NAIL POLISH IN IPC

GUIDELINES ON LONG NAILS ,ACRYLICS AND NAIL POLISH

• Nails: Long nails are difficult to clean, can pierce gloves and harbour
more microorganisms than short nails.
• Keep natural nails clean and short.
• The nail should not show past the end of the finger.
• Nail polish: Studies have shown that chipped nail polish or nail polish
worn longer than 4 days can harbor microorganisms that are not
removed by hand washing, even with surgical hand scrubs.
 Nails can harbor some of the most common and economically
impactful causes of infection, such as MRSA, Clostridioides difficile,
and Candida albicans. However, many healthcare systems lack
adequate policies for regulating fingernail treatments of their staff.
• Data from ten studies on the microbial burden of healthcare workers’
fingernails suggests that there is a higher bacterial load on artificial
nails than on natural nails.
• Chipped nail polish also poses increased risk compared to recently
painted, unchipped nails.
• Finally, gel-based nail polish may be associated with higher pathogen
counts and handwashing may not be effective for removing bacteria
from gel polish.
ARTIFICIAL NAILS OR NAIL
ENHANCEMENTS
• It has been shown that acrylic nails harbor more microorganisms and are
more difficult to clean than natural nails.
• It has been implicated in the transfer of microorganisms such as
Pseudomonas species, Klebsiella, pneumonia and yeast; and in outbreaks,
particularly in neonatal nurseries and other critical care areas. Surgical site
infections and hemodialysis-related bacteremia's have been linked to
artificial nails.
• They are also associated with poor hand hygiene practices and result in
more tears to gloves.
• For these reasons, artificial nails and nail enhancements are not to be worn
by those having direct contact with a client/patient/resident.
• Alarmingly, an estimated 70 percent of HAIs are preventable by using
evidence-based strategies.
• Hand hygiene policies should consider not only handwashing
procedures, but fingernail polish and artificial nails as well, as these
adornments reduce the effectiveness of sanitization by providing
microbes additional surfaces to adhere to.
• It is imperative to consider the guidelines, establish policies and
procedures, and audit for clinical effectiveness.
• While preventing HAIs requires a systemic strategy and
implementation, it is important that healthcare workers and policy
makers address the link between fingernails and infection, and review
the evidence-based guidelines provided by leading health institutes.
The World Health Organization (WHO) and AORN recommend against
healthcare workers wearing fingernail polish or artificial nails, in
addition to keeping fingernails short, to prevent the spread of
pathogens.
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