of antiseptic agents against various pathogens and the acceptability of hand hygiene products by personnel. Characteristics of a product that can affect acceptance and therefore usage include its smell, consistency, color and the effect of dryness on hands.

As part of these recommendations, CDC is asking health care facilities to develop and implement a system for measuring improvements in adherence to these hand hygiene recommendations. Some of the suggested performance indicators include: periodic monitoring of hand hygiene adherence and providing feedback to personnel regarding their performance, monitoring the volume of alcohol-based handrub used/1000 patient days, monitoring adherence to policies dealing with wearing artificial nails and focused assessment of the adequacy of health care personnel hand hygiene when outbreaks of infection occur.

Allergic contact dermatitis due to alcohol hand rubs is very uncommon. However, with increasing use of such products by health care personnel, it is likely that true allergic reactions to such products will occasionally be encountered.

Alcohol-based hand rubs take less time to use than traditional hand washing. In an eight-hour shift, an estimated one hour of an ICU nurse's time will be saved by using an alcohol-based handrub.

These guidelines should not be construed to legalize product claims that are not allowed by an FDA product approval by FDA's Over-the-Counter Drug Review. The recommendations are not intended to apply to consumer use of the products discussed.

# # #

CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

K O'Malley · Feb 3, 2003

Not only have false nails been documented to spread infection, and even kill patients as in the newborn nursery, in a health care setting they also look downright trashy, and I mean the ones that are brightly painted daggers. I personally haven't noticed other female professionals such as lawyers and doctors wearing them. Why would you want to risk giving your pts an infection?

Anaclaire · Feb 3, 2003

a summary of the cdc report on hand hygiene (oct 2002) is now available through the national guidelines clearinghouse . the following link will take you to the ngc website:

http://www.guideline.gov/static/whatsnew.asp?view=whatsnew

once at the website, just scroll down the "new guidelines released this week" or type "hand hygiene" in the search box. the document can be downloaded as an html or pdf document.

this is the definitive statement on what are and are not acceptable hand hygiene practices.

addressed by the guidelines are:

when handwashing is required
what type of soap or cleansing agent should be used
when alcohol-based decontaminating agents are appropriate
issues regarding nail length and artificial nails are also addressed

hope this helps us all learn more about how to be the best caregivers possible.