Exactly why I avoid finger foods
oh, another thing.
keep your damn fingernails clean!
I have a pet peeve about women who have artificial nails. Sorry if I offend any ladies here who have them, but they are more prone to be gunk traps.
One of the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 2007 National Patient Safety Goals (NPSG) revisits the importance of hand hygiene and artificial nails. NPSG #7 reads as follows:
Goal 7 Reduce the risk of health care-associated infection.
7A Comply with current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines.
7B Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-associated infection.
For goal 7, the JCAHO notes that avoiding the wearing of artificial nails is a Category IA CDC recommendation and is required for those individuals providing care to patients at high risk of acquiring infections. (And, while you did not ask about nail length, the CDC has a Category II recommendation that natural nails be less than a quarter inch long when caring for patients at high risk of acquiring an infection. Thus, the JCAHO recommends this but does not require it.)
For those working in perioperative patient care, where patients are considered at high risk of acquiring an infection, the Association of periOperative Registered Nurses (AORN) has developed recommendations for surgical hand antisepsis as well as for general hand hygiene.
The AORN has the following recommendations about fingernails:
Fingernails should be kept short, clean, and healthy.
A single-use nail cleaner should be used under running water to clean the debris from the subungual area, which harbors the most organisms found on the hands.
Long fingernails may pose a hazard to patient safety when moving or positioning the patient.
Long fingernails require extra effort when cleaning subungual areas.
When fingernails are long, gloves may tear, presenting a risk to both the nurse and the patient.
The AORN has the following recommendations about fingernail polish:
If used, nail polish should not be chipped.
Studies have demonstrated that chipped nail polish may support the growth of organisms on the fingernails.
While no studies have demonstrated a relationship between freshly applied nail polish and infection, there is concern that individuals with fresh manicures may be hesitant to perform rigorous hand hygiene in an effort to protect their nails. Compromises in hand hygiene technique may then lead to transmission of infection.
If nail polish is worn, it should not be worn for more than 4 days. At the end of 4 days, nail polish should be removed and freshly reapplied.
Individuals who choose to wear nail polish should be guided by their surgical conscience, which requires a combination of clinical experience, judgment, critical thinking, and the ability to question a practice when one believes it is not the right thing to do.
The AORN recommends the following concerning acrylic (artificial) nails:
Artificial nails should NOT be worn.
Numerous studies validate the increased number of bacteria cultured from the fingertips of persons wearing artificial nails, both before and after hand washing.
State Boards of Cosmetology report that fungal growth occurs more frequently under artificial nails.
The Bottom Line
Even the World Health Organization guidelines on hand hygiene state that wearing artificial acrylic nails can contribute to hands remaining contaminated with pathogens after use of soap or alcohol-based hand gels.